Please help get Finster back on track

Finster

Finster

Member
Finster, 15 years of age, was diagnosed about six weeks ago.
Six months prior to diagnosis he was on Prednisilone 5 mg twice daily. He has seasonal allergies and asthma. His appetite increased the longer he was on the prednisolone. June I took him to vet and blood work showed diabetes.
Vet sent us home with Prozinc script 1 unit twice daily and script for low glucose wet food also instructed to ween off prednisolone. Took us a few weeks to figure out the food and ween from Pred. He is now on an inhaler of Adivar. Went back to vet at 8 day mark for BG curve and it was higher-500's. Vet increased insulin to 2 units twice daily. In the mean time I found fancy feast chicken and tuna that he will eat and got him off the prednisolone. The first time I gave 2 units he freaked out. Tried to hide, unsteady on his feet, tail twitching, just very upset. I stepped down to 1.5 units and it was better but still not himself. I've been back at 1 unit for weeks now BUT two days ago I stepped down to .5. His next PS was at 149 and that seemed high so I went back to 1 unit. Then last night he wouldn't eat and I gave the 1 unit anyway. In the night he threw up a huge fur ball which explains why he didn't want to eat last night. This morning his BG was 120 too low to give shot. I've been taking it all day and it's gone even lower EVEN after eating most of his 3 oz can of fancy feast. What Should I do? Skip tonights shot as well? Only give half?
Thanks for any guidance. I really appreciate any and all help.
Lisa
 
Hi there! What is he currently eating? Diabetic cats need to be on a low carb diet. Is he only eating the Fancy Feast now? Is it the Low Carb pates? The prescription foods are all too high in carbs for a diabetic cat.
 
My reaction to reading his spreadsheet is to reduce insulin to .5 units for now - but it’s important to know what kind of food he is eating. Switching to a low carb diet can lower blood glucose- so if you are in the process of switching then you need to be extra careful. His numbers are low already, especially considering that you are using an Alpha Trak meter. I am very happy to see that you have been tracking this with more frequent testing. Well done!
 
Thanks so much for the quick replies! He eats Fancy Feast Chicken and Tuna-full stop-nothing else for about two weeks. Just checked BG and its 126. That's 11 hours post shot with about 3 oz of Fancy Feast chicken and tuna so far for the day. Is that high enough to give .5 Units for PM shot? Thanks again!
 
Finster said:
Thanks so much for the quick replies! He eats Fancy Feast Chicken and Tuna-full stop-nothing else for about two weeks. Just checked BG and its 126. That's 11 hours post shot with about 3 oz of Fancy Feast chicken and tuna so far for the day. Is that high enough to give .5 Units for PM shot? Thanks again!
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And just to make sure, you do know about the no food for two hours prior to the preshot test rule — so that the preshot test is accurate and not in any way influenced by food?
 
Suzanne & Darcy said:
Hi there! What is he currently eating? Diabetic cats need to be on a low carb diet. Is he only eating the Fancy Feast now? Is it the Low Carb pates? The prescription foods are all too high in carbs for a diabetic cat.
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The website lists "Dry matter carbs" as 1.9%
 
"Can you tell me the exact name on the label. I will look it up. I just pulled up the food chart."
The Label reads
FANCY FEAST CHICKEN & TUNA FEAST-FLAKED
 
That’s what I needed to be sure of - the food and carbs. Please forgive me, but it’s very important to the interpretation of the BG numbers.
 
He looks like he’s been doing a whole lot better since you switched to the low carb food. As he has a similar BG to a few nights ago when you gave .5 units, it looks like it would be safe. You could even try giving just .25 units- although we don’t know his actual preshot number yet. Hopefully you can find a dose where he will be able to have it consistently so we can see where he goes on a given dose. If he drops below 68 on the Alpha Trak meter, you would reduce his dose.
 
Suzanne & Darcy said:
He looks like he’s been doing a whole lot better since you switched to the low carb food. As he has a similar BG to a few nights ago when you gave .5 units, it looks like it would be safe. You could even try giving just .25 units- although we don’t know his actual preshot number yet. Hopefully you can find a dose where he will be able to have it consistently so we can see where he goes on a given dose. If he drops below 68 on the Alpha Trak meter, you would reduce his dose.
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Thank you! I picked up his food at 5:30 pm so I'll take BG at 7:30 and give .5 if BG is in the blue?
 
You can skip and gather data to see if he goes above normal range if you feel comfortable with that. Just do get some tests in tonight though.
 
Suzanne & Darcy said:
You can skip and gather data to see if he goes above normal range if you feel comfortable with that. Just do get some tests in tonight though.
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I gave .5. What low am I looking for tonight? I have kit with Karl syrup and instructions, if needed.
Also, I'm worried about am shot. :( diabetes is so confusing. Thanks for taking the time to help us.
 
Finster said:
I gave .5. What low am I looking for tonight? I have kit with Karl syrup and instructions, if needed.
Also, I'm worried about am shot. :( diabetes is so confusing. Thanks for taking the time to help us.
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If your shot time was 7:30 eastern? Have you gotten a +2 yet?
 
