New diagnosis and testing at home with crazy results

[Smokey and Jessica]

About a month ago my cat was diagnosed with diabetes. Glucose readings were in the 500’s. After 5 glucose curves spread over two weeks we were set to 2 units of prozinc twice a day. About 2 weeks later I started home testing. First day I got 157 pre- shot and it continuously went up all day peaking around 430. Next day started at 168 and 3 hours later 38. He was fine and bounced right back after some food and reached 380 by that night. 3rd day after having those crazy results I took him to the vet for them to do another curve. Once again continuously went up all day to around 430. Today we started with 207 pre-shot and I decided to lower his dose to 1.5 but we still hit a low too low 47. He’s comfortable now around 150. I’m planning to lower again tonight to just 1. Am I right thinking he’s getting too much insulin? He’s being treated at a Japanese vet and they advise free feeding which I ignore, and have gradually moved him to a strict 2 meal per day wet food diet with a few pieces of dry diabetic as treats after tests. I’m hoping it’s the change in diet that is helping me to lower his dose so soon? It seems 2 units is putting him in this roller coaster one day too low one day too high too low too high. I don’t think we are near remission since approx 1/8 cup of diabetic dry brought him from 38 to 280 in less than 2 hours I think he definitely still needs it just maybe not so much?
Also, this vet as I said wants me to free feed, but another told me absolutely not to. Free feeding isn’t really an option because he’ll just eat it all and I don’t know how long I can guarantee to feed other meals at the same time every day. I’m getting a lot of negative feedback on choosing to go to twice a day and looking for suggestions how to possibly space out food without causing even more crazy results. We obviously still haven’t found the right balance of anything and I worry making these changes again will set us back.

 

[Chris & China (GA)]

Welcome to the FDMB Jessica!! This is the best place you never wanted to be!!

Am I right thinking he’s getting too much insulin?

Yes, you're thinking right!! If they drop below 50 (on a human meter) that's too low for a cat receiving insulin.

What's been happening with the quick "bounces" back to high numbers is exactly that...a "bounce"!

Bounces happen when 1. they drop too low, 2. they drop too quickly, 3. they drop into numbers their body isn't used to anymore (or any combination of all 3)

Their bodies are used to living in those higher numbers, so even if they don't drop "too low", the liver releases stored sugars and hormones to bring them back up quickly. Bounces can take up to 6 cycles to clear those sugars and hormones.

Free feeding isn’t really an option because he’ll just eat it all and I don’t know how long I can guarantee to feed other meals at the same time every day.

You might want to look into buying an auto-feeder. They've saved the sanity of many a sugarcat parent! The PetSafe5 is a favorite around here. You can program it to open and offer mini-meals throughout the day.

It used to be important to feed a large meal before giving insulin....back when older, harsher insulin's were all that was available, but with the newer, gentler insulins like ProZinc and Lantus, it's not the same.

Smaller meals are easier on the pancreas to deal with than big meals. The pancreas has to work harder to release enough insulin to deal with a huge amount of food all at once, so giving smaller, more frequent meals don't stress it out as much.

The only time we really don't want them to eat is the 2 hours immediately before shot times, so that when we test (the "pre-shot") we get a number that's not influenced by food.

As for the "diabetic" dry, it's very high in carbs and not a good choice for any diabetic. A low carb diet like Fancy Feast Classics, Friskies Pate's or 9-Lives ground are all affordable and easy to find.

There's a LOT of great information on feeding cats in general (and specialized info on diabetic cats) at Dr. Lisa's "Feeding your cat...Know the basics of feline nutrition"

I think your idea of dropping back to 1U is a good one, at least until you're testing more and can really see what's going on inside his body.

Keep asking questions!! The people here are very generous with their time and love to help!!

 

[Smokey and Jessica]

So for the feeding I would basically be splitting 1 can of hills m/d into like 4 feedings per day and then the occasional 3-4 pieces of dry I give after test? I have a full case of that and with his insulin dose in question I don’t want to change it just yet anyway.He used to eat about 1 1/2 cups of dry food before this and would just snack, but the wet food doesn’t seem to fill him up. I’m pretty sure he’s going to hate that. He’s constantly hungry as it is and those 2 times a day he gets half the can is the only time I can walk into the kitchen without getting yelled at and my legs attacked! I almost hate the feeding more than the shots and ear pricks. I feel like I’m starving him. It seems like such a small amount of food.

 

[Squalliesmom]

So for the feeding I would basically be splitting 1 can of hills m/d into like 4 feedings per day and then the occasional 3-4 pieces of dry I give after test? I have a full case of that and with his insulin dose in question I don’t want to change it just yet anyway.He used to eat about 1 1/2 cups of dry food before this and would just snack, but the wet food doesn’t seem to fill him up. I’m pretty sure he’s going to hate that. He’s constantly hungry as it is and those 2 times a day he gets half the can is the only time I can walk into the kitchen without getting yelled at and my legs attacked! I almost hate the feeding more than the shots and ear pricks. I feel like I’m starving him. It seems like such a small amount of food.

