New Member and Introduction!

[Appa and Susan]

Hi! I'm happy to have found this forum...

Appa came into my local animal services in Dec 2023 when a concerned citizen called about him. Appa had injured and infected ears, and needed some help. Initially, he was thought to be a healthy tomcat in good body condition (17 pounds) who needed to be neutered, have his ears treated, and then be adopted out. He charmed everyone in animal services, from the animal control officers, to the staff, to the vet (who was the one who gave him his initial name - Uncle Frosty Megapaws). He was in the shelter for about 3 weeks, and then we took him home to foster as part of the "Home for the Holidays" program. We noticed excessive drinking, urination, and weight loss - and animal services confirmed he had diabetes with a full blood panel.

At that point the shelter vet reached out to us with a long and extremely informative email on feline diabetes. Animal services would not typically adopt out an animal with a chronic illness like diabetes - its a lot to take on (as you all know). But we had had our very special boy for three weeks by then. We decided to keep him and do whatever it takes to get him healthy (and crossing our fingers for remission).

We are doing our first glucose curve next week after we have a Freestyle Libra 2 put on him. He is on wet food (Hills Glucosupport, and Fancy Feast). I'm a bit overwhelmed on the "what do you feed a diabetic cat" and hoping it all become easier and clearer once we see what his blood glucose levels are. At this point we aren't seeing excessive urination or thirst, but he is down to 13.5 pounds from 17...

We are not ever going to be able to do glucose testing on his ears.. there aren't enough of them left (as you can see in the avatar - he is not a Scottish fold, just a domestic medium hair with tomcat cauliflower ears).

So here we are - diabetic cat between 4 and 9 (probably) who has bad teeth, chronic ear problems, some dermatitis, constipation, the sweetest disposition ever, and lets me trim his claws without any problem... We love him very much!

 

[Bron and Sheba (GA)]

Hi and welcome to the forum Appa and Susan. It is wonderful you are taking care of him. Thank you so much
I will ask a few questions if you don't mind to get a bit more information about Appa.
Has he been started on insulin yet?
If so what is the insulin and what is the dose?
Do you know if they tested for ketones at diagnosis? It would be in a urine test or a blood test result
If he has not been started on insulin I would try and get a urine from him and test for ketones in the urine. We don't want to see any ketones. To do this you will need to buy a bottle of ketostix from a pharmacy and collect a urine sample and follow directions on the bottle. It is a simple test. the hardest part is getting the urine sample form Appa. You need to read the result exactly 15 seconds after dipping the test strip into the urine.
I will put a link to how to catch a urine below.

As far as food goes any low carb canned food is OK. you don't have to feed the prescription food. It is expensive and is higher carb than we like.
With the chart I will link you to, look for foods that are 10% or less carbs
FOOD CHART

How often are you feeding him. We recommend feeding a good meal before the dose of insulin and then giving several snacks during the cycles, mostly during the first half of the cycles when the insulin is strongest.
Once we know what type of insulin he is getting, we can tell you how soon after the food you should be giving the dose. It can vary depending on the insulin.
He is losing weight at the moment because he can't utilise all the nutrients in the food. Once his blood glucose comes back down near normal he should start to regain that weight. In the meantime, feed him lots of food.

I will also give you a link to our spreadsheet and signature. If you could set up both we can help you a lot more
HELP US HELP YOU

Poor boy with not much of his ears left. He must have been in a few fights in his time.
Some people test using the pads on the paws. Do you think he would let you do that?
Getting his teeth fixed up will be important in being able to get him into better BG numbers

Keep asking lots of questions as it is a steep learning curve in the beginning and can be overwhelming at first.
Bron

 

[Bron and Sheba (GA)]

CATCHING AND TESTING URINE

 

[Wendy&Neko]

Hello, and waving from north of you in BC. Thank you for saving that sweet diabetic boy.

