What to do with these numbers?

[Natalie & Fluffy]

Hi guys! I've been carefully watching Fluffy for the past week since I started hometesting. I want to do a glucose curve but I'm running low on test strips (will order some tonight). So far he's been handling the 1 U of Novolin N okay I think, but he tends to get really meowy for some periods at a time. In the morning when I feed him his full meal, he'll leave some food behind and I save that as snacks if he gets meowy. Sometimes he'll meow even if his ranges are in the mid 100s. He's always been a hungry cat, addicted to dry food!

Any assessment on what I should begin doing next?

I want to get into transitioning his diet. But I don't want to start soon because parents are making me go on a trip from Dec 19 to Jan 3rd. If I had a choice, I'd stay here and be with Fluffy all day He'll be under watch by a vet and kennel but even then I'm worried... I have to also write up very specific instructions on his feeding and insulin and whatnot. And then I'll probably call them everyday to check up on how he's doing. They'll be sick and tired from hearing of me!

 

[Squalliesmom]

Hi Natalie. You're doing a great job! It would be helpful if you could run a curve when you get your test strips. AMPS and PMPS tests are vital, but it's important to run a few curves to find Fluffy's nadir (lowest point of the cycle), too.

You are absolutely correct about wanting to put him on a low-carb, canned food diet, and also correct in deciding to wait till you're home from your trip to start. The transition must be done slowly and Fluffy will need to be monitored closely to make sure his BG doesn't drop too low. A cat's BG can drop significantly when switched from a dry food to a low carb, wet diet, and may even require a dose reduction.

Make sure you have all your instruction written out clearly for the kennel, and don't worry about whether or not they get tired of hearing from you, lol! There's nothing wrong with calling once a day to see how he's doing.

Enjoy your trip, let us know when you get back and we can help you with the diet transition!

 

[Natalie & Fluffy]

Hi Natalie. You're doing a great job! It would be helpful if you could run a curve when you get your test strips. AMPS and PMPS tests are vital, but it's important to run a few curves to find Fluffy's nadir (lowest point of the cycle), too.

You are absolutely correct about wanting to put him on a low-carb, canned food diet, and also correct in deciding to wait till you're home from your trip to start. The transition must be done slowly and Fluffy will need to be monitored closely to make sure his BG doesn't drop too low. A cat's BG can drop significantly when switched from a dry food to a low carb, wet diet, and may even require a dose reduction.

Make sure you have all your instruction written out clearly for the kennel, and don't worry about whether or not they get tired of hearing from you, lol! There's nothing wrong with calling once a day to see how he's doing.

Enjoy your trip, let us know when you get back and we can help you with the diet transition!

Hi Lucy!! Thank you so much for the reassurance! I heard fancy feast classics is something I might try... I keep hearing about Evo dry food, but I'll get it if he doesn't react well to the canned. Thank you!

Also his numbers have been slowly and steadily dropping but this morning AMPS it was a whopping 263? Compared to last night's PMPS it shot up just a little over a +100. Is that normal? Could it have been that small snack I gave him? I knew I shouldn't have done that

 

[BJM]

Bouncing:
When a cat's glucose
- drops rapidly
- drops to an unfamiliar level (ex 200s from 400s)
- drops below normal
Or any combination of those, it triggers compensatory hormones which release stored glucose (glycogen) to bring the glucose back up. This elevated glucose may take 3 days to clear.
Testing around +3 to +4 hours after giving the Novolin will help you ID what the cause is.
Be sure to feed about 30 minutes before giving the Novolin; it helps buffer the drop to have some food on board.

 

[Natalie & Fluffy]

Bouncing:
When a cat's glucose
- drops rapidly
- drops to an unfamiliar level (ex 200s from 400s)
- drops below normal
Or any combination of those, it triggers compensatory hormones which release stored glucose (glycogen) to bring the glucose back up. This elevated glucose may take 3 days to clear.
Testing around +3 to +4 hours after giving the Novolin will help you ID what the cause is.
Be sure to feed about 30 minutes before giving the Novolin; it helps buffer the drop to have some food on board.

Thanks BJ! I feed 30 min before I shoot. I'm starting to think that it might be difficult to keep regulating on Novolin. I remember before I was able to hometest he'd do okay for about a week on novolin, and then we'd always have to go to the vet to find out his dose needed to be changed because of his behavior. You mentioned before that I should switch to Prozinc; is that the 12 hr insulin?

 

[Julia & Bandit (GA)]

Thanks BJ! I feed 30 min before I shoot. I'm starting to think that it might be difficult to keep regulating on Novolin. I remember before I was able to hometest he'd do okay for about a week on novolin, and then we'd always have to go to the vet to find out his dose needed to be changed because of his behavior. You mentioned before that I should switch to Prozinc; is that the 12 hr insulin?

