New Diabetic

My cat was diagnosed as diabetic a few weeks ago. I've noticed the past few days that his neuropathy is getting worse and I'm getting concerned. After researching I see I'm cleary feeding him the wrong food - which of course was vet recommended. He is getting dry and wet Hills W/D (more dry than wet). I want to immediately take away the dry food and move him to a low carb wet food. He is getting 1 unit of Lantus twice a day and weighs around 18 pounds. Is this safe to do this weekend - or do I need to wait and consult with my vet.

First, are you home testing? If so, that's great. Right now it seems like you're off to a good start with a long-lasting insulin(Lantus) and only at 1 unit of insulin. I wouldn't recommend changing to the low carb food until you're testing at home just to prevent a situation where he goes low.

I'm sorry I can't help with the neuropathy though, I've never dealt with it myself.

I agree with Cindy. The sudden switch from the dry food to a low carb food can make his insulin needs less.
I would go buy a glucometer and start home testing, if you aren't already.

Good insulin and good starting dose. Bad choice of food, especially the dry. Please buy a meter and learn to hometest. Once you can do that you can then remove the W/D food and start feeding all canned of Fancy Feast, Friskies, etc. Even though 1 unit doesn't sound like much it could still cause a potential hypo if you remove the high carb food, especially the dry, and you don't have a meter to test and tell you what the numbers are. Also, neuropathy can be dealt with by getting numbers under better control and giving Methylcobalamin http://laurieulrich.com/jasper/

Thanks for all the great advice. I am not home testing - my vet didn't mention it. Now that I've read some posts I'm going to go buy one tonight. I may need help interpreting the results. As far as the Methylcobalamin, do I need to consult with my vet, or is this something I can go ahead and administer myself?

Should I take away the dry Hills W/D and for now just feed the wet Hills W/D (appears to be about 26% of carbs vs. the 37% of dry)? Any suggestions on how much I should feed of the wet if I change? Right now he's getting about two tablespoons of the wet during injections and about 1/2 a cup twice a day of the dry (but not eating it all).

No need in consulting with the vet about giving Methylcobalamin. Majority of vets don't even know about it. What the body doesn't use it just pees out. Please, use a meter first before removing any food, dry or wet. You never know if just removing a good percentage of carbs could make even that 1 unit too much.

The owner of FDMB offers free meter kits to newbies: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=60261 It will take a few days to arrive by mail, though. If you want to get started with hometesting right away it's probably best to just head to the local pharmacy and buy a meter. Wal Mart's Relion brand of meters is good and inexpensive. Other brands are good: AccuChek, Bayer, OneTouch, etc. Be sure to buy an extra box of compatible test strips and lancets because the 10 included with the starter kit will not last you more than a few days.

What brands of low carb foods do you think you will evetually feed to your cat? Have you seen Dr. Lisa's food chart? http://catinfo.org/docs/Food Chart Public 9-22-12.pdf Any brand of food that has under 10% carbs is good for a diabetic. Stay awy from gravy canned foods (too high in carbs) and limit seafood to once in awhile meals (some cats get addicted to eating it). You can also use these charts/lists:
Binky's canned food charts (data is 4+ years old so not reliable but chart is still useful)
Pet Food Nutritional Values list
Hobo's Guide To Nutritional Values
Dr. Lynne's Wet Food list
List of low carb gluten free Fancy Feast

Generally newly diagnosed diabetics should be fed multiple small meals daily. Unregulated new diabetics are always hungry because their bodies can't properly use the nutrients the right away. Many people use a programmable timed feeder to let their cats eat several times a day. How much to feed a day varies. Some cats eat as much as a 5oz can per day, others need more or less.

I was able to buy a home testing kit after the 7pm injection. At 10:00pm (after a slight learning curve and an unhappy cat) Eli's reading was 389. What do I do next? Take another reading prior to the 7am injection? His reading when he was diagnosed at the vet was over 500.

:thumbup Good for you. Don't forget to give praise, hugs and kisses after each poke. Always test before feeding and before giving insulin. Test, feed and shoot.

As an update AMPS was 452. I'm going to remove dry food today. While giving the AM injection I started with fancy feast and mixed in some of the Hills W/D wet so it's not such a huge drop in carbs. I would appreciate any suggestions on what to do next. How soon do I take another test? Two hours? When do I feed more wet food (Eli is used to free range dry all day long).

A few updates, 1+ BS was HI. 3+ was back down to 399.

acrutch said:

A few updates, 1+ BS was HI. 3+ was back down to 399.

Click to expand...

That's actually a pretty big drop in 2 hours. 201 points at least. I would do another test at +4.

Have you any ketone test strips? If not, I would suggest you go to any pharmacy, and buy some. DKA can be life threatening, so you'll want to test for ketones when you can, especially when your cat is in the higher numbers.

Good job on the testing, so far :thumbup

Welcome to FDMB, Adrienne! This is truly the best place you never wanted to be.

Great job getting started with home testing and getting Eli's spreadsheet (SS) started. As others noted, you're vet started you on a good dose of Lantus but gave you the standard vet info on food. We advocate for a species appropriate diet that is low in carbohydrates (i.e., under 10% carbs). However, most of us feed less than that 10% -- usually somewhere in the range of 4 - 6% or even lower. As a comparison, W/D is 25% carbs for the canned food and 37% for the dry. I have no doubt this is why you're seeing such high numbers. In fact, the effect right after your shot this morning in notable.