How to check your cat's blood sugar from their paw

 

[Appa and Susan]

Has he been started on insulin yet?
If so what is the insulin and what is the dose?
Do you know if they tested for ketones at diagnosis?
How often are you feeding him.
Some people test using the pads on the paws. Do you think he would let you do that?
Getting his teeth fixed up will be important in being able to get him into better BG numbers

Has he been started on insulin yet? - YES! Dr Vet at animal services ordered insulin and correct syringes for us to have when we formalized the adoption
If so what is the insulin and what is the dose? - Lantus (glargine) - 2U 2x a day
Do you know if they tested for ketones at diagnosis? - Yes they did, and he was negative

How often are you feeding him. - Two "big" meals a day before insulin. Two-ish snacks between the big meals.

Some people test using the pads on the paws. Do you think he would let you do that? - Maybe? I'm going to ask the vet when we see him on Tuesday to get the Freestyle Libra set up
Getting his teeth fixed up will be important in being able to get him into better BG numbers - Absolutely!
I will also give you a link to our spreadsheet and signature. If you could set up both we can help you a lot more - I will look into it tomorrow!

 

[Bron and Sheba (GA)]

Glargine is a great insulin for cats
2 units is more than we would recommend starting on. We would recommend starting with 1/2 to 1 unit twice a day.
Do you have any blood glucose (BG) data since starting the glargine you can share with us?
Great no ketones and I’m glad you are feeding snacks as well as the 2 main meals.

 

[squeem3]

February is Pet Dental Health Month https://www.avma.org/events/national-pet-dental-health-month In the past, many vets would have some sort of dental special or discount or something. You can ask your vet if they have anything like that.

Fancy Feast is fine as long as they are the low carb ones. Use the food chart that someone linked above. Any food that has less than 10% carbs is good for diabetics. Whatever brand your cat likes to eat and you can afford is fine. You don't need the Hills GlucoSupport food. There's nothing in it that will help a diabetic cat. The ingredients are no different from any other canned cat food. No magic ingredient or formulation. You can return the food to the vet for a refund.

 

[Sienne and Gabby (GA)]

Welcome to FDMB!

A quick observation.... The Hill's Glucosupport canned food is 13% carb. We consider low carb as under 10% (and most of the members here feed their cat a food that's in the neighborhood of 5%). Unfortunately, most diabetic "prescription" food is not all that low in carbs. We would consider the Hill's food as medium carb. To be honest, there is nothing prescription worthy in the "prescription" food as was noted above.

Also, a few words about the Libre. It has been incredibly helpful for many of our members. There are a few limitations to be aware of. When a cat is testing in blood glucose numbers that are closer to normal range (around 100 or below), the Libre tends to give false low numbers. You can get scarey readings. If you compare to a handheld glucometer, you will get readings that are more accurate. The sensors can be tempermental -- members have noted that they fall off or stop working in less than the 2 weeks they are supposed to last. The manufacturer will replace the sensor as long as you don't tell them it's attached to your cat! And, of course, some cats are part magician and manage to remove the sensor. There is a Facebook group for people using the Libre (or other continuous glucose monitors) and they can provide instructions on how to replace the sensor versus having to take your cat to the vet.

 

[Appa and Susan]

Glargine is a great insulin for cats
2 units is more than we would recommend starting on. We would recommend starting with 1/2 to 1 unit twice a day.
Do you have any blood glucose (BG) data since starting the glargine you can share with us?
Great no ketones and I’m glad you are feeding snacks as well as the 2 main meals.

2 units is more than we would recommend starting on - I had three different vets tell me to start with 2U, I'm going to go with that. He has been on this dosage for 3 weeks (we were traveling so couldn't do a glucose curve earlier than next week), and he has not shown signs of hypoglycemia. He is pretty big (13.5 lbs).
Do you have any blood glucose (BG) data - Not yet, we have the Libra Freestyle2 put on on Tuesday and will start compiling data

 

[Appa and Susan]

February is Pet Dental Health Month https://www.avma.org/events/national-pet-dental-health-month In the past, many vets would have some sort of dental special or discount or something. You can ask your vet if they have anything like that.

Fancy Feast is fine as long as they are the low carb ones. Use the food chart that someone linked above. Any food that has less than 10% carbs is good for diabetics. Whatever brand your cat likes to eat and you can afford is fine. You don't need the Hills GlucoSupport food. There's nothing in it that will help a diabetic cat. The ingredients are no different from any other canned cat food. No magic ingredient or formulation. You can return the food to the vet for a refund.

