New Member Need Advice

Status
Not open for further replies.
Kev B

Kev B

Member
Hello, All!
My name is Kevin and I'm new to posting. I've been following this website since my 7-year-old Tuxedo, Kit, was diagnosed with FD this past June. Just reading the posts and answers has helped shed a LOT of light on this whole new world for me (us), so I'd like to start by saying a general "Thank You" to everyone associated with this site. So, "Just...Thank You All So Much"...
Now, some background: after having weathered Kit going through a DKA episode, changing insulin type, daily BG monitoring, and vigilant dietary restrictions (for the entire kitty household), my vet thinks the next step in his journey will start with an increase in his insulin and a change in his diet. As of today, he is getting 2 units of Vetsulin twice a day after meals. He is now eating 1.5-2 cans per meal of 9Lives Meaty Pate canned wet food (varieties), also twice a day. In-between snacks include freeze-dried chicken puffs and large syringes of Pedialyte several times a day (this helps with his hunger pangs and keeps him hydrated).
He recently had his bloodwork done, and his Fructosamine level dropped from 608 to 487 in about 7 weeks. Our goal is to get this level below 400. His BG levels have generally hovered around the 350 area when I was giving him 1.5 units (2x a day) of the vetsulin during that 7-week period, and my vet thinks the increase in his insulin will help lower that number. If we can achieve lowering his BG, the hope is that he will be able to use more of his food nutrition, lessen his food intake and help him gain weight (he gained 1 pound in that whole period).
My question is this: My vet thinks getting him on a prescription diet will help change Kit's numbers for the better. The research I have done is saying that the 9Lives I am feeding him is lower in carbs and far less expensive. I even add mashed green beans and carrots to his evening meal per my vet's advice to add good fiber. Also, my vet says that daily BG testing is unnecessary (because it's mainly the Fructosamine level that matters), but I can test infrequently to put myself at ease. My vet actually encouraged me to ask this board for advice (I mention y'all a lot). So, any advice on how I can get my Kit back to a balanced state of health? Diet change suggestions? Thank you, thank you, thank you in advance! Any advice at all would be incredibly helpful!! Please let me know if there is any additional info needed!!
Gratefully,
Kev
 
@Kev B
Hi there
Can you please set up your signature
Information we need about Kit
This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet

  • 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.

Please be sure to put the date when Kit has DKA like you have on your spreadsheet

History of DKA/Ketones: Aug 20 , Ketones was 7.4 and Aug 21, Fructosamine was 608
Date of DKA: August 19, 2024
I'll tag a few members for you

I would change your title to read
New Member Need Advice
To change it tap on the Word Thread Tools then tap on Edit Title and put what I said then tap save :cat:
 
Last edited:
Kev B said:
Hello, All!
My name is Kevin and I'm new to posting. I've been following this website since my 7-year-old Tuxedo, Kit, was diagnosed with FD this past June. Just reading the posts and answers has helped shed a LOT of light on this whole new world for me (us), so I'd like to start by saying a general "Thank You" to everyone associated with this site. So, "Just...Thank You All So Much"...
Now, some background: after having weathered Kit going through a DKA episode, changing insulin type, daily BG monitoring, and vigilant dietary restrictions (for the entire kitty household), my vet thinks the next step in his journey will start with an increase in his insulin and a change in his diet. As of today, he is getting 2 units of Vetsulin twice a day after meals. He is now eating 1.5-2 cans per meal of 9Lives Meaty Pate canned wet food (varieties), also twice a day. In-between snacks include freeze-dried chicken puffs and large syringes of Pedialyte several times a day (this helps with his hunger pangs and keeps him hydrated).
He recently had his bloodwork done, and his Fructosamine level dropped from 608 to 487 in about 7 weeks. Our goal is to get this level below 400. His BG levels have generally hovered around the 350 area when I was giving him 1.5 units (2x a day) of the vetsulin during that 7-week period, and my vet thinks the increase in his insulin will help lower that number. If we can achieve lowering his BG, the hope is that he will be able to use more of his food nutrition, lessen his food intake and help him gain weight (he gained 1 pound in that whole period).
My question is this: My vet thinks getting him on a prescription diet will help change Kit's numbers for the better. The research I have done is saying that the 9Lives I am feeding him is lower in carbs and far less expensive. I even add mashed green beans and carrots to his evening meal per my vet's advice to add good fiber. Also, my vet says that daily BG testing is unnecessary (because it's mainly the Fructosamine level that matters), but I can test infrequently to put myself at ease. My vet actually encouraged me to ask this board for advice (I mention y'all a lot). So, any advice on how I can get my Kit back to a balanced state of health? Diet change suggestions? Thank you, thank you, thank you in advance! Any advice at all would be incredibly helpful!! Please let me know if there is any additional info needed!!
Gratefully,
Kev
Click to expand...
@Bron and Sheba (GA)
@Suzanne & Darcy
 
Hi and welcome to the forum. So glad you have decided to post. I think we can help you a lot.
I have to duck out and pick up kids from school but I will be back to answer your questions.
Probably be a couple of hours.:)
 
Hi Kev
Well done doing hometesting. That’s really important.
Do you think you could get at least one test in each cycle, both am and pm cycles? It’s important to see how low the dose is taking Kit.
I disagree with your vet about the fructosamine test. It’s a great test to get in the beginning to diagnose the diabetes, but after that getting the daily BG tests is a far better way of telling how things are going. The fructosamine test is an average of the last couple of weeks. It doesn’t tell you the highs and the lows. But home testing does and that is what is important.
So save your money on the fructosamine tests and use it for something else.

Are you still testing for ketones? It is really important after DKA to still monitor for ketones as that is your early warning system to tell you if things need to be tweaked. So if you could do those and put the results into the remarks column of the SS that would be fabulous thanks.

Re the food. There is no need at all to feed prescription food. It is expensive and too high in carbs and is not special at all. Choose a low carb wet food, 10% or under carbs. We have a chart you can look at FOOD CHART. If you want him to put on weight, give him snacks during the cycles and he will also gain some weight once the BGs are in better numbers. At the moment he can’t absorb all the nutrients in the food. I would not feed mashed peas and beans…they are not necessary and add carbs. Cats are obligate carnivores.
Do you have a hypo kit set up?

With DKA in the recent past it is important you are feeding more food than he would normally eat. If you are only feeding 2 meals a day, I would recommend you start to give 2 or 3 snacks during each cycle as well. Give those during the first 7 hours after the dose. A snack is a teaspoon or two of low carb food.

Before suggesting a dose increase I would like to see some BG tests which are done during the cycles. In all likelihood Kit is dropping lower during the cycles. And we need to see if that is the case. Dosing is not based on the preshot. We need to see how low the dose takes the cat.

If Kit no longer has any ketones and seems well, I would look at changing him over to a more suitable insulin. Caninsulin is not a good insulin for cats. It’s a dog insulin. A better one is Lantus or Prozinc.
Keep asking questions:)
Bron
 
Diane Tyler's Mom GA said:
@Kev B
Hi there
Can you please set up your signature
Information we need about Kit
This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet

  • 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.

Please be sure to put the date when Kit has DKA like you have on your spreadsheet

History of DKA/Ketones: Aug 20 , Ketones was 7.4 and Aug 21, Fructosamine was 608
Date of DKA: August 19, 2024
I'll tag a few members for you

I would change your title to read
New Member Need Advice
To change it tap on the Word Thread Tools then tap on Edit Title and put what I said then tap save :cat:
Click to expand...
Thank You!!! The changes have been made, and I'll be sure to keep them updated as new info comes in!
 