Lantus (glargine) and Levemir (detemir) are long acting insulins that are recommended for cats. Prozinc is also not a bad choice for insulin for cats (it has a slightly shorter duration of action than the other two, but some cats do well on it). I would strongly recommend switching to one of those three insulins, because it's not likely you'll see good control with the Novolin, as it's not recommended for use in cats. Many of us get a script from our vets and order Lantus or Levemir online from canadian pharmacy, because it's MUCH cheaper than buying it from a US pharmacy.

 

[Natalie & Fluffy]

Lantus (glargine) and Levemir (detemir) are long acting insulins that are recommended for cats. Prozinc is also not a bad choice for insulin for cats (it has a slightly shorter duration of action than the other two, but some cats do well on it). I would strongly recommend switching to one of those three insulins, because it's not likely you'll see good control with the Novolin, as it's not recommended for use in cats. Many of us get a script from our vets and order Lantus or Levemir online from canadian pharmacy, because it's MUCH cheaper than buying it from a US pharmacy.

Thank you so much Julia! I talked with my parents about it and they seem a bit open to possibly getting him started on the future. I think they'll be more convinced if I can get my vet to talk himself and them into it. Also do you think I should worry about Fluffy's gingivitis affecting his numbers? It's very mild, and he has never exhibited any pain or problem eating dry foods. I'm attempting to clean his teeth twice a day with a cat toothbrush and paste but it's difficult getting a good scrub :/

 

[Julia & Bandit (GA)]

Thank you so much Julia! I talked with my parents about it and they seem a bit open to possibly getting him started on the future. I think they'll be more convinced if I can get my vet to talk himself and them into it. Also do you think I should worry about Fluffy's gingivitis affecting his numbers? It's very mild, and he has never exhibited any pain or problem eating dry foods. I'm attempting to clean his teeth twice a day with a cat toothbrush and paste but it's difficult getting a good scrub :/

Well, it's hard to tell how his mouth is affecting his BG on Novolin, since cats on Novolin don't typically get good control to begin with. I would say if you switch to one of the "L" insulins, and you're having a more difficult time than usual regulating him, the mouth is probably the culprit and you'll need a dental before you see improvement. In my experience, the earlier you get the dental done, the better off you are, both in terms of controlling BG and the amount of work that needs to be done in the dental. But my experience with Bandit has also been dealing with resorptive lesions, not mild gingivitis, and with resorptive lesions you definitely must get the mouth taken care of before you see an improvement.

 

[Natalie & Fluffy]

Well, it's hard to tell how his mouth is affecting his BG on Novolin, since cats on Novolin don't typically get good control to begin with. I would say if you switch to one of the "L" insulins, and you're having a more difficult time than usual regulating him, the mouth is probably the culprit and you'll need a dental before you see improvement. In my experience, the earlier you get the dental done, the better off you are, both in terms of controlling BG and the amount of work that needs to be done in the dental. But my experience with Bandit has also been dealing with resorptive lesions, not mild gingivitis, and with resorptive lesions you definitely must get the mouth taken care of before you see an improvement.

Yeah I don't like it, but it's the only insulin I can use now until I return from winter break Resorptive lesions? Sounds pretty intense Hope Bandit has being doing okay!

When I drop Fluffy off at the vet boarding, I'm leaving specific instructions, what do you guys think of this so far? Any suggestions? I'll be mentioning I'll be calling basically everyday to check how he's doing haha. I might ask them to do a glucose curve within a week after he gets used to being at the vet boarding.

"Fluffy eats ½ cup of food at 6:30 am, and ½ cup of food at 6:30 pm. 30 minutes after his meal, Fluffy must get 1 U of Novolin N insulin (at 7 am, and 7 pm). Attached I have a spreadsheet of his blood glucose numbers. If possible, please check his BG right before each shot (located in the columns AMPS, and PMPS) and write them down. If he’s mewling unusually loudly at certain periods of the day, please check his BG. If it is in the low 100s, or below that, especially during his peak times (+3, +4?), then it would be alright to give him a small snack of his dry food to ease his BG drop. Anything past +8 hrs, try not to give him a snack unless BG is very low."

I want to mentioned something about ketones; How and when should they check for it? I was recently worried since about two weeks back when I took Fluffs to the vet his breath smelled like alcohol or sterilizing wipes. He's obviously much better but thinking about it back then he could have had ketones?! Dx That was when he was on 2 U and his levels by the fructosamine test showed they were consistently low.