Fancy Feast is fine as long as they are the low carb ones - they are - I've been using the chart above for a couple of years (for a different cat). I also made a calculation spreadsheet from Dr. Lisa A. Pierson site, so I do run things through that if they are not on her spreadsheet (I thought it was from her site, but it might have been another one).
You can return the food to the vet for a refund - I got it from Chewy, so I will check into the return policy. He *really* loves kibble - and the kibble is also 13% so I have given him some in a play-toy dispenser (he hasn't figured it out yet, I keep having to roll it). So he gets maybe a couple of tablespoons of that a day.

 

[Appa and Susan]

There is a Facebook group for people using the Libre (or other continuous glucose monitors) and they can provide instructions on how to replace the sensor versus having to take your cat to the vet.

Tuesday will be the first time we use the Libre. I think after that we will be able to put it on ourselves. I have a friend who just switched from the Libre2 to the Libre3, and gave us the two that she had leftover. I am going to get the vet to show us how to do a glucometer test - I know I need it in case of any hypo events. But Appa's ears are not going to be suitable - so much scaring! His paws looked chapped (I can't describe it any other way) - from being outside so long, or something else, not sure. He is *so* good about clipping his claws that I am reluctant to do painful things to his paws and mess that up.

Although he was outside for who knows how long, he has perfect indoor kitty manners - uses the scratcher, litterbox, doesn't cry at the door. Someone had him inside for a good part of his life, I just can't figure out how he came to be 4+ years old and never been fixed and have such bad teeth and ears. He is an inside kitty now (although I might see how he takes to harness training, and there may be a catio in our future).

 

[Hendrick Cuddleclaw]

I'm such a softie, lol. Legit tearing up in front of the keyboard because you have adopted this sweet boy who deserves no less! Give him some pets and scritches for me.

whether paw pads or ears, when you have to get a drop of blood out of a cat most people have found that freeze dried treats like "Whole Life ONE Ingredient" can make a huge huge difference. Also, it's a good practice to pick a spot for the BG test and always do it at that spot, at the same time of day (before each insulin dose, for example). Cats are creatures of habit and routine and we found that our kitty Hendrick, before long, was going to the spot on his own because he knew there would be treats. And lots of pats and cuddles. We used to take him to the spot and just give pats, cuddles, rubs, and then a treat -- no blood drop, no test. Got him used to that routine then worked in the lancet prick and BG test.

That sort of approach has worked wonders for many caregivers.

 

[Bron and Sheba (GA)]

units is more than we would recommend starting on - I had three different vets tell me to start with 2U, I'm going to go with that. He has been on this dosage for 3 weeks (we were traveling so couldn't do a glucose curve earlier than next week), and he has not shown signs of hypoglycemia. He is pretty big (13.5 lbs).

I’m glad Appa has been ok on the 2 units of glargine. For a lot of cats that is too big a dose to start with.
I’m glad you are now monitoring the BGs

 

[squeem3]

I got it from Chewy, so I will check into the return policy. He *really* loves kibble - and the kibble is also 13% so I have given him some in a play-toy dispenser (he hasn't figured it out yet, I keep having to roll it). So he gets maybe a couple of tablespoons of that a day.

Chewy is great with refunds If the case of food is opened, they may just give you a refund and tell you to donate the food. Chewy's Customer Service Live Chat option is quick and easy.

Instead of kibble in the treat dispenser, use freeze dried treats or air dried raw instead. These are way healthier and low carb for diabetic cats. PureBites is one brand of freeze dried treats but there are many others. Many people buy freeze dried treats for dogs since the bag is bigger. The treats are bigger but they're easily broken up into smaller pieces for a cat so you end up getting the equivalent of like 20 tiny cat sized bags for just a bit more than the cost of a single cat bag. I use Northwest Naturals freeze dried treats.

2 units is more than we would recommend starting on - I had three different vets tell me to start with 2U, I'm going to go with that. He has been on this dosage for 3 weeks (we were traveling so couldn't do a glucose curve earlier than next week), and he has not shown signs of hypoglycemia. He is pretty big (13.5 lbs).

