Oscar 13 just been diagnosed, please help

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Oscar2009, May 18, 2022.

  1. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Hello all,
    First let me say what a wonderful community you have here, it was a great comfort finding the forum when Oscar was diagnosed last week with diabetes.
    Oscar was pacing around looking a bit uncomfortable and was more vocal than normal and peeing a lot, noticably more than usual.
    Oscar has always been quite a vocal cat so i didnt really twig something was off until i noticed that he suddenly seemed to be drinking a lot more water, which was unusual and also peeing more.
    I had also noticed within a short period of time he seemed lighter than usual, i knew something wasnt right.
    So off to the vets we went for a conplete blood test, everything was ok except for the blood glucose level which was 25 mnol/l, we did a urine test and that came back with a high level of glucose in the urine.
    A fructostosamine test was done, the result was 561.
    He weighed 4.1KG at the vets last week and was 4.6KG in 2020 during his last visit.
    So we went back to the vets and were prescribed Caninsulin, 2 units, twice a day.
    Before starting Oscar on the insulin i wanted to get a Glucometer, to get some sort of reference baseline to start from pre insulin, i ordered a GlucoNavii which arrived today.
    Ive just taken a blood test and it gave a reading of 18.3 mnol/l which is still very high but has come down from the 25 from last week.
    Reading the Caninsulin spec sheet it mentions glucose levels of less than 20 mnol/l should start with 1 unit, twice a day and if over 20 mnol/l to use 2 units, twice a day..
    So i guess my question is because the glucose number has come down a bit from 25 to 18.3 should i be giving 2 units twice a day as the vet prescribed or should i start at 1 unit per day? Id rather be cautious at this stage- clearly the vet knows a lot more about this than me but i thought i would ask here for peoples thoughts.
    Oscar was fed a pouch of whiskas "simply" at 10 AM and i took the blood test at 4:30 in the afternoon, so i guess 6 1/2 hours after his meal i could expect the blood glucose level to be a bit lower than right after eating first thing in the morning?
    One other thing i should mention after getting the diagnosis of diabetes i began a big search on the internet about treatments and things to do and not to do. I read about not feeding kibble, so that stopped immediately, he has not been fed any kibble since his diagnosis and is only on wet food, 1 pouch in the morning around 8-10, one in the evening around 6-8 and one pouch shared with his sister Ruby at about 9 in the evening.
    I did definitely notice as soon as i stopped the kibble he was peeing less and drinking a lot less than he was...... I did tell this to the vet on the last visit but she didnt seem convinced it would have made much difference and so we didnt run a quick glucose blood test, i just collected the needles and insulin.
    Clearly his blood sugar level is still way too high so tomorrow morning we will start with the insulin.
    I would be very grateful if you great folks could advise about the right insulin dosage?
    2 units twice a day seems quite a lot to be giving as a first dose, especially as his blood test today showed a value of 18.3, which was under the 20 mnol/l value that Caninsulin recommend for 2 units, twice a day?
    According to their literature under 20 mnol/l should be 1 unit, twice a day?
    So im a bit confused, maybe i should call the vet to discuss.
    But anyway, i would very grateful for any comments or advise about insulin dosage.
    I will do my best for Oscar and i hope he responds well to the insulin, i was so sad when i got the news from the vet, it was such a shock but i realise now that its treatable so feeling a bit better about things!
    Regards, Robert
     
  2. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Hi there and welcome!

    I'll have much more to add later but quick question - is there any history of ketones or DKA?

    Diet change can have a very big impact on BG but varies by cat (take a look at my spreadsheet - he dropped about 200 points alone just from changing diet in 2020). How long ago did you stop the kibble?

    The lowest BG of the cycle on Caninsulin is usually 2-6 hours after the shot, more often than not it's at the 2-3 hour mark. So yes BG still pretty high but the effects of dry food can take a week or two to completely shake out.
     