Bron and Sheba (GA) said:
Hi Kev
Well done doing hometesting. That’s really important.
Do you think you could get at least one test in each cycle, both am and pm cycles? It’s important to see how low the dose is taking Kit.
I disagree with your vet about the fructosamine test. It’s a great test to get in the beginning to diagnose the diabetes, but after that getting the daily BG tests is a far better way of telling how things are going. The fructosamine test is an average of the last couple of weeks. It doesn’t tell you the highs and the lows. But home testing does and that is what is important.
So save your money on the fructosamine tests and use it for something else.

Are you still testing for ketones? It is really important after DKA to still monitor for ketones as that is your early warning system to tell you if things need to be tweaked. So if you could do those and put the results into the remarks column of the SS that would be fabulous thanks.

Re the food. There is no need at all to feed prescription food. It is expensive and too high in carbs and is not special at all. Choose a low carb wet food, 10% or under carbs. We have a chart you can look at FOOD CHART. If you want him to put on weight, give him snacks during the cycles and he will also gain some weight once the BGs are in better numbers. At the moment he can’t absorb all the nutrients in the food. I would not feed mashed peas and beans…they are not necessary and add carbs. Cats are obligate carnivores.
Do you have a hypo kit set up?

With DKA in the recent past it is important you are feeding more food than he would normally eat. If you are only feeding 2 meals a day, I would recommend you start to give 2 or 3 snacks during each cycle as well. Give those during the first 7 hours after the dose. A snack is a teaspoon or two of low carb food.

Before suggesting a dose increase I would like to see some BG tests which are done during the cycles. In all likelihood Kit is dropping lower during the cycles. And we need to see if that is the case. Dosing is not based on the preshot. We need to see how low the dose takes the cat.

If Kit no longer has any ketones and seems well, I would look at changing him over to a more suitable insulin. Caninsulin is not a good insulin for cats. It’s a dog insulin. A better one is Lantus or Prozinc.
Keep asking questions:)
Bron
Click to expand...
Hi! Thank You for responding so quickly (hugs to the kids)!
I was also a little concerned about the testing and think I should test at least a couple of times a day since I started the new dosage increase. I think I need to be more vigilant about WHEN I test him, though. He has more energy now and likes to roughhouse with my other cats, so any testing after that is just a waste of time (his BG goes up by at least 100 points!). My vet suggests the Fructosamine and Complete Blood Test only be done every 3 or 4 months (they have to be sent out), but the Ketones can be tested in-office if there is a question about it. For now, it's mainly observation and monitoring food/water intake. I normally take lots of notes and put relevant info into his spreadsheet (my vet has a link to it as well).
I agree with the diet food. I use 2 different calculators to figure out carb content, and the 9Lives is slightly lower than the prescription food. I don't see a compelling reason to mess with it unless it would prove to be better at lowering his BG levels. I'd rather wait to see what testing shows for the next few days during/after his insulin dosage change. My vet says the veggies help counteract the carbs that are present. I'm confused by the "obligate carnivore" label because I read that it's unnecessary while at the same time reading that any fiber or carbs are ingested along with the prey being consumed (in the "wild"). I'd appreciate more clarity on that subject. Also, I've read that fish/krill oil supplements is great for helping cats utilize insulin. Any truth to that?
Kit started out on ProZinc when he was diagnosed, but the vet thinks he became resistant to it, which is why he ended up with DKA. I was shocked how quickly it came on, but he was near death according to the emergency room I was sent to. He was severely dehydrated, which was shocking to me. The (new) vet put him on Vetsulin "temporarily", and he recovered quickly. So, if this new dosage can bring down his BG numbers, he'll probably go back to ProZinc. It all just seems ECID at this point.
The only hypo kit I have (if I understand correctly) is a bottle of Karo syrup and the emergency room number. Should there be more?
Again, I just want to say "Thank You" to everybody... I can hardly express how relieved and grateful I am to finally be a part of this with y'all.
Kev
 
@Kev B
Hypo kit if needed
Med and High Carb food and have honey in your house



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs



Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods



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.


You can test for ketones at home

CATCHING AND TESTING URINE

Or you can test using a meter
You can get it on Amazon
here are links for the Nova Max Plus supplies on Amazon.

Nova Max Plus (meter)
https://www.amazon.com/Nova-Max-Glucose-Monitoring-System/dp/B01G5OE0QY

Nova Max Plus (ketone test strips)
https://www.amazon.com/Nova-Ketone-Strips-Count-Total/dp/B008P0WMI0
 