It's perfectly fine to disagree with the vet if you're not comfortable with the advice given. Be proactive in your cat's care. If you're unsure about the vet's advice, tell the vet you'll think about it and then ask for opinions here on FDMB as soon as you can. Generally it's better to start low and increase slowly as needed than to start too high and risk a hypo or other issue. 2 units might not see like much but insulin can pack a punch.

I wonder if a pet friendly paw balm would be helpful for your cat? Bag Balm in the green tin is popular. People use it too so you can find at a store pharmacy or big box store.

Treat rewards help with blood glucose testing. Maybe try clipping the claws as usual and offer a treat reward afterwards. Then work your way to squeezing the paw pads firmly but gently and rewarding with a treat. Then move to pressing the lancet device with NO lancet inside and clicking it on the paw pad and reward. Once your cat is used to all that, try the process for real with a lancet loaded into the device.

 

[Appa and Susan]

Chewy is great with refunds

Instead of kibble in the treat dispenser, use freeze dried treats or air dried raw instead.

It's perfectly fine to disagree with the vet if you're not comfortable with the advice given.

I wonder if a pet friendly paw balm would be helpful for your cat? Bag Balm in the green tin is popular. People use it too so you can find at a store pharmacy or big box store.

Treat rewards help with blood glucose testing.

Thumbs up on the Chewy return!

I will try the freeze dried. I don't think that 10 pieces of kibble at 13% cal from carb is going to be too much given that everything else I am giving him is Fancy Feast is (1% cal from carb).

I'll ask about pet friendly balm - maybe just Vaseline, though...

I have been very happy with the vet advice so far. All three have pointed me to the info that is also on this site (catinfo.org, etc). One is a good friend. I don't think they are steering me wrong.

Appa gets his MiraLAX mixed with a churu as a treat after the ear treatment (hopefully we are done this soon - its cleanser, then Tresaderm a half hour later). He is VERY good. Also, cuddles after the insulin seem to be all the reward he

 

[Appa and Susan]

First 12 hours on the glucose monitor... initial readings were 152, but in the middle of the night they spiked up to over 400... So the journey begins.

 

[Diane Tyler's Mom GA]

You need to withhold feeding 2 hours prior to testing first thing in the AMPS and PMPS

Can you please set up your signature
Here is the information we need for your signature. It's at the end of everyone's post in gray letters
Just click on your name up top and then tap signature and add this information.

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Bexacat or Senvelgo (if applicable) and dates
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

This link will explain how to set up our spreadsheet and how to use it so you can track your kitties BG
https://felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/

Here is some information on freeze dried 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

Freeze dried treats that only contain one ingredient (the meat or fish) is zero carb and fine to feed to a diabetes

 

[Diane Tyler's Mom GA]

Hi Susan
If you might be able to test Appa's ears here is some information
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

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 notthe lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will seeone side is curved upward, that's the side you want to poke with

From a member
VIDEO: How to test your cat's blood sugar
She is using a pet meter that has to be coated , Almost all of us use human meter, no coding need

 

[Diane Tyler's Mom GA]

YES! Dr Vet at animal services ordered insulin and correct syringes for us to have when we formalized the adoption

I hope the vet ordered these syringes with the half unit markings because we increase or decrease by 0.25 units at a time
U100, 3/10 ml, 30 or 31 gauge, 6 or 8 mm insulin syringes with 1/2 unit markings

You can read all about Lantus/ Glargine here
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/


You can order the U-100 syringes with half unit markings from Amazon without a doctors script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

• Full and half-unit syringe scales:

 

[Appa and Susan]

Hi Susan
If you might be able to test Appa's ears here is some information

Unfortunately, his ears are extremely damaged from ear infections, tomcat fights etc. There is so much scaring that its not clear where the veins are on one. He also has an ongoing ear infection that we have been treating for 3 weeks, and might need an ear ablation. You can kind of see that in his profile picture.

I'll have to use another spot.

 

[Appa and Susan]

I hope the vet ordered these syringes with the half unit markings because we increase or decrease by 0.25 units at a time

She did not - but OMG so helpful!!!

