New Member - Stormy AKA Pretty - Diag DM 2025-01-02

Stormy AKA Pretty

New Member
Greetings and salutations. My name is Mathias. I've discovered your community throughout various search engines particularly on the topic of feline diabetes mellitus. I recognize there are many guidelines on how and where to post, the acronyms used, posting new thread with the required subject format, creating a spreadsheet, etc. I ask for your patience while I become accustomed to these. :)

We have an almost 7 y/o indoor female dilute calico named Stormy (I call her Pretty) weighing in at 12.15lbs currently (she's quite a long and tall cat). She was diagnosed on 2 January 2025. What led up to her diagnosis were a variety of behavioral changes which included increased thirst, weight loss, extreme hunger, loss all interest in play, accidents directly outside her litter box, rarely sleeping with us, etc. She loafs on a kitchen chair with a bird's eye view of her food dish and runs to greet (turn meow-a-saurus) one of us whenever we walk throughout areas closest to the kitchen or harass us during her bouts of extreme hunger. When she was first diagnosed she wouldn't wake us up in the middle of the night for food and waited until the usual 6:00AM wake up call. Now, she's waking us up as early at 3:30AM with meows and cries for food.

Prior to diagnosis, her meals were a mixture of Purina dry food and Purina Fancy Feast wet food. She casually grazed with the dry and had a can or two of wet. She absolutely love experimenting with new canned foods. We introduced some new healthier options into the rotation from manufacturers like "Cats in the kitchen, Fussie Cat". She weighed in between 17-18lbs (2 lbs more than when we first adopted her). We gradually (shame on us :( ) introduced table scraps such as low sodium potato chips cos she likes the crunch, pieces of chicharron (she goes MENTAL when she smells it! LOL ). In the summer of 2024 we switched her over to wet only and this is when we started to notice the changes.

Wet food feeding: [2] cans of 3oz food breaking them up into 4 meals throughout the day.
She doesn't/can't tolerate a [2] meal a day w/ snacks throughout the day.

The day of her diagnosis she was put on Senvelgo. Three days later she began having constant bloody diarrhea. Specimen collection results all clear; no ketones or parasites. Our vet had put her on metronitizole (sp?) for two weeks to help with her toileting. Initially I thought it was because I had fed her some chicharron that caused all this as we'd given it to her before with no issues. A couple of days after she finished her meds the symptoms came back. Took her to an ER VET, full blood panel, ultrasound show healthy w/ elevated liver enzymes. She got put back on metro... and changed her diet to a gastrointestinal wet food to help with her toileting. Again when the meds finished, diarrhea returned. One month into being on Senvelgo and having given her one of the Fussie Cat wet cans she likes, she vomited quite a bit the next morning. Yet, the day before when I fed her that can, her mood changed as if she were back to herself somewhat. Sleeping on her perches, resting quite fine without running down the stairs when she heard one of us in the kitchen. It was a remarkable turn around. During this time we did not monitor her sugar with a glucometer.

Reading the information leaflet that came with the Senvelgo, she presented the symptoms for a cat who is not suitable for the medication. We notified our vet and made the transition to Lantus insulin once she presented hyperglycemia. From here is when we began using a glucometer. Started off with 1 unit every 12 hours and only checked her BG AMPS 1 hour after a meal.

Her BG is always in the 300s with some rarity being in the high 200s. Under vet advisement, we continued increasing the dose up to 2 units yet this did not help with her BG.

Current wet food: Purina Dietetic DM 5.25oz cans broken into [4] meals a day.
Additions to her food: Lettuce (LOVE IT!), fish flakes, and most recently cooked plain chicken.

She now sees a specialist in internal medicine, switched from metro...to Tylosin powder (diarrhea) and is now up to 4 units. Once that Tylosin ran out, the diarrhea was gone! Amazing...! I fed her chicharron on a day when I was emotional cos of her hunger pains and the next day the bloody diarrhea returned and now she's back on the Tylosin until her toileting returns normal. She will no longer be fed that.