Okay. I am signing off for the night. I checked your spreadsheet and I don’t see any tests yet- so I am assuming all is well. See you tomorrow.
 
He ate again at 10 pm and slept with us all night. I didn't check BG. His ears are a mess. I was putting neosporin pain relief on each time I pricked his ear and turns out he's allergic. All the fur fell off and he's got scaly patches :(
0600 BG was 145. I gave 1 unit at 0715. His appetite has decreased for some reason during past week. He has lost about 1/2lbs. He also seems nauseous. licking his lips a lot. He did throw up huge fur ball yesterday morning but still not very interested in food today. Maybe I should I look for new food? Or change dose to .5 for a few days and see how he does? Or put dose to 1 unit and leave it for a few days?
 
Finster said:
His ears are a mess. I was putting neosporin pain relief on each time I pricked his ear and turns out he's allergic.
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I know that a lot of people put plain coconut oil on their ears if they seem irritated. I have used extra virgin olive oil before. These won't hurt them if they lick them off after cleaning ears with their paws. It's no longer recommended to put neosporin on cats ... I'd have to find the article on that. I'm so sorry about poor baby's ears! Such a beautiful cat! The fur will come back though -- one of my cats (a white one) had skin cancer on both of his ears and had surgery to trim it all off this past December. His ears are all furry again.
 
I would not have shot one unit this morning at all. Not so much because of the preshot number -- what I am considering here is that yesterday in the a.m. cycle, you skipped the shot and look at the blue and green numbers that you got -- and the Alpha Trak meters already read a little higher than the human meters that most of us use here (and those numbers are the ones used in the dosing methods used here.) You did shoot the recommended .5 unit last night, but then we have no tests to see what happened on that reduced amount. I am not criticizing this, but it gives us absolutely no data to go on. I'm just concerned for Finster's safety. His numbers aren't very high anyway and he may not even need insulin at all. What was his Fructosamine blood level when he was diagnosed at the vet?
 
Finster said:
Then last night he wouldn't eat and I gave the 1 unit anyway.
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Also, it is very important when giving insulin that your cat eat first. The food will help stabilize their BG. It's fine if they eat a small meal at pre-shot time and have small meals throughout the day as well -- just no food for two hours before the preshot test. A lot of vets give the bad advice to only feed twice a day. This is not good for diabetic cats on insulin.
 
I'm wondering what is causing his nausea. Sniffing and walking away from food, licking lips, only licking a little of the top and walking away, tooth grinding also... these are some of the signs of nausea. You said he was licking his lips a lot. Do you have any idea what could be causing this nausea? Do you have a copy of the lab work that was done in June? Do you know what his BUN and Creatinine were at that time? Anything out of range?

Please do get some BG tests in today. I'm concerned about that 1 unit dose taking him too low.
 
Hi Suzanne and Darcy, thanks thanks thanks so much for following us through this. Should I give him some high protein treat? I have some freeze dried chicken breast treats. He didn't eat much this morning but the 149 BG concerned me. I'm so worried I'm going to kill my sweet boy :( The vets office is using a one size fits all approach and I don't like it but not sure how to adjust plan. should I do curve today? his ears have some bruising along with dry scaly patches, but if I need to do it I will. I'm not sure what the fructosamine was but I will find out. Also, the fact that he's been off the pred and on a strict diet for weeks now should be accounted for. Thanks again!
 
Finster said:
Hi Suzanne and Darcy, thanks thanks thanks so much for following us through this. Should I give him some high protein treat? I have some freeze dried chicken breast treats. He didn't eat much this morning but the 149 BG concerned me. I'm so worried I'm going to kill my sweet boy :( The vets office is using a one size fits all approach and I don't like it but not sure how to adjust plan. should I do curve today? his ears have some bruising along with dry scaly patches, but if I need to do it I will. I'm not sure what the fructosamine was but I will find out. Also, the fact that he's been off the pred and on a strict diet for weeks now should be accounted for. Thanks again!
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Looking at his numbers, I'm not sure that he even needs any insulin at all -- or perhaps just a small dose. Look how well he did yesterday when you skipped. Definitely he's way lower now he's off the pred and on a low carb diet. He's doing great in that way. I'm concerned about the nausea though. Some cats will feel odd when their numbers are lower and they definitely can eat less because they don't feel as hungry -- but his seems like more than that.
 
He was the most like his old self yesterday! We kept thinking that. I'm trying to figure out how to attach his june results. I'll look around the forum for instructions and post in two minutes.
 
If he will eat the freeze dried chicken treats that's fine, but I doubt if it will be enough. My cats love those chicken treats crumbled up on the top of their food. Do you have any Forti Flora on hand. Most cats love the smell and taste of that and it's good for getting them to eat if you sprinkle it on their food. Also, some cats love a sprinkle of parmesan cheese on their food. Baby food is always good -- baby foods that are pure meat with no onions or garlic (like the Gerber or Beech Nut meat baby foods). Some cats love these. Ham is a favorite.
 