We are currently over 350 for the last 24 hours with the Libra Freestyle2 (and yes, I am scanning obsessively every half hour). He has been on 2U for 4 weeks, so I've called the vet to see about upping the dose. Unfortunately our vet is on vacation, so hopefully another vet can advise. I am *not* comfortable adjusting the dose without consulting with the vet.

Thank your for the links - I will look at them and see about setting up a spreadsheet. I'm planning on getting some guidance on doing a BGT on his paws or maybe inner thigh (I've heard that is a thing) because the ears are just not going to work.

 

[Diane Tyler's Mom GA]

Unfortunately, his ears are extremely damaged from ear infections, tomcat fights etc. There is so much scaring that its not clear where the veins are on one. He also has an ongoing ear infection that we have been treating for 3 weeks, and might need an ear ablation. You can kind of see that in his profile picture.

I'll have to use another spot.

Poor baby

 

[Diane Tyler's Mom GA]

She did not - but OMG so helpful!!!

Any of these syringes are correct

• BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
• Or
• You can order the U-100 syringes with half unit markings from Amazon without a doctors script
  https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

@Appa and Susan

 

[Appa and Susan]

Poor baby

He is the sweetest, most gentle boy... He is tolerating our ear cleaning and drops (2x a day) plus the injections (no need for treats, just pets). He has a thundershirt on over his Freestyle Libre2 and it doesn't bother him *at all*. He looks a bit like a hobbit in a vest. And yesterday I put a harness on him and we went for a walk to the mailbox. He walks better on a leash than some dogs. He loves everyone who comes in the door, is super chill at the vet, and loves his belly rubs.

We just need to get the diabetes thing under control (and the teeth, and the ears).

 

[Diane Tyler's Mom GA]

@Appa and Susan
Awe he sounds like he is a sweetheart and such a love bug. I wish I could meet him
Give him lots of kisses for me

 

[Appa and Susan]

@Appa and Susan
Awe he sounds like he is a sweetheart and such a love bug. I wish I could meet him
Give him lots of kisses for me

A thousand kisses.

We are on day 3 of the BG monitor, and it has been consistently high/out of range for 2-1/2 of the days. I guess it takes a bit for the Libra Freestyle to calibrate, and I had read that it can read low at first - which apparently it did. ... Anyway, as a result of these high readings, we also did a manual BG test with the AlphaTrak glucose monitor. It was consistent with the Freestyle Libra, so with that double check, and given the consistent readings over 400 our vet is adjusting the dose to 3U 2x a day. I know a lot of cats are on less, but I am confident that he needed more insulin given the data (I haven't set up a spreadsheet yet, I will get there).

ALSO very important that we know how to use the glucose monitor. I'm thinking the next time we do an insulin adjustment we can do a glucose curve at home because he was completely blasé about having his paw poked. DH doesn't want to poke his paws, but I'm of the mind that wearing the monitor and the thundershirt for 2 weeks is more annoying to him... Perhaps we will be lucky and this will be the last adjustment (hahaha)

His ears continue to be a mess... we have been treating them for 2 weeks and they are not better - so the vet is doing a culture so we can (hopefully) have a specific antibiotic for them. I'm hoping he doesn't need an ear canal ablation. Poor boy has been through enough. He will need a dental. His teeth are brown, and I can see at least one canine that is broken. Fortunately this isn't impacting his ability to eat!

 

[Diane Tyler's Mom GA]

A thousand kisses.

We are on day 3 of the BG monitor, and it has been consistently high/out of range for 2-1/2 of the days. I guess it takes a bit for the Libra Freestyle to calibrate, and I had read that it can read low at first - which apparently it did. ... Anyway, as a result of these high readings, we also did a manual BG test with the AlphaTrak glucose monitor. It was consistent with the Freestyle Libra, so with that double check, and given the consistent readings over 400 our vet is adjusting the dose to 3U 2x a day. I know a lot of cats are on less, but I am confident that he needed more insulin given the data (I haven't set up a spreadsheet yet, I will get there).