Last edited:
Kev B said:
Hi! Thank You for responding so quickly (hugs to the kids)!
I was also a little concerned about the testing and think I should test at least a couple of times a day since I started the new dosage increase. I think I need to be more vigilant about WHEN I test him, though. He has more energy now and likes to roughhouse with my other cats, so any testing after that is just a waste of time (his BG goes up by at least 100 points!). My vet suggests the Fructosamine and Complete Blood Test only be done every 3 or 4 months (they have to be sent out), but the Ketones can be tested in-office if there is a question about it. For now, it's mainly observation and monitoring food/water intake. I normally take lots of notes and put relevant info into his spreadsheet (my vet has a link to it as well).
I agree with the diet food. I use 2 different calculators to figure out carb content, and the 9Lives is slightly lower than the prescription food. I don't see a compelling reason to mess with it unless it would prove to be better at lowering his BG levels. I'd rather wait to see what testing shows for the next few days during/after his insulin dosage change. My vet says the veggies help counteract the carbs that are present. I'm confused by the "obligate carnivore" label because I read that it's unnecessary while at the same time reading that any fiber or carbs are ingested along with the prey being consumed (in the "wild"). I'd appreciate more clarity on that subject. Also, I've read that fish/krill oil supplements is great for helping cats utilize insulin. Any truth to that?
Kit started out on ProZinc when he was diagnosed, but the vet thinks he became resistant to it, which is why he ended up with DKA. I was shocked how quickly it came on, but he was near death according to the emergency room I was sent to. He was severely dehydrated, which was shocking to me. The (new) vet put him on Vetsulin "temporarily", and he recovered quickly. So, if this new dosage can bring down his BG numbers, he'll probably go back to ProZinc. It all just seems ECID at this point.
The only hypo kit I have (if I understand correctly) is a bottle of Karo syrup and the emergency room number. Should there be more?
Again, I just want to say "Thank You" to everybody... I can hardly express how relieved and grateful I am to finally be a part of this with y'all.
Kev
Click to expand...
Welcome Kev and Kit, it is really great that your Vet is preceptive and is ok for you to continue to refer to our Forum, ask away, ask away, in reference to the HYPO KIT the contents of this should be KARO SYRUP, some medium carb food between 11-15% and some High Carbs between 16-24% most of the time these are the gravy foods are high carbs , below is the Drs. Food Chart (3rd column has the % of carbs) where you have many brands and flavors to pick from, most of us use the Fancy Feast Pates, with 0-10% carbs and they are US made so the food that goes in the can is regulated and no waste goes in it, I agree with Bron prescription foods are just a profitable Vet source and are very high in carbs, Corky was prescribed at first by his X-Vet Royal Cannin for diabetic cats and his BG never got better within that time, it wasn't until I became a member in this Forum that my Corky began to see the light, and no Vet/Test/Xray's/Blood work, just this Forum that's how blindly I trust the members giving advice, of course all cats are different, with different ailments, Corky happens to be an inside cat since birth 11th birthday yesterday, and is extremely healthy, but his X-Vet disappointed me when he was first diagnosed and hospitalized for 8 days, , a lot of members here have experience a lot of issues referring this issues, Vets are familiar with Dog diabetes, but not for feline diabetes, so they treat it the same and sometimes it becomes an expensive and dangerous zone. But you are doing great, and home testing is very important especially before dosing AMPS/PMPS, you do not want to shoot insulin not knowing his BG at the time of dosing, and again, welcome and we are here for you:bighug::cat::cat:
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Kev B said:
Hi! Thank You for responding so quickly (hugs to the kids)!
I was also a little concerned about the testing and think I should test at least a couple of times a day since I started the new dosage increase. I think I need to be more vigilant about WHEN I test him, though. He has more energy now and likes to roughhouse with my other cats, so any testing after that is just a waste of time (his BG goes up by at least 100 points!). My vet suggests the Fructosamine and Complete Blood Test only be done every 3 or 4 months (they have to be sent out), but the Ketones can be tested in-office if there is a question about it. For now, it's mainly observation and monitoring food/water intake. I normally take lots of notes and put relevant info into his spreadsheet (my vet has a link to it as well).
I agree with the diet food. I use 2 different calculators to figure out carb content, and the 9Lives is slightly lower than the prescription food. I don't see a compelling reason to mess with it unless it would prove to be better at lowering his BG levels. I'd rather wait to see what testing shows for the next few days during/after his insulin dosage change. My vet says the veggies help counteract the carbs that are present. I'm confused by the "obligate carnivore" label because I read that it's unnecessary while at the same time reading that any fiber or carbs are ingested along with the prey being consumed (in the "wild"). I'd appreciate more clarity on that subject. Also, I've read that fish/krill oil supplements is great for helping cats utilize insulin. Any truth to that?
Kit started out on ProZinc when he was diagnosed, but the vet thinks he became resistant to it, which is why he ended up with DKA. I was shocked how quickly it came on, but he was near death according to the emergency room I was sent to. He was severely dehydrated, which was shocking to me. The (new) vet put him on Vetsulin "temporarily", and he recovered quickly. So, if this new dosage can bring down his BG numbers, he'll probably go back to ProZinc. It all just seems ECID at this point.
The only hypo kit I have (if I understand correctly) is a bottle of Karo syrup and the emergency room number. Should there be more?
Again, I just want to say "Thank You" to everybody... I can hardly express how relieved and grateful I am to finally be a part of this with y'all.
Kev
Click to expand...
Kev, you can test for ketones at home and this is something you should be doing with DKA in the recent past. All you need is a bottle of Ketostix from a pharmacy. Collect a urine sample from Kit and then follow the directions on the bottle. There should be no ketones. If there are ketones, this is telling you that there is not enough insulin or not enough food.
The carbs the cats get in the wild is from the stomachs of the prey. It is a small amount and that is if the cat eats the stomach. I feed my cats a homemade raw diet and it does not include any vegetables. You said My vet says the veggies help counteract the carbs that are present. This is not true.
If you are feeding a balanced canned food you should not need to add any oil. I have not heard it helps utilise insulin. But a balanced diet is essential for cats.
Kit would have got DKA because he wasn’t getting enough insulin, enough food and most likely had an infection or inflammation. That is the recipe for DKA in cats. While vetsulin is an ok insulin for cats if they have had DKA and still have ketones, it is not a good insulin for cats moving forward. This is because it is a dog insulin and it does not last the 12 hours necessary for the cycles in cats….this is because cats have a much faster metabolism than dogs. And vetsulin is a harsh insulin for cats as it hits hard and fast. Are you feeding Kit 30 minutes before giving the insulin?
Once ketones are in the distant past you are better to swap over to a more gentle longer lasting insulin such as Lantus. It lasts the 12 hours and is more gentle.
Don’t forget to get those all important mid cycle tests in please. It looks like you are holding the doses too long, it we need to see how low the dose is taking Kit before advising you to increase.
 
I'm including a link to the guidelines for diabetes treatment from the American Animal Hospital Assn. They stopped recommending Vetsulin for diabetic cats in 2018 given that it has too short of a duration respective to a cat's fast metabolism. In other words, Vetsulin doesn't last 12 hours so. you see swings in blood glucose levels. The insulins that are recommended are Prozinc and Lantus (glargine -- it's available in generic/biosimilar form).

As for diet, you are correct, cats are obligate carnivores. In the wild, when they eat prey, they may consume what's in the digestive tract of their prey but the carbohydrates that may be in the system of their prey is partially digested. Feeding a cat foods that contain carbs is not recommended either for their diabetes or due to their inability to fully metabolize those foods. Despite what your vet may think, not all fiber is equal. You would need to be sure you're feeding your cat dietary insoluble fiber. Given that many cats are not big fans of vegetables, you might consider adding psyllium husk to your cat's diet if you want to add fiber. Personally, I would stick with a low carb diet -- most members use foods with similar carb count to what you're feeding Kit.

This is a link to our info on Vetsulin. Since you've been using the board, I'm not sure if you've seen the dosing guidelines. The one thing that stands out on Kit's spreadsheet is that we adjust doses far more often that what you're vet has been recommending. I would also strongly encourage you to test at least 4 times per day. You want to keep testing at AMPS and PMPS. It's also important to get at least one test during both the AM and PM cycles. The other down side of Vetsulin is that it can cause blood glucose numbers to drop hard and fast. If you're not getting any tests during the cycle, you may miss the need for a dose reduction since numbers can bounce back to high levels after a drop. My cat was notorious for starting a cycle in the 400s, dropping to the 40s, and then being back in the 400s by shot time. If I hadn't been a testaholic, I would have missed the need to reduce her dose.
 
Bron and Sheba (GA) said:
Kev, you can test for ketones at home and this is something you should be doing with DKA in the recent past. All you need is a bottle of Ketostix from a pharmacy. Collect a urine sample from Kit and then follow the directions on the bottle. There should be no ketones. If there are ketones, this is telling you that there is not enough insulin or not enough food.
The carbs the cats get in the wild is from the stomachs of the prey. It is a small amount and that is if the cat eats the stomach. I feed my cats a homemade raw diet and it does not include any vegetables. You said My vet says the veggies help counteract the carbs that are present. This is not true.
If you are feeding a balanced canned food you should not need to add any oil. I have not heard it helps utilise insulin. But a balanced diet is essential for cats.
Kit would have got DKA because he wasn’t getting enough insulin, enough food and most likely had an infection or inflammation. That is the recipe for DKA in cats. While vetsulin is an ok insulin for cats if they have had DKA and still have ketones, it is not a good insulin for cats moving forward. This is because it is a dog insulin and it does not last the 12 hours necessary for the cycles in cats….this is because cats have a much faster metabolism than dogs. And vetsulin is a harsh insulin for cats as it hits hard and fast. Are you feeding Kit 30 minutes before giving the insulin?
Once ketones are in the distant past you are better to swap over to a more gentle longer lasting insulin such as Lantus. It lasts the 12 hours and is more gentle.
Don’t forget to get those all important mid cycle tests in please. It looks like you are holding the doses too long, it we need to see how low the dose is taking Kit before advising you to increase.
Click to expand...
I bought ketone testing strips today and will start using them as soon as I get the hang of having one available when Kit's in the act! Thanks for the advice on the oils. It sounded a bit too good to be true, but I'm glad I asked (and you knew).
You are absolutely correct about the infection; when his blood test results came back his white blood cell count was far above normal. The vet had him start on a two-week round of antibiotics immediately. He actually started eating and drinking on his own again (after being syringe fed) after only a day. The first couple of days he was on subcutaneous fluids (about 3 times) which he responded well to, so we dodged the hospitalization route. I still don't know why his BG readings seemed okay if he developed a resistance to the ProZinc, but it does make sense that the infection (however that happened) would have fast-tracked his DKA. Also, I'm stumped as to how I could have missed his being dehydrated so badly (according to his blood tests) that the ER vets said he was very close to death. Anyway, we survived it and I think I'm more hyper-alert now to any changes that could ever lead to something like that again.
I started testing his BG levels today, so his chart will start reflecting the new numbers. I feel more comfortable, at least for now, especially since his dosage has increased. It's been 5 days so far. How long does it take to see any differences due to the dosage change? My vet asked to keep an eye on his behavior and report anything unusual within the next week (basically 10 days after his first increase). He wants me to finish this bottle of Vetsulin and then decide whether to change it. I regularly dose Kit within 30 minutes of him finishing his meals. His testing will now be AM/PM pre-feeding and then 4 hours after his doses, so his spreadsheet will reflect those numbers soon.
Thank You for your advice and insights! They are so important to us! Thank You!!
Kev
 