    Oscar2009 likes this.
  3. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Hi FrostD,
    Thanks for the message and warm welcome :)
    I cant be sure about ketones or DKA, up until the end of December 21 i was working full time and so was leaving early and returning home late and hadnt noticed anything that had alarmed me.
    Whilst being home for the last few months, ive spent a lot more time with the cats, they are indoor cats that have the run of the house and a large outdoor cat run but i had a chance to see them most of the day.
    Over the last few months in particular i had noticed that Oscar seemed to be a bit more vocal than usual, i had always thought because he had access to the outdoor cat run and would sometimes see other neighbours cats roaming in the garden that he somewhat resented being inside, usually the meowing would be when he was outside in the cat run. I think that he also gets bored easily, in general he is quite demanding, much more so than his sister. But he is a well looked after cat, sleeps on my bed and is well loved and generally happy cat.
    I guess other than being more vocal of late i had had noticed he seemed to be peeing quite a lot, occassionally outside of the box, also he would vomit sometimes but it wasnt frequent.
    Within the last id say month or two id also noticed that he seemed to be a bit lighter when i picked him up, perhaps a bit weaker, id put that down to not overfeeding him and that he was perhaps just a healthy weight and getting a bit older.
    Then about 2 weeks ago on one particular day he seemed to go into a bit of crisis, it was quite unsettling, he was pacing, very vocal, couldnt settle and was peeing a lot including outside of the box and drinking much more than usual, i knew then that something wasnt right and got him into the vets.
    Ive not done any BG tests at home in the past, they had never been to the vets at all being house cats and fit and healthy i hadnt needed to.
    In the beginning as kittens i gave them wet food in the morning, wet food in the evening and then kibble before bed, later on id say 3-4 years ago when they started to get a bit picky about eating the wet food, i tried mixing wet food brands to make food a bit more interesting for them and also adding in kibble to the wet food which they seemed to enjoy ini order to encourage them to finish their food and not leave left overs. Up until recently i was feeding them 1/2 pouch of wet food each with handful of kibble in the morning, same in the evening and then small bowl of kibble each late evening before i went to bed. They both seemed to be doing ok on that diet, good weight not leaving food. But now i know, that was quite a lot of kibble..... i had know idea it was so bad for them.
    Ruby his sister seems to be fine, they are from the same litter brother and sister. She is a good weight and doesnt pee or drink water excessively.
    But ive switched both back to wet only, must be about a week and a half now without any kibble. 1 pouch each in the morning, one in the evening and then half a pouch shared between them late evening.
    In going to try to get them down to 2 meals 12 hours apart as recommended by the vet only problem at the moment is Oscar has such a big appetite that i feel bad if i dont give him the last meal before bed, hopefully with the insulin his appetite will go back to normal. At the moment he finishes his food and watches and waits for Ruby to eat most of hers and wander off and then clears her plate.
    Im really hoping Oscar responds well to the insulin and hopefully goes into remission.
    Im not sure how regularly ill be able to test Oscar's BG levels as i have to go back to work as soon as i find something suitable.
    If nothing else i should be able to test before the morning meal and shot before i go to work and then when i return in the evening test before dinner and second shot and then do a curve when needed at the weekend when im not working.

    Im wondering if the reading of 25 mnol/l at the vets a week and a half ago and the reading of 18.3 mnol/l today using my glucometer is down to the difference in the meters or if the change to wet only food has brought his numbers down all by itself, or a bit of both?
    I havent started on insulin yet, im starting tomorrow.
    Do you find that the human glucometers readings are much different to the pet meters? Surely they should be quite close
    Its a bit confusing tbh, the biggest question i have really at the moment prior to starting the insulin shots is his latest BG test of 18.3 from today using my meter, as i mentioned in my last message the Caninsulin spec sheet said that for values of less than 20 mnol/l that i should use 1 unit twice a day, whereas the vet told me to give him 2 units twice a day (when his BG was 25 at the vets last week)... I guess maybe i should call the vet first thing in the morning and see what she thinks??
    Thanks again
     
    Chrispooky12 likes this.
  4. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    He didn't have a UTI by chance? Some of what you describe sounds like a UTI. And if it is a long-running one, it can mimic diabetes on the fructosamine test.

    The main difference between pet and human meters are human meters tend to read lower. Pet meters read higher, and that is especially true at higher numbers. When the numbers get more regulated, the difference is small. Human meters are allowed 20% variance here in the US, I believe I read pet meters 15%. It's really not a big deal, we do factor that in when considering doses. Human meters much cheaper long term!

    I would start at 0.5U to be safe, ideally on a day you can test hourly-ish. We can always increase a little faster if it shows not to be working well for him.

    I'll drop some links later for getting signature and spreadsheet set up, as well as hypo kit.
     
    Oscar2009 and Chrispooky12 like this.
  5. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
  6. Chrispooky12

    Chrispooky12 Well-Known Member

    Joined:
    Oct 11, 2021
    You need to feed your kitty's more than twice a day. Your kitty will be hungry all the time until he is a regulated diabetic. I have 2 kitty's one sugar boy & one non sugar boy. I feed them Fancy feast pate's only every 4hrs. So that would be 3 3oz cans a day for each kitty. @FrostD can tell you more about why to feed more often.
     