Her BG is still over 300 daily, her hunger is non-stop, and I'm at a breaking point where I just don't know what to do to 1) get her BG under 200 2) make her feel comfortable, healthy 3) encourage play. I humbly ask for the communities help because I feel what we've gone through and tried just isn't working.
 
Welcome!!!

I saw that Stormy used to eat Fancy Feast. You are better off with the FF Classic Pates than the DM. Many of our members use the FF Classic Pates. The Purina Dietetic DM isn't great quality and not specific to diabetes. Most members here do not use the "prescription" foods. They're expensive and don't provide value above commercially available low carb foods. Here is a helpful website on feline nutrition that's authored by a vet. This is the link to a chart that lists most of the canned cat foods available in the US along with their nutritional information including carbohydrates. Most members feed their cat a variety that's in the 5% neighborhood, although we consider under 10% low carb.
 
I also see that you are testing BG at home, that's great! What kind of meter are you using?
We test before every insulin shot (so we know that it is safe to shoot), and we also try to get some BG values between shots. This gives us valuable information about how low the insulin is taking the BG and helps to avoid dangerous hypos.

Stormy needs a spreadsheet so that we can help you! Here are the instructions for making your spreadsheet. Copy the spreadsheet template that matches your meter.
 
Current wet food: Purina Dietetic DM
Regarding Pro Plan Veterinary Diet DM is actually listed on Dr. Pierson’s spreadsheet, with 6% calories from carbs.
Even though it's low carb there is no reason to feed that , nothing special about it except the price.
Kobe's Mom Lesley gave you the link to the food chart above .
Most st feed Fancy Feast Classic Pates or Friskies Pates
 
Welcome!!!

I saw that Stormy used to eat Fancy Feast. You are better off with the FF Classic Pates than the DM. Many of our members use the FF Classic Pates. The Purina Dietetic DM isn't great quality and not specific to diabetes. Most members here do not use the "prescription" foods. They're expensive and don't provide value above commercially available low carb foods. Here is a helpful website on feline nutrition that's authored by a vet. This is the link to a chart that lists most of the canned cat foods available in the US along with their nutritional information including carbohydrates. Most members feed their cat a variety that's in the 5% neighborhood, although we consider under 10% low carb.

Bless you, Kobe. :bighug: I completely agree about Purina DM as the primary ingredient is Meat by-products which are the scraps of everything, it has become quite the anchor on the purse and hasn't helped maintain a stable BG. We still have FF grilled...something (it's upstairs, too lazy to walk right now ;) ), but they have soy, wheat gluten, corn and synthetic vitamins I'd like to try and keep out of her diet.

Yes, I've been reading the feline nutrition today. Thank you for sharing.
 
[noticed my direct reply to your post has been flagged for moderator approval]
Bless you, Kobe. :bighug: I completely agree about Purina DM as the primary ingredient is Meat by-products which are the scraps of everything, it has become quite the anchor on the purse and hasn't helped maintain a stable BG. We still have FF grilled...something (it's upstairs, too lazy to walk right now ;) ), but they have soy, wheat gluten, corn and synthetic vitamins I'd like to try and keep out of her diet.

Yes, I've been reading the feline nutrition today. Thank you for sharing.
 
Wet food feeding: [2] cans of 3oz food breaking them up into 4 meals throughout the day.
She doesn't/can't tolerate a [2] meal a day w/ snacks throughout the day.

Her BG is still over 300 daily, her hunger is non-stop, and I'm at a breaking point where I just don't know what to do to 1) get her BG under 200 2) make her feel comfortable, healthy 3) encourage play. I humbly ask for the communities help because I feel what we've gone through and tried just isn't working.

My cat can't do two meals a day like that either. MANY members break up feedings into small meals throughout the day. Some freeze food and leave it out to thaw, others use timed feeders. The small meals are helpful for regulating BG levels. You want to avoid feeding 2 hours before shot so that your Pre-Shot BG value is not affected by meal time.