Finster said:
He was the most like his old self yesterday! We kept thinking that. I'm trying to figure out how to attach his june results. I'll look around the forum for instructions and post in two minutes.
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You can take a photo of it and drag and drop it in. The upload link does not work.
 
Suzanne & Darcy said:
Looking at his numbers, I'm not sure that he even needs any insulin at all -- or perhaps just a small dose. Look how well he did yesterday when you skipped. Definitely he's way lower now he's off the pred and on a low carb diet. He's doing great in that way. I'm concerned about the nausea though. Some cats will feel odd when their numbers are lower and they definitely can eat less because they don't feel as hungry -- but his seems like more than that.
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Total Protein 7.5 5.2 - 8.8 g/dL
Albumin 3.6 2.5 - 3.9 g/dL
Globulin 3.9 2.3 - 5.3 g/dL
A/G Ratio 0.9 0.35 - 1.5
ALT (SGPT) 45 10 - 100 IU/L
Alk Phosphatase 48 6 - 102 IU/L
Urea Nitrogen 24 14 - 36 mg/dL
Creatinine 1.4 0.6 - 2.4 mg/dL
BUN/Creatinine Ratio 17 4 - 33
Glucose 579 64 - 170 mg/dL
The glucose concentration in this cat is >170 mg/dl. A fructosamine
level may be helpful in differentiating stress hyperglycemia from
early or sub-clinical diabetes mellitus. If you would like to add on
this test please call Customer Service. Please use test code 500016
for this additional testing.
Potassium 4.4 3.4 - 5.6 mEq/L
 
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Hopefully this works. page 2/2
 
Kidneys look okay. That's a relief. Do you have any anti-nausea medication to give him (like Cerenia or Ondansetron). Probably not, I would imagine.

I would get a +2 at 9:15 and see where he is at that point.
 
Finster said:
Total Protein 7.5 5.2 - 8.8 g/dL
Albumin 3.6 2.5 - 3.9 g/dL
Globulin 3.9 2.3 - 5.3 g/dL
A/G Ratio 0.9 0.35 - 1.5
ALT (SGPT) 45 10 - 100 IU/L
Alk Phosphatase 48 6 - 102 IU/L
Urea Nitrogen 24 14 - 36 mg/dL
Creatinine 1.4 0.6 - 2.4 mg/dL
BUN/Creatinine Ratio 17 4 - 33
Glucose 579 64 - 170 mg/dL
The glucose concentration in this cat is >170 mg/dl. A fructosamine
level may be helpful in differentiating stress hyperglycemia from
early or sub-clinical diabetes mellitus. If you would like to add on
this test please call Customer Service. Please use test code 500016
for this additional testing.
Potassium 4.4 3.4 - 5.6 mEq/L
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You know, his labs look really good (except the glucose.) I'm uncomfortable that they didn't diagnose him with a Fructosamine test (as it recommends on the labs sheet as a matter of fact.) However, it's likely that, at that time, it was high because of the Pred anyway. Some of those labs are because of the steroid. Low lymphocytes would be caused by the Prednisolone. The absolute neutrophils are okay (which is what you really need to look at and not the percentage number.) So I don't think any infection was present.
 
Suzanne & Darcy said:
You know, his labs look really good (except the glucose.) I'm uncomfortable that they didn't diagnose him with a Fructosamine test (as it recommends on the labs sheet as a matter of fact.) However, it's likely that, at that time, it was high because of the Pred anyway. Some of those labs are because of the steroid. Low lymphocytes would be caused by the Prednisolone. The absolute neutrophils are okay (which is what you really need to look at and not the percentage number.) So I don't think any infection was present.
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He did eat the freeze dried chicken and some more of the fancy feast :) Next week I can get a mobile vet to come do a fructosamine test.
I'm going to do the BG right now and will post shortly.
 
Finster said:
BG 76. That seems low for only +2.
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It is low for +2. And that's on an Alpha Trak. I'm very concerned. Do you have any higher carb food that you can give to him? Anything like Fancy Feast Gravy Lovers? Fancy Feast Grilled foods are medium carb foods.
 
You may be in for a long day of testing. That one unit was too much insulin, I fear. Please keep checking him so we can avoid a hypo. If all you have to feed is low carb food, then you can put a little drop of Karo syrup on there. I don't want to wait until he drops further.
 
Suzanne & Darcy said:
You may be in for a long day of testing. That one unit was too much insulin, I fear. Please keep checking him so we can avoid a hypo. If all you have to feed is low carb food, then you can put a little drop of Karo syrup on there. I don't want to wait until he drops further.
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I have some science diet wet food but it's like 24% carbs. It's what he was on before diagnosis. How much of that do you think I should feed?
 
Finster said:
I fed him two tablespoons of science diet chicken and rice melody. He ate it all!
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Okay. That’s fine. We just don’t want him to get full because you may need to give him lots of little snacks through the day to keep his BG up. So we usually just give small spoonsful.
 
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