Sienne and Gabby (GA) said:
I'm including a link to the guidelines for diabetes treatment from the American Animal Hospital Assn. They stopped recommending Vetsulin for diabetic cats in 2018 given that it has too short of a duration respective to a cat's fast metabolism. In other words, Vetsulin doesn't last 12 hours so. you see swings in blood glucose levels. The insulins that are recommended are Prozinc and Lantus (glargine -- it's available in generic/biosimilar form).

As for diet, you are correct, cats are obligate carnivores. In the wild, when they eat prey, they may consume what's in the digestive tract of their prey but the carbohydrates that may be in the system of their prey is partially digested. Feeding a cat foods that contain carbs is not recommended either for their diabetes or due to their inability to fully metabolize those foods. Despite what your vet may think, not all fiber is equal. You would need to be sure you're feeding your cat dietary insoluble fiber. Given that many cats are not big fans of vegetables, you might consider adding psyllium husk to your cat's diet if you want to add fiber. Personally, I would stick with a low carb diet -- most members use foods with similar carb count to what you're feeding Kit.

This is a link to our info on Vetsulin. Since you've been using the board, I'm not sure if you've seen the dosing guidelines. The one thing that stands out on Kit's spreadsheet is that we adjust doses far more often that what you're vet has been recommending. I would also strongly encourage you to test at least 4 times per day. You want to keep testing at AMPS and PMPS. It's also important to get at least one test during both the AM and PM cycles. The other down side of Vetsulin is that it can cause blood glucose numbers to drop hard and fast. If you're not getting any tests during the cycle, you may miss the need for a dose reduction since numbers can bounce back to high levels after a drop. My cat was notorious for starting a cycle in the 400s, dropping to the 40s, and then being back in the 400s by shot time. If I hadn't been a testaholic, I would have missed the need to reduce her dose.
Click to expand...
Hi! I brought the Vetsulin issue up to my vet a couple of weeks ago, and he mentioned something about Vetsulin having both a short-term and long-term effect, which went over my head. Then, he mentioned returning to ProZinc after seeing if raising Kit's dosage to 2 units helps bring his numbers down. I just started back to testing 4x a day (after 5 days of the dose increase) to see if there is any difference. I'll update Kit's spreadsheet soon. I'll be looking for those drastic drops as well as any other unusual numbers (with 3 other cats around, his numbers tend to spike up a bit, especially since he has more energy).
Thank You for the info! Even though I have been reading the posts on these threads for a while now (even before becoming a member), it's as if the info coming from everyone here to me and Kit personally makes such a big difference. It's almost as if you are all reminding me of what I already learned from here, only it makes more sense.
Thanks, again...
Kev
 
Bron and Sheba (GA) said:
I can’t see any increase in dose. Have you updated the SS yet?
Click to expand...
Hi! I haven't updated the spreadsheet yet. I will update it tomorrow, as I will have a full 4 BG readings planned for today (I started back testing yesterday, but only got 3 readings. The reason I stopped doing BG readings after the increase was because my vet wanted me to be aware of [and report] any behavioral issues at first). Now, that I'm posting, I'll start updating Kit's spreadsheet more often (before I just logged it in once a week).
Kev
 
Kev B said:
Hi! I haven't updated the spreadsheet yet. I will update it tomorrow, as I will have a full 4 BG readings planned for today (I started back testing yesterday, but only got 3 readings. The reason I stopped doing BG readings after the increase was because my vet wanted me to be aware of [and report] any behavioral issues at first). Now, that I'm posting, I'll start updating Kit's spreadsheet more often (before I just logged it in once a week).
Kev
Click to expand...
I do not believe that behavioral issues are relate to knowing or testing for BG, actually I would assume that since there was a change in dosing your Vet would want to know as well as yourself how he is body is reacting to the new increase, especially after increase a full testing cycle can be safe, and if you happen to come across any issues, without the daily BG cycles on the Spreadsheet is going to be difficult to really know or guide you on how to proceed, this is my suggestion, to me testing , increasing/decreasing dose, and the low carb foods are the most important and have been up to now, I know many, many members here do not have the time or consistency in testing and logging as me, I am fortunate to be home and I have to admit I became an obsessive tester since the beginning, especially when the dose is changed (increased) I spend testing almost every hour give or take, he is on ProZinc as well. I admire you; I wish I would have been as calm as you when I started this journey with Corky, I was loosing my mind, if it wasn't for this
Forum I do not know if Corky would still be with me, financially I cannot in any form afford Vet visits, and this Forum has been there, now mind you, Corky is an excellent health as well, You are going to be great I see you have all of this in control! You Got This!:bighug::bighug::cat::cat:
 
Hi, Y'all!
I updated Kit's spreadsheet. The vet wanted me to observe his behavior because of my concerns that Kit went into DKA even though his BG numbers seemed fine. I was certain that it had to be something I did or did not do, or notice, or pay enough attention to because I thought everything was fine based on his BG numbers. I missed that he wasn't urinating, which is how he became so severely dehydrated that two different vets said he had to go into the hospital immediately or he would die (Corky, as much as I'd like to say I was level-headed and calm during this, I cannot say that. I was a laser-focused, seething brick that refused to shed a tear until this was resolved. I had my lovebug's life dangling between my empty wallet and a $5000 MINIMUM vet bill and I was acceptably defiant and damned determined to keep him alive if I had to spit in his mouth to do it. I was on the phone talking to one clinic while driving to another. I was trying to remember where I put my car title for a quick loan while constantly repeating to myself there's a way there's a way there's a way. I was trying to remember if anyone owed me money, or who I could borrow from. At one point I had one hand on Kit, the other on the phone and my knee on the steering wheel. And after all of that I am so happy to just be able to say, "I just updated Kit's spreadsheet").
And, yes, I told all that to Kit's new vet. Fortunately, he agreed to first try the subcutaneous fluid route (the other vets said it wouldn't work), and we would take it step-by-step. Then I would feed him with a syringe until he could eat on his own. After that, I knew absolutely I would need all of you more than ever.
And here we are.
(Again, Thank You Thank You Thank You)

Also, I was able to (finally!) get a Ketone reading. It's a color-coded results chart, and his test strip was between colors denoting "negative" and "trace", which numerically translates to somewhere between 0-5 mg/dL. He urinates frequently (he loves his Pedialyte), his energy levels are up, and he eats two to four 5.5oz cans of food a day. Looking at his chart, I can see where he was rough-housing with my other little loves, and I think I might have to go draconian on him for one day just to get a realistic BG curve reading (isolating him for a day and testing without interference). I give an update on Kit's progress to his vet later today to find out where he thinks we should go from here.

