Dosing help..

[Adam Flowers]

The following is a post I made on Facebook in a vet group in Lincoln, Nebraska. It gives a run down of what has happened with Mogee since diagnosis:

"My cat Mogee was diagnosed with diabetes last month. Before starting insulin my vet recommended changing his food (Royal Canin Glycobalance) to see what it would do to his blood glucose levels.

The food did not bring Mogee's levels down enough so we started him on insulin (Prozinc) on September 26th. My vet started him at 2 units, twice a day. We rechecked his levels again 2 weeks later and my vet recommended increasing Mogee's dose to 4 units, twice a day.

When Mogee was first diagnosed, I wanted to learn more about feline diabetes and how to properly care for a diabetic cat. I quickly joined the Feline Diabetes Message Board (FDMB).

I guess the main issue I am having along my journey thus far is this: I can not seem to get Mogee's numbers under control whatsoever. Based on my research, I believe Mogee needs to be on a food that is at least under 10% carbs. The food my vet has prescribed him is 14%. Also, from what I have read, should he be on wet food as opposed to dry? Would a lower carb wet food bring his numbers down?

Also, I started home testing Mogee prior to starting insulin because I felt his numbers were higher when we went to the vet to get a glucose reading due to stress - Mogee hates the car and the vet. My vet has highly recommended that I do NOT home test Mogee as it stresses him. Mogee likes when I home test and comes running when I get the supplies out (YouTube "Mogee Pickles" .. I have multiple videos showing this). Looking at his spreadsheet, it seems that increasing his insulin has not done much (see attached spreadsheet). My vet has already said that he believes Mogee will be up to 7 units, twice a day. Too me, that sounds like way too much.4

I believe it is frowned upon on this page to seek advice on what vet to use but after already paying almost $800 on vet bills, medicine, and supplies last month I REALLY need someone to point me in the direction of a vet that really knows and has experience with feline diabetes and who will work with me along the way.

I love Mogee with all my heart and would love to see some progress."

After that post, I finally found a vet in Lincoln that goes with everything I have learned on FDMB. They will let me transition to wet food and like that I home test.

I will be meeting with them next week but would love to switch Mogee to fancy feast classic low carb wet food prior to that appointment.

Can someone please look at my spreadsheet and let me know what they believe I should reduce mogees dose to? He is currently on 4 units twice a day but I do not want his to go hypo when I switch his food out.

Should I reduce him back to 2 units twice a day? Is it dangerous to decrease that amount? Any advice is appreciated. Thank you!

 

[Rachel]

Hey Adam! It looks like you're usually able to monitor during the day, is that right? Are you planning to switch all at once, or slowly? Most people transition to a new food slowly...like mix a little in to the old food and then slowly increase that amount over a week or two. That helps to reduce tummy upset from new food as well as keeping the numbers from suddenly going so low. You might try that and instead of reducing his insulin, monitor and see if he needs lower. If you can't monitor, I might jump back to 3 units instead of 2...he doesn't really drop that far, and I hate to see you drop too far back. Let's see what others think, but that's my initial thoughts.

 

[Adam Flowers]

Hey Adam! It looks like you're usually able to monitor during the day, is that right? Are you planning to switch all at once, or slowly? Most people transition to a new food slowly...like mix a little in to the old food and then slowly increase that amount over a week or two. That helps to reduce tummy upset from new food as well as keeping the numbers from suddenly going so low. You might try that and instead of reducing his insulin, monitor and see if he needs lower. If you can't monitor, I might jump back to 3 units instead of 2...he doesn't really drop that far, and I hate to see you drop too far back. Let's see what others think, but that's my initial thoughts.

Yes, I am able to test throughout the day. I planned on switching over the weekend so I can watch him closely. I would say the transition would be about 5 days, that's how fast I switched him from his old food to the Glycobalance and his tummy did fine.

I appreciate the advice, I was thinking either 2 or 3 units twice a day but I did not know if it was okay to reduce that much insulin right away.

 

[Djamila]

I agree with Rachel, I would not recommend decreasing given the numbers you're seeing. If you're concerned about a sudden drop, I would spread out the food transition so that you'll see it coming before anything too dramatic happens.

Fingers crossed that the food change helps bring Mogee's numbers down! And so good to hear that you found a more like-minded vet.

 

[FurBabiesMama]

If you are not doing an immediate food change but rather a gradual transition, I would not drop the dose at all. Just monitor very carefully to make sure he does not go too low.