I am so sorry that this has been so hard for you and Stormy. You probably never wanted to have to join this forum, but you'll be so glad you did. You don't have to do this alone. This forum will help you!!! :bighug::bighug::bighug:
 
@Stormy AKA Pretty

We don't increase the dose of insulin by whole units.
With Lantus are you using the U-100 syringes with the half unit markings since we adjust the dose by 0.25 units at a time.
We adjust the dose by how low the dose is taking them which is called the nadir, the lowest point in the cycle, not the pre shots.

You need to withhold food 2 hours prior to testing the AMPS and the PMPS so it's not influenced by food.
We feed the bigger meal at AMPS and then smaller snacks about 2 teaspoons of the low carb food around @+3, @+5 , same goes for the PMPS cycle.
You said that

Now, she's waking us up as early at 3:30AM with meows and cries for food.
She is hungry because her BG is not regulated
You need to be at AMPS then a few additional tests after that such as get a +3 ( Than means 3 hours after you gave the insulin) and get a test @+6
Same goes for the PMPS .
Try and mix up the testing times
One day get a +2. @ 4 and a +6
Next day a +3. a +5 and a +7
Like filling in the pieces of a puzzle.

You can give her some freeze dried treats also for snacks

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
These are the Syringes you need to be using

  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Levemir, or the Biosimilars from vials, cartridges, and pens.
  • 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.
  • Syringes come in 5/64 inch (6mm), ½ inch (8mm) or 5/16 inch (12.7mm) needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
  • Full and half-unit syringe scales: below you want the ones on the left

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


If you are by a Walmart

Walmart, you can get U100 insulin syringes with half unit marks for $12.58/100.
You need to go into the store to get them
I don't know if you need a vets script though

Either of these 2 boxes are the ones you want (with a purple stripe). You have to go into the store , can't buy them on line
upload_2024-4-22_23-37-23-jpeg.69946





This was posted by a member and copied it for you
If you're going to Walmart, ask for Relion 3/10ml, 31 or 30 gauge insulin syringes. (Don't mention half unit marks because this tends to confuse them and they think you don't know what you want and will try to convince you that you need 1/2ml syringes---you DON'T)

ALL of the 3/10ml Relion syringes at Walmart have half unit marks. Trust me on this. You will want one of these boxes of syringes (the difference is the needle length...blue box are shorter needles than white box but both work fine). As long as the box has the purple stripe, they are the correct syringes.
 
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[noticed my direct reply to your post has been flagged for moderator approval]
Bless you, Kobe. :bighug: I completely agree about Purina DM as the primary ingredient is Meat by-products which are the scraps of everything, it has become quite the anchor on the purse and hasn't helped maintain a stable BG. We still have FF grilled...something (it's upstairs, too lazy to walk right now ;) ), but they have soy, wheat gluten, corn and synthetic vitamins I'd like to try and keep out of her diet.

Yes, I've been reading the feline nutrition today. Thank you for sharing.

I guess you got approved! :woot:
The Fancy Feast Grilled somethings are definately high carb (most around 20% and one 15%). Don't throw them all out. Save them for your Hypo Kit. The FF Classic Pates are low carb.
 
@Stormy AKA Pretty

In your signature you have
Name of your meter?
What is the name of the meter?
Is it a human or pet meter
Almost all of us use human meters, that what our numbers are based on and the test strips are so much more affordable

To add the name of the meter tap on your name up top then tap on signature and add it then tap save

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 17.88 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 on line
 
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Hello and welcome.
I guess you got approved!
Guilty as charged. :p. Sometimes there is a bit of a time delay before things get automatically approved, so one job as a mod is to approve earlier.
Started off with 1 unit every 12 hours and only checked her BG AMPS 1 hour after a meal.
Are you varying when you test now? With insulin (all types), we test before each shot to make sure it's safe, then somewhere in between shots to see how low the insulin dose is taking her. We dose based on those nadirs, or low points. Lantus doesn't onset (start to take effect) until typically 2-3 hours after the shot, so testing 1 hour after the shot she'll likely be high.