Thanks for keeping up with us! Y'all are absolutely wonderful...

Kit & Kev
 
Kev B said:
Hi, Y'all!
I updated Kit's spreadsheet. The vet wanted me to observe his behavior because of my concerns that Kit went into DKA even though his BG numbers seemed fine. I was certain that it had to be something I did or did not do, or notice, or pay enough attention to because I thought everything was fine based on his BG numbers. I missed that he wasn't urinating, which is how he became so severely dehydrated that two different vets said he had to go into the hospital immediately or he would die (Corky, as much as I'd like to say I was level-headed and calm during this, I cannot say that. I was a laser-focused, seething brick that refused to shed a tear until this was resolved. I had my lovebug's life dangling between my empty wallet and a $5000 MINIMUM vet bill and I was acceptably defiant and damned determined to keep him alive if I had to spit in his mouth to do it. I was on the phone talking to one clinic while driving to another. I was trying to remember where I put my car title for a quick loan while constantly repeating to myself there's a way there's a way there's a way. I was trying to remember if anyone owed me money, or who I could borrow from. At one point I had one hand on Kit, the other on the phone and my knee on the steering wheel. And after all of that I am so happy to just be able to say, "I just updated Kit's spreadsheet").
And, yes, I told all that to Kit's new vet. Fortunately, he agreed to first try the subcutaneous fluid route (the other vets said it wouldn't work), and we would take it step-by-step. Then I would feed him with a syringe until he could eat on his own. After that, I knew absolutely I would need all of you more than ever.
And here we are.
(Again, Thank You Thank You Thank You)

Also, I was able to (finally!) get a Ketone reading. It's a color-coded results chart, and his test strip was between colors denoting "negative" and "trace", which numerically translates to somewhere between 0-5 mg/dL. He urinates frequently (he loves his Pedialyte), his energy levels are up, and he eats two to four 5.5oz cans of food a day. Looking at his chart, I can see where he was rough-housing with my other little loves, and I think I might have to go draconian on him for one day just to get a realistic BG curve reading (isolating him for a day and testing without interference). I give an update on Kit's progress to his vet later today to find out where he thinks we should go from here.

Thanks for keeping up with us! Y'all are absolutely wonderful...

Kit & Kev
Click to expand...

Kev I sympathize with you in every way on how overwhelming all this can be especially financially, I also had to emptied my savings and pawned some jewelry, Corky stayed hospitalized for 8 days $10,000. later, I was able to reach out in this forum though to a Foundation called DCIN, they have been supplying me with all the supplies, including the insulin, they are amazing, my suggestions is to make sure your Vet is actually well schooled on Feline Diabetes, most Vets are not so they treat the cat the same way they treat a dog, and when they see us so impatient and eager and desperate, sometimes they do not act in good faith, I trust this Forum blindly, Corky has not stepped foot in a Vet since he left the hospital, then again every cat is different, but his Vet for 10 years, really let me down,(by experience) I saw the SS and noticed high numbers even on 2u of ProZinc, I am not an expert on ProZinc by all means, but this is the insulin I use as well, if you could test a few more times after shooting to be able to see what actually happens after the dose, also are you sure the syringe is actually going inside, sometimes we get what we call Fur Shots, the numbers should at least go down after +3 significantly, see the link on shooting below and you may email the DCIN Foundation as request help, they will guide you along the way on how to do so, I was told by the members, to take a step back, breath in and breath out, and to realize that all my anxiety I was transferring it to Corky, cats really feel our anxiety, and that was not good, I needed to relax:bighug::cat::cat: I am also tagging a ProZinc expert for you
@Suzanne & Darcy

DCIN gmail is Isabelledavenport@gmail.com she will be able to guide you thru the process, let her know that Corky's mom Maria send you. she might be able to help you Good Luck!

https://www.felinediabetes.com/FDMB/threads/how-to-shoot-your-cat.290439/
 
Last edited:
CORKY said:
Kev I sympathize with you in every way on how overwhelming all this can be especially financially, I also had to emptied my savings and pawned some jewelry, Corky stayed hospitalized for 8 days $10,000. later, I was able to reach out in this forum though to a Foundation called DCIN, they have been supplying me with all the supplies, including the insulin, they are amazing, my suggestions is to make sure your Vet is actually well schooled on Feline Diabetes, most Vets are not so they treat the cat the same way they treat a dog, and when they see us so impatient and eager and desperate, sometimes they do not act in good faith, I trust this Forum blindly, Corky has not stepped foot in a Vet since he left the hospital, then again every cat is different, but his Vet for 10 years, really let me down,(by experience) I saw the SS and noticed high numbers even on 2u of ProZinc, I am not an expert on ProZinc by all means, but this is the insulin I use as well, if you could test a few more times after shooting to be able to see what actually happens after the dose, also are you sure the syringe is actually going inside, sometimes we get what we call Fur Shots, the numbers should at least go down after +3 significantly, see the link on shooting below and you may email the DCIN Foundation as request help, they will guide you along the way on how to do so, I was told by the members, to take a step back, breath in and breath out, and to realize that all my anxiety I was transferring it to Corky, cats really feel our anxiety, and that was not good, I needed to relax:bighug::cat::cat: I am also tagging a ProZinc expert for you
@Suzanne & Darcy

DCIN gmail is Isabelledavenport@gmail.com she will be able to guide you thru the process, let her know that Corky's mom Maria send you. she might be able to help you Good Luck!

https://www.felinediabetes.com/FDMB/threads/how-to-shoot-your-cat.290439/
Click to expand...
Hi, Maria!!

Thank you for that info! This is one more reason I am so grateful I have found this forum; I can't really think of anyplace else anyone could possibly relate to this kind of experience! Also, I am so glad to know that Corky is doing well and that, one day, it will be me and Kit's story, too! I literally asked potential vets on the phone if they were "good at" feline diabetes! As crass and to-the-point as that sounds, I just felt that time was NOT on my side and I went with the first vet that would do the subcutaneous fluids. It was blind faith and recklessness. Every once in a while, I look at Kit and it floors me to think how differently it all could have gone.

I was hoping I would see better numbers with the increase in dosage, but I'm not seeing it. I have only had one "half" Fur Shot because Kit flinched, but I was able to see the insulin on his fur. Every other time it has been solid. This brings me back to wondering if he's getting immune to the insulin, if he needs more, if the insulin is still effective, can his diet be better... So many variables to consider.

When I talk to my vet, the idea of going back to ProZinc is definitely on the table, so I should know more this afternoon. I'll post an update as soon as I can.