ALSO very important that we know how to use the glucose monitor. I'm thinking the next time we do an insulin adjustment we can do a glucose curve at home because he was completely blasé about having his paw poked. DH doesn't want to poke his paws, but I'm of the mind that wearing the monitor and the thundershirt for 2 weeks is more annoying to him... Perhaps we will be lucky and this will be the last adjustment (hahaha)

His ears continue to be a mess... we have been treating them for 2 weeks and they are not better - so the vet is doing a culture so we can (hopefully) have a specific antibiotic for them. I'm hoping he doesn't need an ear canal ablation. Poor boy has been through enough. He will need a dental. His teeth are brown, and I can see at least one canine that is broken. Fortunately this isn't impacting his ability to eat!

Tagging Bron and Sienne for you
@Bron and Sheba (GA)
@Sienne and Gabby (GA)


@Appa and Susan
Hi Susan will you be using the Libre Monitor for good if so please add that to your signature. If that's going to be your main way to see his BG numbers
Just tap on your name up top then tap on Signature and add it then tap save .
Try and get your Spreadsheet up as soon as you can
If you need some help setting your spreadsheet up just ask we have a wonderful member who can set it up for you , she will send you a message ,it would be in the inbox up top


@Staci & Ivy
Hi Staci can you give Susan some information on the Libre
Thanks Staci

 

[Bron and Sheba (GA)]

Susan do you have a spreadsheet for Appa? It is very hard for us to give dosing advice if we can’t see any data.
do you need help with setting up the spreadsheet?
I can ask @Bandit's Mom to help you set it up.
And looking back on this thread it looks like Appa was having 2 units twice a day. We would not reconnect going up by 1 unit. That is too much. We need to see some data before we can recommend any increase.

 

[Appa and Susan]

Susan do you have a spreadsheet for Appa? It is very hard for us to give dosing advice if we can’t see any data.
do you need help with setting up the spreadsheet?

ETA - I have set up my spreadsheet. I am not looking for dosing advice at this time - my vet has been communicative (even giving advice while he is on vacation). As you can see from the spreadsheet data, Appa's numbers are still over 400 at this point. I know that it will take time to stabilize, I'm trying to be patient with the process.

@Diane Tyler's Mom GA I'm not sure that we will stay with the Libre2 - I've been checking it every half hour, and its kind of making me crazy. We have been having some sensor crankiness after 4 days. I think that we will wind up doing glucose curves with the AlphaTrak3, and occasional spot checks. But the jury is still out.

 

[Diane Tyler's Mom GA]

@Appa and Susan
Hi Susan on your spreadsheet the color codes up top , well the last 2 the dark green and the lime green are reflecting that you are using the Alpha Trak
The Libre is actually a human meter

You can change the last 2 yourself
The dark green should be 50-99
The lime green should be BG<50

Just a suggestion if I were you I would buy a human meter since that what our numbers are based on
Most use the Relion Premier Classic
Here is the link for the meter and test strips so you don't have to search for them. Most of us use human meters
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 16.86 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart

I first started with the Alpha Trak but the strips were so expensive , then switched to the Relion. I got Tyler into remission for 3 years and 4 months following the advice from the experienced members here .
Unfortunately he past August 2024 due to cancer. I know if he didn't pass he would still be in remission

You can buy any human meter

 

[Diane Tyler's Mom GA]

He *really* loves kibble - and the kibble is also 13% so I have given him some in a play-toy dispenser (he hasn't figured it out yet, I keep having to roll it). So he gets maybe a couple of tablespoons of that a day.

If he's still getting the kibble can you please add that to your signature Hill's Glucose support dry and wet if you are still feeding the wet

@Appa and Susan

 

[Appa and Susan]

@Appa and Susan
Hi Susan on your spreadsheet the color codes up top , well the last 2 the dark green and the lime green are reflecting that you are using the Alpha Trak
The Libre is actually a human meter

You can change the last 2 yourself
The dark green should be 50-99
The lime green should be BG<50

Done... I changed the conditional formatting on the sheet so that the cell color will change to match the legend... If we switch to the AlphaTrak3 I can change conditional formatting for the cells below to reflect the change in meter...

 

[Appa and Susan]

If he's still getting the kibble can you please add that to your signature Hill's Glucose support dry and wet if you are still feeding the wet

@Appa and Susan

Nope, just wet food. GlucoSupport and the low carb Fancy Feast (I have a spreadsheet to calculate percent carbs by dry weight, and percent carbs by calorie content - some of the Fancy Feast classic pates that are supposedly low carb are not - perhaps the formula changed).

