Doing shockingly well...Am I missing something?

[Beezkat]

So my little Skitter was diagnosed with DM with BG 446 about 2 weeks ago. Her heaviest weight was 17.5lbs and the vet has been giving me a hard time about it for years. I tried prescription diet kibble (she pukes on wet food) and she lost almost nothing, then switched to a higher protein kibble (Purina Healthy Metabolism something or other) from the grocery store and she was sitting around 16.5 for awhile. When I brought her in, she was down to 15lbs. At follow up she was down another # in 2 weeks (yikes!), but her BG was 147 on my AlphaTrak2 and 157 on the vet's .

Anyway, I was taught to give insulin and over the past 3 days, I've only given it 3x because her BG is below 120. This morning, she was at 106, so she's >24 hrs with no insulin.

Is this normal? Did she get misdiagnosed? I'm still waiting for an email from the vet. Anyway, the new food is canned and <8% carb and she tolerates it really well.

 

[FurBabiesMama]

Hi. What did they do to diagnose her? Did they find glucose in her urine? Their blood glucose can skyrocket from stress at the vet's office, so the vet is not supposed to base a diagnosis on that alone. Also, when did you switch to low-carb wet food only? That can impact the levels pretty dramatically.

I wish I had your 'problem'.

 

[Beezkat]

Hi. What did they do to diagnose her? Did they find glucose in her urine? Their blood glucose can skyrocket from stress at the vet's office, so the vet is not supposed to base a diagnosis on that alone. Also, when did you switch to low-carb wet food only? That can impact the levels pretty dramatically.

I wish I had your 'problem'.

Yeah, tell me about it! I've been reading all this stuff on here and expecting the worst!
They checked her urine. The appt was on Saturday and I got word on Tuesday and switched her food that evening--no mixing of wet/dry, just full switch. The f/u was 2 weeks later. Prior to the dx there was a TON of urine in the litter box and it was super sticky, so I made the appt figuring she was diabetic. But for her to convert to normal so fast?? I might be the luckiest fur-mama of all time!!

 

[Lillie]

My cat converted to normal very quickly after losing weight and not eating any dry food at all. I feel blessed, I really do. His specialist felt it was transient diabetes but there is always a chance it could come back if he gains a lot of weight and eats a high carb dry food again which I never will feed him again so chances are good he stays normal. (fingers crossed)

 

[Jess and Marky Mark]

We are in the same boat with Mark. Our vet wants to keep him on 1.5U Lantus for three months to see how he maintains. She said if I get worried about his numbers going too low, to give him just 0.5U to keep the insulin in his system consistently. We are hopeful that this means good things for his future!

 

[Beezkat]

My cat converted to normal very quickly after losing weight and not eating any dry food at all. I feel blessed, I really do. His specialist felt it was transient diabetes but there is always a chance it could come back if he gains a lot of weight and eats a high carb dry food again which I never will feed him again so chances are good he stays normal. (fingers crossed)

Cool! So, I'm not the only one. I feel like I need to keep a close eye on her for awhile longer...it's only been about 3 days since starting the insulin and regular tracking, so I'm hopeful, but not out of the woods yet. And yes, definitely will not be going backward with the diet.

My other cat has CKD2, but is on abx for a UTI and has f/u with the vet in 2 weeks. I'm hoping she'll also get back on track with the wet food and I can avoid having too much medical treatment with her.

 

[Marvin's Mom - Nat]

Hi, I didn't notice but how much insulin and what type are you giving? Are you testing BG just before shot time or do you try and get a few more tests in during the day? It does seem like kitty is reacting well to insulin, and may need a decrease. Like others mention, sometime just the change to low carb wet, makes a huge difference, also multiple small meals a day help (4 - 6).

 

[JeffJ]

Kudos to you for treating your cat, and for testing. The only way to know for sure is some followup blood tests with your Alphatrak.

Don't dose under 150, and probably not under 200. If you do more doses, please read up on Hypos and how to handle them. See the stickies at the start of the insulin subforums.

Also, I'm with the others. I wish Leo had that problem. If you think about cats eating in the wild, they do not eat any dry food at all. So that is a human invention and many cat foods cause some level of diabetes.

 

[Beezkat]

Hi, I didn't notice but how much insulin and what type are you giving? Are you testing BG just before shot time or do you try and get a few more tests in during the day? It does seem like kitty is reacting well to insulin, and may need a decrease. Like others mention, sometime just the change to low carb wet, makes a huge difference, also multiple small meals a day help (4 - 6).

She's on Lantus and my vet said it doesn't tend to drop the BG too fast. So far, she's been asymptomatic. With 36 (actually 37 because I got home late) hours off insulin, she went up to 201 pre-shot and this morning was 79. I've never given more than 1u. Actually, last night both cats really hit the food hard, which is unusual, so I added another 3oz can, still low-carb.

The problem with multiple meals is 1) I'm not home much. I have a variable work schedule and some days the best I can do is a 7am and a 745pm feeding. After that, I'm going to bed. Skitter isn't loving the BG check, so I'm trying not to torture her and just watch for symptoms. Last night before bed, she just acted hungry, so I fed her more. 2) The cats don't meal feed. They eat and walk away and then go back for more a bit later. They always have done and is why it took a nasty dx to finally switch to the wet food. The stuff stinks, but the girls are getting better about eating a bit quicker.

 

[Beezkat]

Kudos to you for treating your cat, and for testing. The only way to know for sure is some followup blood tests with your Alphatrak.