Kit & Kev
 
Hi, Y'all!
Question: I have just increased Kit's Vetsulin dosage to 3 units (PM shot only) while maintaining a 2-unit AM shot for a week. Shouldn't I be seeing a decrease in the AM and PM BG levels by now if these dosages are working? I understand the importance of checking his BG levels at different times of the day (for nadir identification), but shouldn't his "resting" BG numbers be decreasing as well? His diet is stable, his energy levels are still high, his appetite is relatively the same, but I'm not seeing anything dramatic happening in his BG numbers. His Ketone levels are negative as well.
I've been reading through the suggested links and I'm finding great info and experiences, but it still seems to be ECID stories about dramatic instances where things became clear and stable. I've also read stories of hypoglycemia being the "aha" point at which a stabilizing dosage amount has been reached.
My vet keeps saying that after a "two-week period" of making a change is the point at which major decisions should be made. Does that sound familiar to anyone?
I get the feeling that I'm getting stuck in a "no news is good news" slump. My hope is that Kit can reach remission and maintain a healthy diet-based, non-insulin life. It has been a little over 4 months and an episode of DKA, and my vet doesn't think that scenario is likely to happen. I'm okay with a situation like that if there are no other options. So, any ideas on how to proceed from this point? This week I start randomly testing Kit's BG levels for any significant movement in the numbers (maybe the insulin is no longer effective), but I still think the answer is in the "resting" AM/PM numbers.
Any thoughts?

Kit & Kev
 
Kev B said:
Hi, Y'all!
Question: I have just increased Kit's Vetsulin dosage to 3 units (PM shot only) while maintaining a 2-unit AM shot for a week. Shouldn't I be seeing a decrease in the AM and PM BG levels by now if these dosages are working? I understand the importance of checking his BG levels at different times of the day (for nadir identification), but shouldn't his "resting" BG numbers be decreasing as well? His diet is stable, his energy levels are still high, his appetite is relatively the same, but I'm not seeing anything dramatic happening in his BG numbers. His Ketone levels are negative as well.
I've been reading through the suggested links and I'm finding great info and experiences, but it still seems to be ECID stories about dramatic instances where things became clear and stable. I've also read stories of hypoglycemia being the "aha" point at which a stabilizing dosage amount has been reached.
My vet keeps saying that after a "two-week period" of making a change is the point at which major decisions should be made. Does that sound familiar to anyone?
I get the feeling that I'm getting stuck in a "no news is good news" slump. My hope is that Kit can reach remission and maintain a healthy diet-based, non-insulin life. It has been a little over 4 months and an episode of DKA, and my vet doesn't think that scenario is likely to happen. I'm okay with a situation like that if there are no other options. So, any ideas on how to proceed from this point? This week I start randomly testing Kit's BG levels for any significant movement in the numbers (maybe the insulin is no longer effective), but I still think the answer is in the "resting" AM/PM numbers.
Any thoughts?

Kit & Kev
Click to expand...
@Bron and Sheba (GA)
@Suzanne & Darcy
@Sienne and Gabby (GA)
 
I would mention again that a 1.0u increase, especially with Vetsulin, is not a great idea. It's even less of a good idea given that you're not getting PM cycle tests. You have no idea if Kit's numbers are dropping and bouncing back up by AMPS. Bounces may not resolve for several days. I linked our dosing guidelines for Vetsulin in my previous post (#12).

There are a number of things your vet has suggested that I've never heard before and have no idea what he's referring to. Given that your vet has been suggesting dose increases that are 4 times larger than what we recommend, we clearly have a different approach. One of the big issues with large dose increases is that you can sail past what would be a good dose and end up with numbers staying higher than what you would expect.

I also am not clear on what you mean by "resting" AM/PM numbers.

My best recommendation is to follow the dosing methods we use.
 
Kev, I totally agree with Sienne.
I was alarmed to see the vet had suggested increasing the pm dose to 3 units, with no testing during the cycles. That is risking Kit having a hypo event, and if it is at night, you would not even be around to help him.
At the moment you have no idea how low these doses are taking Kit. He could be dropping really low overnight and you have no idea at all. With vetsulin it is common to see high preshots because the insulin does not last 12 hours.
Please get some testing in during every cycle. Even 1 test each cycle will tell us a lot. Around 4 hours after the insulin is giving is a good place to start. These mid cycle tests need to be done consistently because if Kit is bouncing after dropping really low, you might see three days of high numbers and think he needs a dose increase, when in fact, the dose needs to be reduced.
Here is information 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).
Sienne has given you a link to the vetsulin dosing method in post 12. I would really recommend you follow that dosing method to keep Kit safe. I’m sure your vet is good but I do question if he knows much about feline diabetes.
I’m going to tag @Suzanne & Darcy again as she is a vetsulin user.
 
Sienne and Gabby (GA) said:
I would mention again that a 1.0u increase, especially with Vetsulin, is not a great idea. It's even less of a good idea given that you're not getting PM cycle tests. You have no idea if Kit's numbers are dropping and bouncing back up by AMPS. Bounces may not resolve for several days. I linked our dosing guidelines for Vetsulin in my previous post (#12).

There are a number of things your vet has suggested that I've never heard before and have no idea what he's referring to. Given that your vet has been suggesting dose increases that are 4 times larger than what we recommend, we clearly have a different approach. One of the big issues with large dose increases is that you can sail past what would be a good dose and end up with numbers staying higher than what you would expect.

I also am not clear on what you mean by "resting" AM/PM numbers.

My best recommendation is to follow the dosing methods we use.
Click to expand...
Hi, Y'all!

I checked the links and they were all filled with great info! I also had reservations about the large dose increases, and on one occasion reduced it just because I felt uncomfortable with it. I let my vet know and he basically said to make sure that I keep an eye on him for at least 4 hours after giving the increase for the first time. Again, observation was stressed.
My issue is that I am not seeing any changes in his BG levels. The goal is around 200 for his AM/PM Pre-shot levels, but he has been in a holding pattern around 350 for weeks now, regardless of his dosage. It just seems logical that there should be more than minor variations in his BG numbers considering the doses he's being given and the length of time he maintains those amounts. But I'm not seeing anything significant. I also think that there would be a pattern of "bouncing" if that was happening, even if it's in his behavior. So far, he has been energetic, hungry, playful and clear-eyed with no signs of unusual behavior. I even thought maybe his insulin was losing potency, but that should cause a rise in his BG levels, so I ruled that out. His numbers just seemed stalled.
I'm thinking it might be time to do a curve chart, but I'd have to isolate him for a day for 3-hour BG level checks. Is that too severe? After reading the info on Vetsulin his Nadir should appear around +4. I've been checking him around +3, but only during the day. I'll start tracking his PM numbers tonight as well, to get a better idea of what his numbers look like after his 3-unit shot.
I've also been checking out the remission stories on here, and it seems that all of the charts show a dramatic decrease in BG numbers over a short period of time. After Kit's initial diagnosis in June, I thought that pattern was happening. Then, everything changed so suddenly with his DKA diagnosis. Now, with his numbers stalling at a little over 4 months, I'm thinking that maybe maintenance is a more realistic goal. I've also read that a turning point tends to be an episode of Hypoglycemia, which I was hoping to avoid.
Oh, I also thought it best to stop giving him the veggies with his meals. I don't think they were making a difference either way, though.
I'll keep testing and posting, so hopefully someone will be able to see something I'm missing.
Let us know what you think!! Thank You!

Kit & Kev
 
Hi Kev,
Unless you are doing tests during the cycles, you are not going to be able to see if Kit is making progress, especially with vetsulin. All you are seeing are the preshot numbers which are going to be high because you are using vetsulin which doesn’t last 12 hours.