 

[Diane Tyler's Mom GA]

Done... I changed the conditional formatting on the sheet so that the cell color will change to match the legend... If we switch to the AlphaTrak3 I can change conditional formatting for the cells below to reflect the change in meter...

Thank you Susan ,yes you can change it back if you plan on just using the Alpha Trak

@Appa and Susan

Sometimes when I want to find out the carbs on a certain food and Google it and if Chewy has it you will see to the right how many answered questions there were and might see where someone asked about how many carbs are in it and they will get the answer Either as fed or dry matter

If you want to stop feeding the 13 % wet food you can also try
You can even feed the Fancy Feast Roasted/Flaked/Chunky
The are either 4%, 5% , and 6% which are also ok to feed

Chunky Chicken Feast - is 4% carbs.

 

[Diane Tyler's Mom GA]

ETA - I have set up my spreadsheet. I am not looking for dosing advice at this time - my vet has been communicative (even giving advice while he is on vacation). As you can see from the spreadsheet data, Appa's numbers are still over 400 at this point. I know that it will take time to stabilize, I'm trying to be patient with the process.

@Sienne and Gabby (GA)
@Bron and Sheba (GA)

Susan has set up her spreadsheet if you want to take a look at it , I know you have been asking her if she had one. APPA is no longer eating any kibble just the FF Pates and the Hill Gluco Support wet 13% carbs

 

[Appa and Susan]

Sometimes when I want to find out the carbs on a certain food and Google it and if Chewy has it you will see Questions up top and might see where someone asked about how many carbs are in it and they will get the answer Either as fed or dry matter

I uploaded a spreadsheet that calculates the %carbs by calories, and %carbs on dry matter basis. I haven't done the work to make it easily fillable or done any conditional formatting, but I could if people are interested. The reason I did %carbs by calories is I had a vet who wanted the carbs assessed that way - but some formulations have the %carbs by dry matter basis. The two are very close, and to be honest, the exact percentages are going to vary between cans...

Some of the FF pates are higher in carbs than the GlucoSupport (Cod and Sole is 15% for example, Whitefish is 13%).

 

[Larry and Kitties]

Relion Premier Classic Meter at Walmart for 9 dollars

The much smaller Premier Compacrt@$17.88 is easier to use is really about the same price since the Compact comes w/50 test strips while the Classic does not come w/any test strips.
https://www.walmart.com/ip/ReliOn-Premier-Compact-Blood-Glucose-Monitoring-Kit/352439457

 

[Bron and Sheba (GA)]

Susan well done getting the spreadsheet set up.
I can see you increased to 3 units, probably on the advice of the vet. Is that correct?
We don’t recommend going up in 1 unit increments but I know you are wanting to follow the vets advice but I would be very careful about continuing to increase in 1 unit increments moving forward.

Now that you are seeing blue BGs I would stay with that dose for at least 10 cycles. I know Appa is going back up into red BGs but that is from bouncing. The fact the BGs are dropping to blue BGs means the dose is working.
Here is an explanation on bouncing

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

[Appa and Susan]

I can see you increased to 3 units, probably on the advice of the vet. Is that correct?

Yes, it was. The plan is to wait at least a week on this dose (14 cycles) and see how he settles out. He had been on the dose of 2 units for 3 weeks (42 cycles) so the change has not been precipitous. Its just that we adopted him, got him on insulin and then left on a 9 day (previously planned) vacation. So there wasn't time to do a glucose curve. Not ideal. But, life. He stayed with friends (one is a retired nurse practitioner) who have had cats and were happy to take on the various health care needs.

I'm hoping the Libre2 will stay on for the next week, so we can get BG numbers on a scale that is consistent with the previous week. We are waiting on a culture of his ears - 2 weeks of treatment has not cleared them up. So we may have an in-person recheck next week.

 

[Appa and Susan]

Well.. after 6 cycles of the new dose, the BG numbers remain high. I double checked with the AlphaTrak3 last night, and the BG was 501, so its not a false high on the Libra2. The Libra2 gives high and low reading for each hour, and anything over 400 is "out of range", so I just use 400. I've been putting the high number into the spreadsheet, since that is the one I normally see when I do a reading. I'm crossing my fingers this is just the "bounce".

