New Member - Need advice on food and insulin

Hi everyone!

My name is Lallana (or Lana), from Malaysia. My cat, Katy (11 years old) was diagnosed with DM in December 2019 (found out when he had DKA - thankfully she survived the terrible ordeal). Her diet since then consists of Royal Canin Diabetic Kibbles (<40g per day; very bad food choice I know) and boiled chicken breasts.

She was prescribed with Lantus (2 iu AM; 1 iu PM), which she has been thriving on except until end of 2020. Out of nowhere, her numbers starts to get high (>25 mmol/L) both AM and PM for few months. Tried increasing dosage for awhile but still the same; so we change to NovoRapid which was a terrible idea; her numbers drop to below 20 but doesn`t last long; almost 5 injections per day needed). So, we change to Levemir (starting on 21/1/2021; initial dosing is 3iu AM and 3iu PM).

At that time, I haven`t join this group so I was missing out on ALOT of things (e.g. TR, bouncing, etc etc) hence why I rushed into changing insulins. I am so glad and grateful that I joined this group.

Now that I have done some readings, I wish to change my cat`s diet to wet food. Most probably would go for Nature`s Variety (Instinct), Avoderm or Fussie Cat Premium (To my knowledge, Tiki Cat, Fancy Feast Pate and Weruva are not available in Malaysia).

My concern is now that we are still increasing her dosage (by 1 iu as instructed by my vet) to find the perfect nadir, is it alright to change her food or shall I wait first? Also, I would really appreciate any members` kind help to check Katy`s SS. I am not 100% sure but is she bouncing now? I know I need to be patient but at times can`t help but doubt at myself.

If I am not mistaken, I read that if 6 iu or more insulin needed, it is best to check for acromegaly or IAA. Should I be concern with this now or later?

Thank you in advance.

 

Hi and welcome Lana and Katy to the forum
Levemir is a good choice of insulins.
We recommend only increasing in 1/4 unit increments unless the nadir is over 300 (16.6) in which case, increase in 1/2 unit increments. So in your case you would increase in 1/2 unit increments. If you do it in 1unit increments you can go past the best dose.
Levemir also likes consistency so don’t chop and change the dose unless you are increasing.
If you are doing TR hold the dose for at least 6 cycles.

Changing the diet from a dry to a wet diet can drop the BGs by up to 100 points (US) or 5.5 points (rest of the world numbers) so you need to be testing the BGs regularly and doing it over a period of days not abruptly and reducing the dose of insulin as needed. We can help you with that. Don’t increase the dose if you are intending to change the food. Change the food first, then see how the BGs are.

She is not bouncing, she is just high.
Are you testing the urine for ketones? It would be a very good idea to do so. You can buy a bottle of Ketostix from a pharmacy.

I would not worry about getting to 6 units at the moment. I would change the food first as it can make a huge difference.

 

Thanks for your reply, Bron! (Is that alright; to address you as Bron?)
I was able to give increments in 0.5 previously if I had too but recently 0.3ml insulin syringe needles are very hard to find! Luckily Katy was on 2iu twice a day at that time so I can just switch to pen needles. Most pharmacies don`t carry them anymore (0.3 ml insulin syringe) because people would rarely buy it so I`m left with 0.5ml ones... or is that still ok to use?

That`s quite a significant BG drop! Okay, I will hold the current dose for now and monitor her BG closely throughout the transition.
No, have yet to test urine for ketones. Will definitely try that and update soon.

Noted. Hopefully, we will be able to see favourable results with the food change!

Thank you so much for helping me out. I really appreciate your advice and comments.

 

Hi Lana.
Yes I am Bron.
You can use the 0.5 unit syringes but the 0.3 ones are much better and easier to use and are really needed for smaller doses when you get to them.
I can send you the link to a place in the UK where they will send you 0.3 ml syringes with half unit syringes. They will take about 10 days to get to you.
https://www.hyperdrug.co.uk/bd-micr...-03ml-pack-of-100/productinfo/BDMICROFINE03ML

Keep losing each day so we can see how you are going .
Bron

 

Thank you for the link although will try to find another supplier over here if possible...
Any products shipped from the UK is tad bit expensive for me but still, I appreciate your help
Will keep you posted!