    Oscar2009 likes this.
  7. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Oh yes thank you I meant to address this!

    The feeding twice a day is old school thought process. Multiple smaller meals is actually easier for their pancreas to handle. With caninsulin you will want larger meals at shot time, so he has carbs on board before the insulin kicks in. We recommend feeding, waiting 30 minutes, then giving the shot. Then probably a smaller snack 2 hours after each shot, possibly another 4 hours after. A lot of us use autofeeders to make life easier. When you do start testing, you will want to fast him for 2 hours before each pre shot meal, but no need to fast any other time. So you would fast for 2 hours, test, feed, wait 30 minutes, shoot, then snacks as needed. Repeat in PM cycle.
     
    Oscar2009 and Chrispooky12 like this.
  8. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks so much for the info.
    I got the glucometer 2 days ago in the afternoon, ran a quick test on Oscar after unpacking it and it read 18.3 mnol/l at 16:30, about 6 1/2 hours since feeding hiim.

    I am keen to get him started on insulin ASAP, will more than likely start tomorrow.
    Yesterday i thought it would be a good idea to do a BG curve prior to starting his Insulin.

    So i tested him every 2 hours, i found it difficult to get blood from his ear and so used the paw on his foot, i managed to get enough blood first time on all but 2 occassions, the reading at 11:50 AM bless him, i couldnt get enough blood and had to keep redoing it i think the 6th time i finally got enough blood.
    Hes not keen on the paw pricks but just about tollerates it, i dont want to create any scar tissue, so im going to give a bit of time out today.
    I also got some urine test strips today, so will try to get some pee when i see hom going for the litter tray at some point.
    Now that he is not peeing a lot, since going to a wet only diet i wonder if that means there is less or no glucose in his urine? Apparently there was lot when we went to the vets just over a week ago.
    I guess i will find out later when i can get a pee sample to test.

    Here is his BG curve from yesterday:
    7:30 - 18.0 mnol/l
    7:30 - Fed 100g Whiskas Simply pouch
    9:30 - 16.9 mnol/l
    11:50 - 24.6 mnol/l (this is the test that i had to keep redoing 6 times because i couldnt get enough blood, dont know if it stressed him a bit and BG went higher?)
    1:30 - 20.6 mnol/
    3:30 - 19.7 mnol/l
    5:30 - 17.7 mnol/l
    8:00 - 16.7 mnol/l
    8:00 - Fed 100g Sheba flakes pouch
    10:00- Fed 50g Whiskas wet food (1/2 pouch)

    Id be really grateful for any feedback with regards to his numbers prior to starting with the insulin treatment tomorrow.
    The vet wants me to start him with 2 units of Caninsulin, twice a day, 12 hours apart.
    Does 2 units, twice a day sound like a lot??

    Also one last question, Oscar usually likes to sleep after his first meal of the day, so when i start him on the insulin tomrrow, i will feed him wait 30 minutes and inject him, but he will likely then have a sleep, which will make monitoring him for any problems difficult? Any thoughts please?
     
    Last edited: May 20, 2022
  9. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Just a quick update, i managed to get a urine sample from Oscar and run a test.
    From what i could interpret from the results:
    Protein: Negative
    PH: 6.5 to maybe 7 (5 is normal.... does diabetes raise the urine PH?)
    Blood: Negative
    Ketone: Negative
    Glucose: Dark Brown, which is the highest score on the chart, so very high glucose in the urine.
     
  10. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    You kind of have to keep at the ear, be sure to check the tips link I posted. It takes a few weeks for the ears to form the extra capillaries.

    I would start at 0.5U twice a day, 12 hours apart. Ideally, aim for the two preshots tests, and a test 3 hours after the shot. That will tell us a lot about how he responds to insulin. You can always increase dose, but you cannot remove too much insulin. So also be sure to put together the hypo kit I linked.
     
    Oscar2009 likes this.
  11. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    I will check your links, thanks!
    Im going to start him on insulin tomorrow morning, i will take the preshot tests as you recommend and update the thread tomorrow.
    Many thanks
     
    FrostD likes this.
  12. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Hi all. Hope your having a good weekend.
    I got Oscar started on the Insulin this morning.
    The vet had recommended 2 units every 12 hours but i wasnt comfortable with that as a starting dose, especially as its the weekend and the vets are now closed until monday and i didnt want to risk a problem. The Caninsulin spec sheet recommends 2 units if BG over 20 mmol/l and 1 unit if under 20 mmol/l
    Pre shot BG test at 8:00 was 16.2 mmol/l so i decided to go for a dose of 1 unit.
    Then fed him at 8:00, 1x 100g pouch of whiskas simply he ate all of it and then ate the leftovers Ruby my other cat had left in her bowl.
    Insulin jab at 8:30, i wasnt 100% sure at the time that the Insulin went in because he pulled away but im sure now it did because....
    I then tested his BG at 11:30 +3 and it had come down to 11.9 mmol/l which seemed incouraging
    I then tested again at 3:30 +7 and it was rising up to 18.6
    He has been a bit quiet and sleepy but otherwise seems ok, doesnt seem to be craving food like he has been, ate all his food this morning, not drinking or peeing excessively, quite normal i would say....