Another post for you: New? How You Can Help Us Help You!

Regarding food, the Cats in the Kitchen are a little too high for regular feeding for diabetics. They are mostly what we call medium or high carb foods. Good for bringing a cat out of low numbers, but not as part of the diet. My girl Neko quite liked them. On that feline nutrition site, you'll see this food chart, look for options under 10% carbs. Unfortunately the chart is dated now, and the Fussie Cat has newer options now, some of their old ones were too high in carbs as well.

Another food related topic you might be interested in is an automated feeder. They can be used for dispensing wet food, valuable for when you are out during the day, or want to sleep during the night. The Catmate and Petsafe 5 models are popular ones. Neko loved her friend "Otto"feeder.
 
@Stormy AKA Pretty

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.

Or Weruva Pates
You can try Weruva Pates

low carb/ low phosphorus which is better for the kidneys
if you tap on this link and look at post #32 I listed some Weruva pates for another member that's low carb/ low phosphorus with kitties with CKD
https://felinediabetes.com/FDMB/threads/new-member-11-8-and-i-am-tired.283363/#post-3124085
You can order them on line also


We need you to set up our spreadsheet so you can track Stormy's BG numbers when ever you have a chance
This link will also explain how to use it
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Let us know if you need help setting up the spreadsheet, we have a wonderful member who will be happy to do it for you,
 
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I never fed Fancy Feast, there are lots of commercially available options.

With your comment on diarrhea, you might want to keep track of diarrhea and what types of proteins she's getting before that, to see if there is an allergy to one of them. Fish, beef, chicken are common allergens. Sometimes it's another additive in the food besides the meat. Beware of products with "meat by products" as you don't know what meat you are giving.
 
I also see that you are testing BG at home, that's great! What kind of meter are you using?
We test before every insulin shot (so we know that it is safe to shoot), and we also try to get some BG values between shots. This gives us valuable information about how low the insulin is taking the BG and helps to avoid dangerous hypos.

Stormy needs a spreadsheet so that we can help you! Here are the instructions for making your spreadsheet. Copy the spreadsheet template that matches your meter.

Signature updated with meter, dosing, and spreadsheet
 
@Stormy AKA Pretty

We don't increase the dose of insulin by whole units.
With Lantus are you using the U-100 syringes with the half unit markings since we adjust the dose by 0.25 units at a time.
We adjust the dose by how low the dose is taking them which is called the nadir, the lowest point in the cycle, not the pre shots.

We use Ulticare VetRx U-100 syringes whole unit scale.
Help us understand the lowest point (nadir), not the preshot, please.
 
@Stormy AKA Pretty

In your signature you have
Name of your meter?
What is the name of the meter?
Is it a human or pet meter
Almost all of us use human meters, that what our numbers are based on and the test strips are so much more affordable

To add the name of the meter tap on your name up top then tap on signature and add it then tap save

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 17.88 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 on line

Signature updated :)
 
He didn't!
The sneaky bugger dipped all the way down to 64 on the 26th! He got a reduction in his dose that day.
upload_2025-3-31_22-13-36.jpeg


I couldn't always get mid cycle data, but when I did, it gave me and the people helping me critical info. :woot:
 

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Are you varying when you test now? With insulin (all types), we test before each shot to make sure it's safe, then somewhere in between shots to see how low the insulin dose is taking her. We dose based on those nadirs, or low points. Lantus doesn't onset (start to take effect) until typically 2-3 hours after the shot, so testing 1 hour after the shot she'll likely be high.

Our vet had explicitly told us to feed first, 1 hour later do BG and shoot. I've cared for human diabetics and when I mentioned how this differs, they told me to treat cats and humans separately. No doctor here, so I went with their instructions. This is how we've been checking her with an occasional +5.
Going forward, we're going to AM) AMPS, shoot, feed with +2 +4 +6; PM) PMPS 2 hours before ( in my head -2 ) last meal [includes snack, yes?], shoot, feed, +2 +5. Switch it up as mentioned. :)

I had NO IDEA there was a wet-food automated feeder option! This is definitely a must try! :)
 
We use Ulticare VetRx U-100 syringes whole unit scale.
Help us understand the lowest point (nadir), not the preshot, please.