Not changing anything, don't worry - I know its too early to make changes. I just want my boy to be well.

ETA - Numbers are lower this afternoon. Crossing my fingers, toes, and eyes...

 

[Appa and Susan]

Last night Appa's numbers are down into 140's. We kept in a close eye on him this evening to make sure he didn't go low (he didn't). He is back up this morning... I guess that is the bouncing.

 

[Appa and Susan]

BTW - Appa has DH wrapped around his toe-bean.

Appa - "Walkies"
Me - "Its 630am and cold"
Appa - "Walkies"
DH - "Lets go!"

 

[Diane Tyler's Mom GA]

You need to add today's date on your spreadsheet

 

[Bron and Sheba (GA)]

Yes that’s bouncing.
Keep up the good work.
DH…that is devotion! Love it!

 

[Appa and Susan]

I think the combination of bouncing, and the ability to look at the glucose monitor constantly is (arguably) not a great one for to reduce my fretting.

Last night the Libra2 read low for 4 hours (below 70 is what it is set at by default) and then the app started screaming at me when it went below 55. I went ahead and did a BG test to check if this was a false low or not - when the Libra2 read 64, the AlphaTrak3 read 112, so I did not panic. Also, Appa showed no signs of a hypo event. When the Libra2 started reading below 70 I gave him his 10pm evening snack (1/4 can of FF) and then, since it stayed low, another one at about midnight. By then I was not particularly awake.

I've updated the spreadsheet (including yesterday's date). And now Appa is telling me its walkies. NOW. please?

I'm finding the tillydiabetes graph to be very helpful in visualizing what is going on.

 

[Bron and Sheba (GA)]

The libre can be unreliable if under 100 so great you checked with the manual meter.
The 3 units is working well so you need to stay on that dose at the moment unless the BG drops under 90 on a manual meter.
Bouncing is frustrating but very common.
Keep up the good work!

 

[Appa and Susan]

Bouncing is frustrating but very common.

It is so frustrating! We had another low glucose event at 2am last night (the alarm is loud, very alarming at 2am) - I tried to get a manual meter read, but after 3 pokes and no success I gave up. Appa had absolutely no signs of hypoglycemia. I gave him a little food and he stayed lower until after his insulin shot this morning, when he went back up. *sigh*. Now I need a nap.

I think I want to not replace the Libre2, wait a week and do a manual glucose curve - I feel confident we can do this at home. The Libre2 is kinda stressing me out... What do you think?

 

[Bron and Sheba (GA)]

With the blue and green BGs you are now seeing I would continue with the libre until you are able to test ok manually.
Did you give insulin this morning? There is no number in the dos ecolumn

 

[Appa and Susan]

Did you give insulin this morning?

We did! The spreadsheet is up to date. We took off the Libre2 on Friday - I was going out of town for an event and DH was taking care of Appa (they did great) and didn't have the app on his phone (you can only have one app connected at a time...).

ETA to add that we removed the sensor on Feb 14. We won't have more data in the spreadsheet until we do a glucose curve and a week or so.

I talked to Dr. Vet - he was concerned about the low glucose numbers, but when I told him that I had checked with the AlphaTrak3 and confirmed they were not actually low (over 100) we decided to stay on the 3U for now. He commented that too high an insulin dosage can contribute to bouncing. The plan is to do a BG curve at home in a week or so and see if there is still bouncing (if we can, bouncing doesn't seem to happen every insulin cycle). He would be fine with going down to 2-1/2 U.

Good news on the ears, despite seeing bacteria with the quick stain, the cultures were negative! So while Appa's ears are still dirty, they are not infected. We are going to continue to clean them a couple times a week, because with the deformity and injury they probably will never clean themselves the way they should.

I'm going to modify the spread sheet so it corresponds to the formatting for the AlphaTrak3 and preserve the Libra data.

 

[Sienne and Gabby (GA)]

Ummmm....
Unless my laptop is misbehaving, I'm seeing data only through 2/14 on your spreadsheet. Can you update for the last couple of days?