    So what to do... i guess i should keep the dose at 1 unit for now?

    I will do another pre shot test at 8:00 and give another shot of insulin at 8:30 PM and then maybe another test at +3 11:30 PM

    One other question, now that ive started with Insulin can i expect the glucose to go from the urine? Do you need to get down to certain BG number before this starts to happen?

    Thanks again for any help and comments
     
    Last edited: May 21, 2022
  13. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    That's pretty typical of Caninsulin - drops them hard and fast, doesn't last long, and they climb back up. Hold the 1U for a few more days to give him time to settle in.

    Renal threshold dictates when glucose spills into urine. For most cats it's somewhere between 200-300, but for some it is lower. So if BG is under renal threshold for long enough, the glucose will come out of the urine. But once he climbs back above it, the glucose will come back (so theoretically at his current numbers you could do 4 urine glucose tests a day and 2 might be positive and 2 might be negative).
     
    Oscar2009 likes this.
  14. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks, makes sense about the urine, i guess it will stop when he becomes better controlled. His urine smells very strong today, that fruity smell, but theres not a lot of it.

    I started Oscar on insulin yesterday and its all been a bit nerve wracking, i get a bit shakey at times because i dont want to upset or hurt him, i cant get blood from his ears and so am using his foot paws, this works but im worried if i keep pricking there it will get sore and because hes moving around on it maybe get infected?

    Yesterdays numbers were:
    8:00 am BG 16.2
    Fed at 8:00 am
    Shot insulin at 8:30 1 unit caninculin
    11:30 am BG 11.9
    3:30 pm BG 18.6
    Tried to get BG at 7:00 but couldnt get enough blood tried 3 times and gave up as cat was getting a bit stressed :(
    Fed at 7:00 pm
    Shot second insulin at 7:40 pm
    9:40 pm BG 13.2

    Today has been a bit discouraging...
    I got up nice and early as ii want to get into a regular routine of feeding them at 7:00AM, giving the shot at 7:30AM and then food again at 19:00 pm and second shot at 19:30 and then a little wet snack at 9:30 PM.
    Im currently looking for and applying for jobs, so this schedule should work when i go back to work.

    Today his BG was 18.9 at 7:00 AM
    I was going to test 3 hours after that but he looked really tired and was asleep on my bed i couldnt bring myself to wake him, pick him up move him to test, so i thought id let him rest, but he'd been sleeping all day so far and not moved off the bed, i checked on him and he seems ok, but just very tired.
    I decided to pick him up and bring him downstaris at 2:00 PM and then tested him, his BG at 2:00 is 23.7 which is pretty dissapointing and hes just slumping around not wanting to move or do anything.
    The 23.7 BG number today made me wonder if he actually got the shot OK this morning? But im sure that he did, i noted that you said that Caninsulin will drop the numbers hard and fast and then they dont stay down for long. Maybe the dose is too low?
    But im confused as to why he seems so lethargic today?
    I guess i will see where his BG is at 7:00 PM just before the evening meal and then second shot.
    Its all so difficult to know what is best for him. Hopefully it will get easier.
     
    Last edited: May 22, 2022
  15. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    When you get a chance please do get a spreadsheet put together, it gets difficult trying to read through threads to find all the data and mentally figure out the times.

    If you miss a shot you will smell it, very distinct smell - almost like fresh new tires. A lot of us rub our hands around the injection spot and smell our hands as a double check.

    I never did like the idea of paw testing but a fair amount of people do it...to your point yes seems to me it would get sore and more prone to infection.

    He is going to need an increase, but give this dose a couple more days so you have time to get used to testing. If you want you can increase by 0.25U.

    The lethargy is probably the higher BG, and the swings he's experiencing on insulin. Doesn't exactly feel good to go from 23 to 11. Is he eating and drinking ok?
     