Check out Kobe's cycle on the 26th again.
upload_2025-3-31_22-19-19.jpeg

His AM PreShot value was 357, on the high side. If you only looked at the PreShot value, you might think Kobe would get more insulin in the PM. Instead, he got a reduction because the 2 units took him all the way down to a nadir (low point) of 64.
SLGS reduces for nadir under 90.

Our dosing methods determine the insulin dose based off the lowest BG of the cycle instead of the preshot value so we keep kitty safe from hypo.
 

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Check out Kobe's cycle on the 26th again.
View attachment 73335
His AM PreShot value was 357, on the high side. If you only looked at the PreShot value, you might think Kobe would get more insulin in the PM. Instead, he got a reduction because the 2 units took him all the way down to a nadir (low point) of 64.
SLGS reduces for nadir under 90.

Our dosing methods determine the insulin dose based off the lowest BG of the cycle instead of the preshot value so we keep kitty safe from hypo.

WOW! That is quite the drop, indeed. It is my goal to get pretty within 180 or lower. The strangest thing is her AMPS PMPS don't seem to change with all the SLGS and her feeding has stayed relatively the same. ECID, am I right? ;) lol
 
WOW! That is quite the drop, indeed. It is my goal to get pretty within 180 or lower. The strangest thing is her AMPS PMPS don't seem to change with all the SLGS and her feeding has stayed relatively the same. ECID, am I right? ;) lol

You are right. Every cat is different. There's a kitty on the Lantus forum that started his OTJ trial today after being diagnosed as diabetic earlier this month. Only been on insulin a couple of weeks. Some cats need insulin for a couple months or years, and some stay on it.

I see you are considering TR. I would have picked that too, but Kobe has had problems with nausea, lack of appetite, and ketones. We couldn't get him to consistently eat enough Low Carb wet food to meet his caloric requirements. Without enough food, he ended up in the hospital because of ketones. So, because Kobe still eats kibbles, we picked SLGS by default. It has worked well for him, though.

I know it looks like there isn't much variability in Stormy's AMPS and PMPS, but she could be hiding a 64 or two of her own somewhere mid cycle. :D
 
Our vet had explicitly told us to feed first, 1 hour later do BG and shoot. I've cared for human diabetics and when I mentioned how this differs, they told me to treat cats and humans separately.
The difference is related to the type of insulin and how it acts in the different species. With the older insulins (not Lantus) you did want to feed and make sure they ate before shooting. Not so much with Lantus. It doesn't onset (start to lower the blood sugar) until typically 2-3 hours after the shot, so you have time to make sure they eat. Plus Lantus is a slower gentler insulin, vs. older ones that drop a cat's numbers hard and fast.
Help us understand the lowest point (nadir), not the preshot, please.
The nadir is the lowest blood glucose (BG) value during a particular cycle, which is the time between one shot and the next. A typical nadir time is +6 or midpoint between shots, but can vary by cat to cat and cycle to cycle. We determine how to change the dose based on how low the dose is taking the cat. Hence the need to see more data in the middle of the cycle. Many cats also go lower at night, so if you can get a test 2-3 hours after the night time shot and before you go to bed, it'll fill in a lot of the picture of what is happening.

Does 4 units seem high?
It's hard to tell with very little data in the middle of the cycle and no PM data. The numbers I do see tell me either Stormy needs more insulin, or Stormy has gone past a good dose and is bouncing to high numbers. If you could do some spot checks mid cycle and those PM cycles for a couple days, we'd get a better picture about what is happening. Here is the definition of 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).

As mentioned before, going up by 1 unit at a time is too much. It'd be good if you can get your hands on some half unit marked syringes. In post #9, Diane linked a bunch of different ones and where to get them. Depending where you live, you may need a prescription for them.
 
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