If you have a supply of strips for your meter and will be home this evening to monitor, I would get rid of the prescription food. (FYI: your vet or the store where you purchased the food should take it back. Most of us have been through this before coming here. Just say your cat won't eat it.)

At the beginning of this process, testing every 3-hours (i.e., a "mini-curve") is helpful so you have a sense of when Lantus onset begins and where Eli's nadir (lowest point in the cycle) falls. As you collect test data, this pattern will become more evident.

I'd also suggest you read the starred, sticky notes at the top of the Lantus board. These notes contain the following information:

• Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal version -- the “Tilly” Protocol developed by the counterpart of this group in Germany, which was also published by Kirsten Roomp & Jacqui Rand, DVM in one of the top vet journals.
• New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
• Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
• Lantus depot: This is an important concept for understanding how Lantus works.
• Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

One other suggestion might be helpful. Given that Eli has been sitting in higher numbers, it would be prudent to test for ketones. This is much easier than testing or giving insulin although you will need to stalk your cat to the litter box. You can purchase urine ketone test strips, Ketostix, at most pharmacies. You follow the instructions on the box and pass the paper end of the strip through your cat's urine. The paper will change color after 15 seconds (see the box) based on whether ketones are present. There is a color code on the container for you to compare with. Ketones are dangerous and an unfortunate complication of diabetes.

Welcome!

It doesn't look like anyone has addressed the food- Mixing it together is good, just slowly decrease the M/D and increase the FF. Just be aware that food changes may lead to poop changes at first so be on the look out for liqui-poo or constipation. Adding water to the canned food will help with the dehydration problems your cat has and maybe lessen the amount of water bowl drinking he does.

We usually tell newbies not to shoot if the PS (pre-shot) number is under 200- namely because you don't know how low your cat goes right now.

Keeping tabs on the numbers is great- so happy you got it the first time- that is lucky as so many of us struggle to get enough blood the first few (several) times.

Never had to deal with the neuropathy but the best things are the methyl B vitamin suggested and getting his numbers down into the low pinks, yellows, and blues (on the spread sheet).

Thanks for all the help! I tested at 5+ and it was 369. Given these are still really high numbers, and I've taken the dry food away, should I consult with my vet to increase the dosage? Or should I wait a few days to see how it goes with the low carb wet food. I'm just concerned that Eli has been on Lantus for two weeks now along with that awful food and I want to get him on track as soon as possible. On a good note, he loves the Fancy Feast - much better than the wet W/D Hills.

Patience is required with FD and treating. Glad you removed the W/D but it may take a few days of numbers slowly improving to see, along with testing, if a dose increase is needed. It doesn't happen overnight ;-)

Welcome! Great job with the home testing! If you would like to post over on the Lantus forum we can continue to help you with dosing advice and any other questions you might have. If you notice, most folks have a link to a spreadsheet in their signatures, as well as a link to a basic profile of their sugar kitty. As you do more testing and get more data, it's helpful as a quick reference for those giving advice. Many people post their numbers daily.

Here's the links on how to set up the spreadsheets:

Spreadsheet http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Profile http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=79123

Thanks Tara. I started a spreadsheet - can you see if under my profile? Just want to make sure it's working. Once I get a little more data I'll move over to the Lantus site.

On an unrelated topic - I was just able to test Eli for Ketones (read that placing aluminum foil under urine stream was easiest - and it worked very well). The result was negative. How often do I have to do this test? Is there anytime of the day that is better?

I can't express how much I appreciate the overwhelming support everyone has provided to me thus far.

Good job on the spreadsheet and the ketone test, too. YAY for Negative!

I would try to get a ketone test at least once a day, if you can, when he's in high numbers like this. Also, if he's ever inappetant or throwing up or acting lethargic, no matter what his numbers are.

Hopefully, you'll start to see some lower numbers soon (in a few days, maybe) with the new diet. Keep testing, and keep asking questions.

I'm happy to report that I'm already seeing progress in Eli with removing the dry and wet Hills W/D. While I know the numbers are still high, I was thrilled at PMPS +6 to see 291. Below is progress thus far since I've started home testing and completely removed the Hills dry food and gradually removed the Hills wet food:
10/14/12: AMPS 452, +1 HI, +3 399, +5 36. PMPS 444, +3 344, +6 291
10/15/15 AMPS 433
I'm planning to test +3, +6 and +9 today. A few questions:
1) I took off work today to do they three hour testing. I can't do all this testing on a regular basis - so other than the AMPS and PMPS, what is the other critical time I need to test - and can I get away with just one additional test in either the AM or PM? Or do I need to do at least one additional test in both?
2) I'm not sure how much to feed Eli and how often. He was on free range dry food. Yesterday (first day of taking away dry good) and fed him half a can of fancy feast at both AM and PM injections. And then about 1/4 a can every three hours. I can't do that much feeding while I'm at work or thru the night. What is his ideal amount to be fed and how often?

Thanks again for any advice!

You can purchase the vitamin B12 (Methylcobalamin) version of B12, from anywhere. I purchased mine from vitacost http://www.vitacost.com/vitacost-vitami ... 0-capsules

To use: open and mix the contents of one capsule in wet food once a day.

If you get tablets, you can melt it in water and mix that into wet food. The daily dose is between 3-5 mg (3000-5000 mcg) once a day. Whatever the cat doesn't use, it will pee out. If another animal eats it, no worries, it will pee out what it doesn't need.

Just be sure to get the correct version of B12.