    Oscar2009 likes this.
  16. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks, your right i just created a Spreadsheet for Oscar its in my signature, hopefully it works ok.
    He is eating fine and drinking, seems ok just really tired.
    Im dissapointed to see the BG rise to 23.7 today +7 after AMPS test, he seemed to do better yesterday. I should have got a +3 BG test today, but he was asleep bless him and looked exhausted so just couldnt bring myself to wake him up.
    Im not going to be able to do BG tests every 2 hours as ill be working soon.
    I also feel terrible about jabbing him all the time, i dont want him to become cautious around me, its very difficult.
    For the moment i would like to perhaps get a AMPS, a +3, a PMPS and another +3, do you think that is workable?
     
  17. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Ok sounds good!
     
    Oscar2009 likes this.
  18. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Evening all,
    Im a bit disheartened. From a really encouraging start, first thing in the morning AMPS of 10.9 at 7AM, gave a shot at 7:20 1 unit, BG then climbed up to 13.5 at +3 and then this evening PMPS is up to 26.9!!
    I am feeding the same meal every day at the same time:
    100G wet whiskas pouch 7 AM, 100G wet Sheba pouch 7 PM, 50g half pouch at 9, 2 hours after evening meal.
    Please help me interpret what is going on here, i dont understand i thought after a shot the BG number always comes down?
    I really dont think i did a fur shot this morning, but dont understand how it could be 10.9 AMPS, then give him 1 unit and for it to climb and climb....
     
    Last edited: May 25, 2022
  19. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    It's possible the 10.9 was a bad strip, or not enough blood. Sometimes instead of an error code for not enough blood, it will toss out a number. Always a good idea to get another test if you get an unexpected number.

    The other possibility is he went lower last night and then bounced - that's when their liver panics in response to the (real or perceived) threat and dumps stored glycogen and counterregulatory hormones to spike BG up; sometimes the insulin isn't enough to offset that.
     
    Oscar2009 likes this.
  20. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks, i wondered about the possibility of it bouncing. Not sure about the test strip, i guess could be that too.
    The BG seems to come down quite consistently after the PM shot, but the AM is all over the place....
    Do you think i should be thinking about changing the dosage, i need to go higher dont you think or should i stay at 1 unit for a while longer?
     
  21. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Typically you would hold the dose for a week, and the 190 this morning gives me pause if it is real. That was a huge drop last night and it's possible that 190 is real (which means he was lower, possibly sub-100, earlier in the cycle). If you are able, when you see a big drop like that it's a good idea to test again in an hour or two.

    Bounces can last up to 6 cycles (3 days) so my preference would be to hold the 1U until the bounce clears. And sprinkle in some later tests, like +4 to +6, when you are able
     
    Oscar2009 likes this.
  22. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Morning all.
    I decided to up the dose yesterday to 1.5 units as 1 unit clearly wasnt going to do it.
    Ran a curve yesterday and the BG is still rising to high levels at say +6 between shots.
    Eventually when i get the insulin dosage correct would you expect this to smooth out the peaks and stop the BG from rising at mid day??
    Also, Oscar weighs about 4KG, he is quite a big cat and he is not skin and bones but he does feel like he could do with putting some weight back on, should i be feeding him more??
    Thanks... have a great weekend peeps :)
     
  23. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Please watch him carefully tonight and tomorrow in case the bounce breaks and he drops low. With caninsulin we only do 0.25U increases.

    Some cats regulate nicely on Caninsulin, but usually if they are on a low carb diet and react harshly from the beginning, they will continue to react harshly. We say to give an insulin 2-3 months before making a decision, since you are in the UK (I think?) ProZinc is the next insulin they'd prescribe.

    As for food - do you know what his ideal weight is? Do you have a scale at home?
     
    Oscar2009 likes this.
  24. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    He was 4.6 KG in 2020 when he went to the vet, that felt like a decent weight.
    He is now about 4KG, possibly 3.9KG, so i guess id like him to get back up to about 4.6KG.
    I do have scales so thats no problem.

    When you say react harsly, do you mean spiking back up a few hours after caninsulin injection which seems to be what hes doing atm if you look at his spreadsheet?

    I think 1 unit was too low- it wasnt making much of a differences to his numbers, the vet wanted to start on 2 units twice a day.
    I gave it a week and thought that 1.5 units was a decent compromise, i know these things take time, but im giving everything a lot of consideration.
    Im not seeing any numbers in the 50-200 range, even with 1.5 units so i think he still has someway to go, but ill be keeping it at 1.5 for at least another week and getting lots of BG info before thinking about any other changes, i am keeping a good eye on him, generally speeaking he does seem better but clearly there is a long way to go.

    If i am doing something wrong please steer me back in the right direction.
    Should i go back to 1 unit instead of 1.5 units?