Why do you have to isolate Kit to do a curve. You don’t have to stop feeding him at any time during the curve. Just feed as normal.
You probably won’t see anything in his behaviour with bouncing unless it is very low numbers…and cats can bounce from higher then low numbers when they are only used to high numbers.
Re remission…the first goal is to get a cat regulated. And not all cats go into remission quickly. Some lucky ones do but most take much longer. And the ones that do…the caregiver has been following our dosing methods.
 
We generally suggest that you test every 2 hours for a 12 hour period for a curve. If you test every 3 hours, the curve should be 18 hours. I can't think of the last time someone did a 3-hour curve.

Not all cats achieve remission and the pattern is quite variable. There have been members whose cats went into remission after 2 years vs 2 months.

I would not rely solely on observational data to determine if Kit is bouncing. I never saw a change in Gabby's behavior with a bounce. As Bron noted, pre-shot data will not give you the full picture. Vetsulin wears off well before 12 hours so the pre-shot numbers will tend to be high. I'm also concerned that you're dosing 2.0u in the AM and 3.0u at PM. We keep doses consistent at each shot time unless a dose change is indicated.
 
Hi, Y'all!

Thanks for the advice! I'm thinking that I am at a fork in the road here: Do I stick with the 2-unit AM/3-unit PM dosage and check every 3 hours over an 18-hour period (giving BG levels after both dose amounts), or do I stick with the same dosage (2 units) and check every 2 hours over a 12-hour period? His feeding schedule would stay the same, and the isolation is so that he doesn't get higher BG readings from playing with the other cats during the testing period. My vet wants me to stick with the dosage for another week with the BG monitoring.
Also, I haven't found anything on the boards that indicate this, but my vet said that Vetsulin is both a short and long-term acting insulin. He says that initially it acts harshly (reaches the nadir quickly), but then gradually wears off over a longer period of time. The long-term insulins take longer to nadir, then climb back up, hence the graph "curve". Any truth to this?
Thanks for sticking with this! It's like a rabbit hole!

Kit & Kev
 
Hi, Sienne! Hi, Y'all!
Thanks for the info! I read this: "In diabetic cats, the peak activity following subcutaneous administration of vetsulin® occurs between 1.5 and 8 hours, and the duration of activity varies between 8 and 12 hours."
Isn't that 1 relatively fast peak with a slower ending per 12 hour "cycle"? Maybe that's what he was talking about. Regardless, I'm still not seeing the movement toward a 200 BG level, and it scares me to go above 3 units of any insulin. I know that I have not seen the BG numbers with Vetsulin that I was seeing with ProZinc. Is it just better to try a different insulin from those? Or...
Has anyone tried resetting the whole process? I think this is what happens when someone goes OTJ, correct? I only thought something was wrong with Kit when he lost so much weight. It wasn't until I took him in for testing that we found out about his diabetic condition. Now, his weight and appetite are good, and his behavior is normal, as if nothing was wrong at all. If I go OTJ for a week and monitor Kit with my glucose meter and ketone strips, would I be able to restart his treatment? After the week, I could start with the .25 or .5 and monitor from there? Of course, I'll pass this by my vet before doing anything like this, but I want to know if anyone has thoughts or experience in this. Maybe I'm just frustrated and grasping, but if it has any merit at all I'd be willing to try.

Thanks!

Kit & Kev
 
Hi Kev,
Please do not stop insulin for a week. Kit needs insulin. Stopping insulin will cause other problems which will not be good for Kit.
‘Resetting’ does not work.
I would go back and reread all we have said. Treating a diabetic cat is a journey not a race and it takes patience on your part ( we all had to learn that)
I would recommend you think about swapping back to Prozinc or swap to Lantus. They are much better insulins for cats. We have dosing methods for all insulins and that is the best way forward in my opinion

But please do not stop insulin or try and reset the dose. There is no such thing… I don’t know who made that up but it is a dangerous move to do that with diabetic cats.
 
Bron and Sheba (GA) said:
Hi Kev,
Please do not stop insulin for a week. Kit needs insulin. Stopping insulin will cause other problems which will not be good for Kit.
‘Resetting’ does not work.
I would go back and reread all we have said. Treating a diabetic cat is a journey not a race and it takes patience on your part ( we all had to learn that)
I would recommend you think about swapping back to Prozinc or swap to Lantus. They are much better insulins for cats. We have dosing methods for all insulins and that is the best way forward in my opinion

But please do not stop insulin or try and reset the dose. There is no such thing… I don’t know who made that up but it is a dangerous move to do that with diabetic cats.
Click to expand...
Hi, Bron & Sheba!
Thanks for the input! The idea was mine. I got it from reading charts where the cats went OTJ, but all those cats had already reached normal levels during insulin therapy. Kit is nowhere near that, but I wanted to ask on the off-chance that it could be possible. Realistically, the necessary conditions just haven't been reached yet. So, I'm still trying to find a reason for the stall in BG numbers after this much time. It has been mentioned before that I might be missing the nadir because it comes on quickly, and that it is possible that a "Somogyi effect" has happened without my knowing it: Kit's BG levels dropped so low so quickly that his body defensively responded by producing more glucose, which "bounces" his numbers back up. My vet actually mentioned that a few weeks ago, but nothing really came of it. Oddly, the "Somogyi effect" happens when too much insulin is being used. So, the "resetting" back to lower doses seemed like the best thing to do. This is also why I pass things by you all so I don't get too deep into the rabbit hole. Thank you, again.
I have this week left on this current protocol. After that, I think these numbers will be enough reason to go back to ProZinc, because I just can't feel good about even thinking of giving Kit more than 3 units of any insulin.
I'll keep updating.

Kit & Kev
 
There is actually no such thing as the Somogyi effect in cats. There is bouncing.
If you swapped to one of the long lasting insulin such as Prozinc or Lantus, I think you would see better numbers.
Following one of the dosing methods takes the guesswork out of it.
It is possible he has just not reached the best dose for him yet. Only time and taking the BGs will tell us that. He may need more than 3 units of insulin. If he does, there is no need for you to be concerned. Every cat is different and they all have different needs. Some cats need more insulin than others.
I would encourage you to keep posting here and let us help you help Kit.:)
 
Hi, Y'all!
Today was the last day of the 2-week testing period for the dose increase of Vetsulin for Kit. Since the BG numbers were generally flat for the 2-week duration of the 2-unit AM dose/3-unit PM dose, my vet suggested a final 3-weeks of a 3-unit dose for both AM and PM, then a Fructosamine test to determine if it's time to abandon Vetsulin.
I expressed my concerns about the unchanging BG numbers and suggested switching to ProZinc as long as it wouldn't put Kit's health in jeopardy. My vet reassured me and said that, as long as I monitored Kit closely after the change, Kit should be fine. He recommended a starting dose of 2-units for both AM and PM shots with the BG tests. He said that if the hoped-for reduction in numbers starts showing, then we made the correct adjustment and it will be reflected in the Fructosamine test results (we're going for around 250. His last test was 487, down from 608 the previous 6 weeks). If not, we'll know that we have to make an adjustment in the dose size, but the insulin will be less harsh.
I think I'll start the change on Monday. Until then, I'm looking through more posts and spreadsheets. I've noticed on some spreadsheets that it seems as if a "curve" is taken every day. I've been reading that a "curve" needs to be taken only once a week, and then only after a change in dose amount. Any advice on this new first week of ProZinc for Kit? After so much info in the last couple of weeks, I want to be as clear as possible about the next steps we'll be taking.