Don't dose under 150, and probably not under 200. If you do more doses, please read up on Hypos and how to handle them. See the stickies at the start of the insulin subforums.

Also, I'm with the others. I wish Leo had that problem. If you think about cats eating in the wild, they do not eat any dry food at all. So that is a human invention and many cat foods cause some level of diabetes.

Thanks! The vet told me to dose 1/2 (if I can) if below 200 and 1u above 200. So far, since taking her to the vet, I've only had last night's reading >200. So, I'm aiming to keep an eye on her BG carefully, so I can see if we can just stop the insulin completely.

 

[JeffJ]

Sounds good. Just make sure you are ready for a hypo. It can happen to any sugar cat that is receiving insulin.

 

[Beezkat]

So, at this point, Skitter seems to be entirely diet controlled. She's looking good, walking more comfortably than I've seen her in quite awhile, weight is staying down, tolerating the diet well. Her last dose of Lantus was Saturday night and I haven't had a reading >90 since then. My plan is to continue the diet, continue 2x/day BG checks for the remainder of the week, then 1x/day. If she continues to be okay for 1 month, how much can I relax on the glucose checks?
Also, because I'm still having trouble getting home at a reasonable time, I'm thinking about using a feeder. How long do you think the wet food can sit out? If I set it at say 715am, what's the latest I can set it to provide food? The current diet is 1 can Friskies for 2 cats (Skitter 14lbs, Phoebe 5.5lbs) 2x/day and 1 3oz can Beyond or Fancy Feast before bed. The 3oz can is so they don't wake me up at 4am...this way they're graciously allowing me till 6:30 before jumping on me and nosing my face.
https://docs.google.com/spreadsheet...ADYNgP5zxFXvn7uWJibwQKP-ro/edit#gid=361360320

 

[Lillie]

I purchased the Pet Safe 5 compartment auto feeder to prevent the middle of the night awakenings for food. There is a small compartment inside for an ice pack. I put wet food in two of the compartments at night and place a large ice pack on top of the feeder to help keep it chilled. Some here freeze the wet food and place in the feeder so it takes a while to defrost at a later time. I'm not sure how long it is safe to leave wet food out but my kitty takes forever to finish his daytime food so it sits for quite a while before he finishes it all. So far it's been ok.

 

[Yong & Maury GA]

If she continues to be okay for 1 month, how much can I relax on the glucose checks?

Depends on you a little bit. Personally, I would keep 2 tests a month, at minimum. I've seen some that test once a month for like 3-6 months, then check every couple months. I'd rather stay on top of things should the diet no longer be enough or some sort of infection starts, it will show in her numbers before she'll show signs of pain. Typically

How long do you think the wet food can sit out? If I set it at say 715am, what's the latest I can set it to provide food?

Depending on your climate, I'd guess without an ice pack 8-10 hours? Might just be another personal thing . I thought I read somewhere that wet food can actually be left out for a day . I'd try to keep Skitter with no food 2 hours prior to the pre-shot (Even without shot) test time so you can see what her "real" number is and just to be fair maybe cut off Phoebe too . After confirming she's diet controlled, you can probably lift the 2 hours fasting period.

 

[TempestsMum]

Yong is right, I tested a lot for a couple of months after- maybe 2x a day for the first month then once a day. now I test about once a month. But if she seems like she's not right, her fur looks less shiny or she throws up or seems off in any way, the test kit comes out.

Wet food can sit for a day although Tempest wouldn't eat it if it's not right so no problem there. It's good to use the ice packs for those feeders it keeps everything nice and fresh. Because Tempest always grazed I just put out enough food for her to have a snack at night and not have anything for 2 hours or more for her amps test. Same during the day, I left enough food out so that when I got home it was either finished or I lifted it 2 hours before her pmps test.

 

[Beezkat]

I purchased the Pet Safe 5 compartment auto feeder to prevent the middle of the night awakenings for food. There is a small compartment inside for an ice pack. I put wet food in two of the compartments at night and place a large ice pack on top of the feeder to help keep it chilled. Some here freeze the wet food and place in the feeder so it takes a while to defrost at a later time. I'm not sure how long it is safe to leave wet food out but my kitty takes forever to finish his daytime food so it sits for quite a while before he finishes it all. So far it's been ok.

Great! That's what I've been looking at.

 

[Beezkat]

Depends on you a little bit. Personally, I would keep 2 tests a month, at minimum. I've seen some that test once a month for like 3-6 months, then check every couple months. I'd rather stay on top of things should the diet no longer be enough or some sort of infection starts, it will show in her numbers before she'll show signs of pain. Typically

Depending on your climate, I'd guess without an ice pack 8-10 hours? Might just be another personal thing . I thought I read somewhere that wet food can actually be left out for a day . I'd try to keep Skitter with no food 2 hours prior to the pre-shot (Even without shot) test time so you can see what her "real" number is and just to be fair maybe cut off Phoebe too . After confirming she's diet controlled, you can probably lift the 2 hours fasting period.

Thanks a lot! I was thinking more like 1x/wk for regular testing. By the time I'm testing Skitter, she's definitely off food for minimally 2 hours...probably more like 5.
For the food issue, the cats usually finish a 5.5oz can in 2-3 hours. Phoebe's looking much better and actually eating and coming back for food, but I usually have to carry her over to the kitchen to be fed (she's been showing signs of dementia for awhile). I'm a little nervous she won't know to check for food. Maybe I'll purchase the feeder and try it over a weekend to see what they're up to.