    Thanks again for the advice its really helpful

     
    Last edited: May 28, 2022
    FrostD likes this.
  25. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    React harshly means the BG drops hard and fast, then yes climbs back up. The climbing you see is lack of duration - it's a known issue with Caninsulin in cats (usually lasts around 9 hours, if that), but duration usually does improve as they get regulated. How much it improves differs by cat - you may get an extra hour out of it, or a few, or nothing at all because it's just too harsh for him. Time will tell.

    I would feel better if you did 1.25U for at least 2 days; if he isn't budging then 1.5U is ok. The concern is that we don't know how low he went the night of the 24th, if the AMPS on the 25th was actually accurate. If he's currently bouncing, when they break the bounce they can have extra downward momentum which can get you in a bit of trouble.

    This is a good starting place to figure out how many calories he needs - https://www.petplace.com/article/cats/pet-health/how-to-calculate-your-cats-daily-calorie-intake/
    Remember that while he's unregulated he will likely need even more than that calculator says
     
    Oscar2009 likes this.
  26. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks thats really useful.

    Im feeling much more confident about testing and giving insulin, im getting the hang of it and have sorted out a routine where i get up early and feed them at 7AM and then again at 7PM. This will work when i go back to work, i had a job interview today so might be sooner than later.
    My main concern really now whilst i try to get him regulated is his weight, he isnt skin and bones, but he has lost weight and he feels weaker, i weighed him today and he was 3.8 KG.... its quite a concern. He is getting about 250g of wet food a day, i dont know if i should increase it?

    I had a complete nightmare with him this morning though.....
    Got up at 7, went downstairs to test him and feed them, tested him and the glucometer shows HI, looking at the manual tells me this means that the BG value is so high that the meter can not show the value, over 33.3 mmmol/l, this freaked me out so i did another test same result.....
    Then i see he has been at the bin and i think eaten a fair amount of bread as i found some in a different room, so i guess bread being a high carb food sent his BG through the roof.
    The +1, test after insulin shot also showed HI..... then +2 was 32.8, +3 29.1, +4 30.6, +6 29.5, +9.5 31.5.... just a a row of solid BLACK on his spreadsheet.
    Totally depressing, i guess it will take a while for him to clear the bread from his system and then the numbers should come back down again?
     
  27. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    These cats! Happens a lot here. Yes it will take a few days, possibly a week for him to settle back down.

    So its not the weight/volume of food that matters, it's calories first and foremost. And all the foods have vastly different calorie counts. What does the can/pouch say? How many calories?
     
    Oscar2009 likes this.
  28. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Bad kitty, felt like i was making some progress his numbers were starting to lower more purple than red and now this.
    Block of black.
    I feel terrible for not feeding him constantly but want to give him what he needs, timed with the insulin rather than just feed him relentlessly to satisfy his cravings.
    My bin is behind a cupboard door under the sink that he needs to open to get at so have put a zip tie on it now!
    Makes me wonder what else he might try to eat, have cats ever been known to eat crisps, open the packets and try to eat them?
    I caught him the other day with an empty wet food pouch, chewing it to bits trying to get the last bits from inside.
    Oh well.... back to the beginning again.
     
  29. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Hi all,
    Oscar seems to be doing a bit better now, more energy and a bit happier and more relaxed in general.
    I upped the does to 1.75 units twice a day and his numbers are getting better, not seen any reds for a few days, more yellows and some purples, the occasional blue.
    I also changed the food to Butchers Classic a UK based canned wet food that seems to be better quality than many of the others...
    All seems to be going in the right direction, just wondering if anyone has any thoughts about what i should be thinking of doing to get his numbers down further?
    Perhaps 2 units a day? I suspect he will end up on something like 2.5 units or more twice a day before he really starts to get down to normal "healthy" numbers.
    But making progress, thanks for all help so far.
    Cheers
     
    FrostD likes this.
  30. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Glad to see progress!

    I would hold this dose at least 2 more days. If you don't see anything under 150, increase by 0.25U. if you do get a number under 150, tag me please.
     