Thank You, Thank You, Thank You...

Kit & Kev
 
Hi Kev,
I’m glad you are swapping to prozinc. Can you draw a line in the spreadsheet when you swap so we can see easily where the change over is thank you.
There is no need to get a fructosamine test test done now that you are home testing. It is a waste of money and the vet should be able to see at a glance if the insulin is at the right dose or not.
With prozinc, you don’t have to wait after feeding to give the dose of insulin.so you test, feed and shoot one after the other with no waiting time in between.
Here is a link to the PROZINC DOSING METHOD and the PROZINC BASICS
I’m going to tag @Suzanne & Darcy as she is a prozinc user.
Please keep posting as we are very interested in now Kit goes on prozinc.
 
Hi, Bron!
Thanks for the quick response! I'm glad Kit is going back on ProZinc, too. I just feel better. I was looking over his spreadsheet and his numbers were so much better then. After his DKA diagnosis, all the literature I read indicated that he had to go on a short-acting insulin to stabilize, which is why the Vetsulin came in. However, I'm not sure about the Fructosamine test being unnecessary; his DKA happened within a 24-hour period, but his BG levels prior to that were acceptable. His Fructosamine level, however, was way off the chart at 608 (while on ProZinc). The test gives a "snapshot" of the prior few weeks (it was only 6 weeks since his FD diagnosis), but his BG levels didn't indicate any issues at all. After using the Vetsulin, his latest Fructosamine test dropped a bit over 100 points (to 487), but his BG levels seemed to stall around an average of 350.
The hope here is that with ProZinc, his BG levels will drop significantly (<200) and continually improve over time, and his Fructosamine level will drop below 350. Also, observation will be a major component; had I paid more attention, I would have noticed his lack of urination/water intake which led to his severe dehydration. Then, I'm certain his infection could have been caught sooner, avoiding the whole DKA nightmare.
Thanks for the ProZinc links. I have been reading through them thoroughly with much more intensity than before, and I'm looking forward to the "slow" method.
I will definitely give a delineation/explanation line when I start using the Prozinc. I'm looking forward to seeing positive BG changes within the first few cycles (actually, I neeeeed to see positive BG changes)!
Thank you for being here for us. I truly am grateful...

Kit & Kev
 
Suzanne & Darcy said:
I will be happy to help you with the ProZinc.
Click to expand...
Hi, Suzanne!

Thank You for responding!

In a nutshell:

As you know, I am about to start Kit back on Prozinc after about two months of Vetsulin (after his DKA diagnosis). I have so many questions, but I'm wondering if I should start a new thread with you or keep this one (until 50 posts? I read that somewhere...). My plan (my vets recommendation) is to start Kit with 2 units of Prozinc for both AM and PM doses.
I've read the stickies about Prozinc protocol, and I still have many questions about those procedures.
I plan on starting him tomorrow, 11/11/24.
Any advice, recommendations, suggestions or insights you have for me/us will be very appreciated (you are highly recommended!).
I look forward to hearing from you!!

Thank You!!

Kit & Kev
 
I think it will be safe to start at 2 units, although it may not be enough. What time zone are you in and what is your shot time? Are you testing for ketones?
 
Suzanne & Darcy said:
Pedialyte has sugar in it (dextrose) is he still getting that? It will raise his BG.
Click to expand...
Hi, Suzanne!

I am in Texas, Central Standard Time. He received his first 2 units of Prozinc at 6:30am. I noticed a couple of weeks ago he started drinking less of the Pedialyte. I assumed it was because he was drinking more bowl water on his own, so he didn't need it as much (after the DKA diagnosis and subcutaneous fluid therapy, it was imperative that he continued getting certain nutrients. So, I syringe fed him with Pedialyte, but I should have stopped giving it to him after he stabilized). I didn't even think of the dextrose playing a significant part in his BG levels. To my vet's credit, he did tell me that it was unnecessary to continue giving it to him. However, I was also using it as a way to curb his hunger between feedings. Do you suggest I just use plain water and freeze-dried snacks instead (he seems to like the syringe for some reason)?

So, that's where I am so far, and it's only been an hour since his first AM shot. According to the Prozinc protocol, I'm keeping an eagle-eye on him for the next 6 cycles (I'm on vacation!? lol...). What do you recommend his BG testing frequency be at this starting point (he's already had his AMPS reading)?

Thank You so very much for helping us with this, Suzanne! Thank You!!!

Kit & Kev
 
What is his current diet and what is his feeding schedule/when are you giving the snacks/mini meals during the cycle? Please forgive me if you stated this somewhere above in this thread. I have read some of it, but haven’t read all of it yet.

I asked above about ketones. Do you have a blood ketone meter or urine test strips? After my boy’s DKA and week in the hospital, I bought a Nova Max Plus blood ketone meter to make it easy to track ketones. I didn’t want to have to stalk him to the litter box (plus I have other cats and it was going to be unlikely I would catch him in time on a daily basis.) I made a column on my spreadsheet to record a his ketone numbers.
 
@Kev B
Hi Kevin. If you are going to follow the SLGS method please add that to your signature and spreadsheet up top:cat: Also add what food you are feeding to your signature and after you have started Prozinc on your signature can you put 11-11-24
 
Hi, Suzanne!

I just updated his spreadsheet. I've noticed since my last post that he looks a little less energetic than usual and refused the syringe of Pedialyte but ate the treats. That hasn't happened before. I'm trying not to blow every little thing out of proportion, but I will feel better after he eats his dinner. I was able to get his Ketone reading, and it was normal (negative/trace) His next BG test is at about 6pm, right before I feed him. His next shot will be 2 units at 6:30 (he's usually good about them and rarely gives me any trouble). At this stage, I'm not expecting to see major drops, but I still have my hypo kit handy. When do you think I will start seeing changes in his BG levels? I'm not rally expecting anything the first few days, but I am keeping a lookout for any changes in his behavior (like earlier).

I'll test him a couple more times tonight and post them.

Thanks again for helping us!

Kit & Kev
 
Suzanne & Darcy said:
What is his current diet and what is his feeding schedule/when are you giving the snacks/mini meals during the cycle? Please forgive me if you stated this somewhere above in this thread. I have read some of it, but haven’t read all of it yet.

I asked above about ketones. Do you have a blood ketone meter or urine test strips? After my boy’s DKA and week in the hospital, I bought a Nova Max Plus blood ketone meter to make it easy to track ketones. I didn’t want to have to stalk him to the litter box (plus I have other cats and it was going to be unlikely I would catch him in time on a daily basis.) I made a column on my spreadsheet to record a his ketone numbers.
Click to expand...
Hi, Suzanne!
He gets fed canned wet only, 9Lives Pate, variety, at 6am and 6pm every day. snacks are at 3pm and 8pm, and is usually freeze-dried chicken treats, a syringe of pedialyte, or a couple (or 3) of temptation treats.
His shots are given at 6:30, AM and PM.
I use the urine strips. I keep a small cup next to each litterbox. When I catch him peeing, I grab the cup and get a sample! The only thing is that the results are color-coded, so I match the strip sample to the control colors on the box.
Please ask me any questions. I will write them over and over for You. Promise.

Kit & Kev
 
Status
Not open for further replies.
Back
Top