    Oscar2009 likes this.
  31. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    I called my vet surgery yesterday to get a repeat prescription for Caninsulin and spoke with the receptionist who said she would speak with Oscar's vet.
    The vet calls me today and after some pleasantries basically tells me that home BG testing is a waste of time, its inaccurate due to the cat being stressed and will not give reliable information and that frankly i shouldnt bother doing it, or only do it sparingly.
    She seemed to think that a Fructosamine test would be much more useful. I was a bit shocked to be honest, the fructosamine test as i understand it gives a snap shot, a rough idea of the average BG levels over the last 2-3 weeks, which i think is much less useful than taking regular BG tests.
    She also said that i shouldnt be increasing the dosage like i have been.
    I tried to explain that i was feeding the same food at the same time every day, 12 hours apart, testing regularly at timed intervals and keeping a spreadsheet, basically trying my upmost to really get on top of his diabetes but ended up coming away from the phone call feeling like i had been doing it all wrong..
    When i mentioned the incident where Oscar ate the bread on the 30th and spiked his BG through the roof for 8 hours she said that his high numbers would have nothing to do with eating the bread!
    She has told me to up the dose immediately to 2 units, (she said that 2 units is a very low dose) and that i should really not bother testing as much as i have been, only do it every couple of weeks or when doing a dose increase when she said a 12 hour BG curve, testing 2 hours apart is useful.
    She also said that she could not prescribe me the 6x 2.5ml vials of insulin that i wanted and could only supply 3 due to the law?
    Any thoughts would be most appreciated.
    I should add that the vet seems like a nice person and im sure she is trying to help but i dont think she is giving me good advice frankly.
    She made it sound like i need to really go hard and fast with this, looking at my spreadsheet am i doing things right??
     
    Last edited: Jun 7, 2022
  32. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    You are doing everything correctly, your vet sadly is very misinformed. I cannot tell you how many cats, nearly all on Vetsulin/Caninsulin, who end up because their cat is seizing (or died) from a hypo by following exactly what your vet has proposed. You are correct that a fructosamine in only a snapshot, it does not at all tell you how low they are going - and that is the potentially debilitating or fatal problem.

    For whatever reason so many people assume testing is this horrible ordeal for all cats - but the cast majority of us here have cats that come to us.ourtin and happy to wait for their test. That doesnt sound like stress to me!

    I can't speak to the vials issue/the law in the UK unfortunately.
     
    Oscar2009 likes this.
  33. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thank you FrostD, i really appreciate your advice.
     
    FrostD likes this.
  34. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Hi FrostD i dont know if your online, but if you are and can give some quick advice?
    I upped the dose to 2 units as we discussed and vet suggested.
    AMPS was 18.8 gave 2u shot this morning, +4 came down to 9.9, had to go out came back and now PMPS he is 10.5, so only gone up a little 8 hours after the +4.
    Is it ok to give another 2 units, usually gets it about now...... just suprised it didnt go up a lot from 9.9 at 11AM till 7PM only gone up slightly now to 10.5
    Dont want to give too much! Thanks

     
  35. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    That's awesome!

    If you can monitor, I would try something like 0.5U and get a test around +2 to start
     
    Oscar2009 likes this.
  36. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks, just saw your message.
    I ended up stalling an hour and his BG had crept back up to 16.1, 1 hour after eating his PM food, so felt comfortable to give the full dose!
     
    FrostD likes this.
  37. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Hi FrostD,
    Hope all is well.
    Havent posted here for a while but just wanted to get some advice if possible please.
    Ive stuck with 2 units twice a day for a while now and its been ok.
    Today, his numbers have dropped quite low, at PMPS i usually expect to see his numbers to have crept back up after his AM insulin shot 12 hours earlier has left his system, it usually creeps back up to 18-20 range, but today it was 6.3.... no change to diet or feeding routine.
    I stalled with the PM insulin shot for an hour, after an hour his BG had gone back up to 12.9 so i gave the full shot, 4 hours later and its come right down to 3.6 which is by some margin the lowest BG value that ive seen.
    He seems fine, but im mindful that these numbers are getting a bit low and that i need to be careful. Any thoughts?
    Im wondering if this is something you tend to see with cats, that after a while their numbers just start to naturally fall more into the normal range when the insulin has had a chance to build up in the body? Any thoughts about dosage? Thanks :)
     
  38. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Yes that is lower than you want, I would reduce by 0.25U. any time he goes below 90 you will want to reduce. I suspect he may need a 0.5U reduction actually given how low he went, your call.

    With that 65 please give a little medium carb food (10-15%) and retest 30 mins after the last test. If he goes below 60 take a 0.5U reduction and keep feeding/testing
     
    Oscar2009 likes this.
  39. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    And yes it looks like he's getting more used to the insulin. Caninsulin doesn't really build up in their body, it's usually gone by 8-10 hours after you give the shot. So the time he's spending in lower numbers is actually letting his pancreas heal a little bit, it's good!
     
    Oscar2009 likes this.
  40. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks for the advice.
    I think i may reduce the insulin as you suggested, maybe it is too much.
    Vet said 2 units was a low dose.
    Its really difficult to know what to do for the best...
    Today he bounced all the way back up to 24.4, i really cant make any sense of the numbers?
    I gave 2 shots this evening after the 24.4 and am going to get a +4 later this evening to see where his numbers go and take it from there.
     
  41. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    He is bouncing from these pretty low numbers. Please reduce to 1.75U at next shot for safety's sake, possibly even 1.5U. We do not want him going that low (60s) on Caninsulin.

    2 units is a fairly average/moderate dose for cats on a low carb diet

    Did you mean you gave 2 units?? You said you gave two shots, did you give two shots of 2 units each?
     
  42. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    @Bron and Sheba (GA) @Bandit's Mom I believe Robert is likely already asleep but tagging to keep an eye out for possible hypo. Not sure if "gave two shots" was a typo or not.
     
    Bron and Sheba (GA) likes this.
  43. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    The SS says 2 units so let’s hope so. He’s tested+5 93
     
    FrostD likes this.
  44. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Morning all,
    Sorry my mistake- i meant to write i gave him 2 units, rather than 2 shots in my last message.
    Ive never gone higher than 2 units to date.
    His AMPS was 18.0 so i gave 2 units again, i didnt see these messages before dosing.
    I will reduce evening shot to 1.75 units as advised.
    Thanks again for the help. :)
     
    Bron and Sheba (GA) likes this.
  45. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    If you get a test in the green BG range I would suggest getting another test in either 1/2 hour if the BG is low green or in an hour if the BG is high green.
     
    Oscar2009 likes this.
  46. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks, duly noted. :)
     
    Bron and Sheba (GA) likes this.
  47. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Just a quick update, i did a AMPS first thing this morning, his number was 18 (324)
    I then gave insulin, 2 units
    It was only then i opened laptop and saw your messages
    Just taken a +4 and his BG has dropped down to 2.8 (50). Yikes, thats a bit low not really comfortable with that number, i think i will see if i can fee him some high carb wet food.
    I need to make some changes to his dosage as you said FrostD, do you think 1.75 or 1.5?
    Thank you :)
    Thank goodness im testing, the vet told me not to bother!!
     
  48. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    That is too low. did you give some high carb food to bring the BG up higher.?
    And then you need to test again to see it is still rising. I would test for 2 hours after that low to see it hadn’t dropped again.

    You need to reduce the dose. I think I would drop the dose to 1.5 units with that drop to 50 on Caninsulin. That is too low for Caninsulin.
    @FrostD
     
  49. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Hi, yes i gave some Sheba gravy wet food, higher carb and he ate a fair bit.
    There was some left over from morning meal, he was sort of grazing today. He is not ravenous like he was a few weeks back. Its more back to his old routine of grazing during the day.
    I will test again at 1:30, for a +5
    I think 1.5 units seems like a sensible move i will adjust to that for his evening shot and going forwards for now.
    Thank you.

     
  50. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I would test 30 minutes after you fed him just to make sure he isn’t dropping lower.
     
  51. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Just got another test, missed opportunity to do a +4.5 test, but just got another test now @ +5 and its risen up to 6. Panic over for now.
    Will reduce dosage for the shot this evening.
    Do you think i should go with 1.75 or 1.5?
    On one hand i really dont want to give too much, on the other i want to give enough to try to keep his numbers in the right range.
    Thank you again.

     
  52. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Can you get another test at +7? Once the high carb food wears off, the BG might drop again and we don’t want that.
    I would reduce to 1.5 because dropping to 50 is too low for Caninsulin. You don’t want it dropping under 90. Under 90 earns a reduction.
     
  53. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Just got a +7 and its back up to 21.1 !
    Any advice for dosing this evening and going forwards much appreciated.
    I dont want to set him back by reducing dose too much, i want to get his numbers in the right "normal" range, but likewise dont want him to drop to low and risk hypos
    Thank you

     
  54. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Yes - please go to 1.5U. remember dose is based on nadir, and below 50 is hypo territory on your meter regardless of insulin. Remember that hypos can cause seizures, brain damage, paralysis, even death. Because Caninsulin can be harsh and unpredictable between cycles, we don't want them under 90. So in this case, based on my experience, you need to take a larger reduction.
     
    Oscar2009 likes this.
  55. Oscar2009

    Oscar2009 Member

    Joined:
    May 12, 2022
    Thanks for the advice.
    Dropped down to 1.5 units for last evening shot and same this morning. Will get a +4 and see what the nadir is now!

     
    FrostD likes this.

Share This Page