Cats with unregulated diabetes are hungry all the time -they are literally starving - because their bodies can't properly utilize the food. It's okay to feed him if he's hungry, just not in that 2-hour window before his shot. If you are gone during the day you can make up some "foodsicles" for him; mix a little bit of water into some canned cat food and freeze it in small containers. Before you leave for the day you can leave one or more out for him to eat later in the day. As long as he's on a low carb food it shouldn't have a negative impact on his blood glucose.

 

[Chris & China (GA)]

So for the feeding I would basically be splitting 1 can of hills m/d into like 4 feedings per day and then the occasional 3-4 pieces of dry I give after test?

How much does your cat weigh? (What's his name?) Unless he's a very small cat (under 6lbs) one can a day isn't enough for even a normal cat to eat.

@Squalliesmom is totally correct too. Until he's better regulated, he'll need to eat more than a "normal" cat. Without the proper amount of insulin, no matter how much he eats, the glucose from the food can't get into the cells so he's basically starving to death (so his brain tells him to eat more and more, but again, without insulin, it doesn't help!)

Think of insulin like it's a key....and on every cell of the body there's a lock. Without enough keys, the glucose that's in the bloodstream can't get in and the cell starves.

Might want to get you some of these to protect your legs....LOL (really, just kidding but I think if you start feeding him more, maybe he won't go for your legs so much)

 

[Smokey and Jessica]

How much does your cat weigh? (What's his name?) Unless he's a very small cat (under 6lbs) one can a day isn't enough for even a normal cat to eat.

When we think this all started he was 18 lbs. I spent a year dieting (free feeding still but low calories food) and thought he was losing weight from that. It’s turned out to be 6lb loss due to the diabetes. He’s 12lbs now and started to gain as soon as he started insulin but I have one vet telling me his weight is fine and another saying he still needs to lose 2-3 lbs which is why she recommended only 1 can / day to help him lose more.
I bumped him up to 3/4 can this morning, I’ll give him 1/4 snack this afternoon then another 3/4 for dinner so I’ll see if that helps. According to the chart that would be 1 3/4 can per day for ideal weight management, not weight loss, but maybe it’ll help to stablize how much insulin he needs over the next week or so and then I can judge if it’s making him gain again. I really don’t even know if he’s a healthy weight or needs to lose. I’ve had 2 vets give me completely different information on all of this and don’t know who to believe!

 

[Chris & China (GA)]

Where would he fall on this Body Condition Score chart?

 

[Smokey and Jessica]

Where would he fall on this Body Condition Score chart?

This is so tricky. He seems to me in between ideal to thin, but like I said one vet says he’s overweight. He has a man-cat droopy belly. Not much but a big droopy bag of skin, but that with his long fur makes it hard to eye any kind of waist. When setting it takes a little push to feel ribs but standing they’re easy to feel and his shoulders and hips by his tail are very easily felt. Since being on insulin he has more ‘firmed up’ than filled out if that makes sense. Same size just more solid and not as loose squishy feeling muscles. He’s very big in general. The average weight for a neutered male adult Nebelung I’ve read is around 14 lbs and he was always 16-18 lbs for the last 10 years. Even at 16 lbs though, vets always told me he needed to lose 4-6 lbs. Now that he has lost that much one says fine one says more still. I think I’ll shoot for same for now until I get better control of his diabetes then later when he’s been stable long enough I’m comfortable I can work on weight gain.
I think attacking weight with diet, and change in diet, and insulin all at once was way too much and judjing by what I read here, it could’ve been extremely dangerous. I definitely want to take it one thing at a time from here.

 

[Squalliesmom]

From your description, it doesn't really sound to me like he needs to lose any more weight. The "firming -up" is him regaining some muscle tissue, a good sign. Can you post some pictures of him? Also, how old is he?

 

[Smokey and Jessica]

From your description, it doesn't really sound to me like he needs to lose any more weight. The "firming -up" is him regaining some muscle tissue, a good sign. Can you post some pictures of him? Also, how old is he?

Here’s a couple. I tried to get some next to my almost 3 yr old so you can get an idea of how big he is. Approx 21 inches nose to base of his tail and standing about 12 from floor to shoulders.
We think he’s around 12 years old (12-14). I’ve had him 10 1/2 years and they estimate 8-18 months old when he came to us.

 

[Squalliesmom]

He definitely does not look to me like he needs to lose any more weight! He's a handsome guy.

 

[Chris & China (GA)]

I agree....he doesn't look like he needs to lose any more weight

Try to get a picture straight down on him like you were trying to take a picture of his spinal column/back

All male cats have a "pouch" but that's not the same as being "fat"

 

[Smokey and Jessica]

 

[Squalliesmom]

Definitely does not need to lose any more weight! If he was my cat, honestly, I'd look to have him gain a pound or two.

 

[Smokey and Jessica]

He definitely does not look to me like he needs to lose any more weight! He's a handsome guy.

Thank you!
On a side note though- does the diabetes have anything to do with poor grooming and / or skin conditions? I’m embarrassed to show pics because he kinda looks greasy and he has a lot of dandruff on his back. He needs a grooming!

 

[Squalliesmom]

Thank you!
On a side note though- does the diabetes have anything to do with poor grooming and / or skin conditions? I’m embarrassed to show pics because he kinda looks greasy and he has a lot of dandruff on his back. He needs a grooming!

Yes, that's classic for diabetes. It will clear up once his blood glucose is better under control.

 

[Smokey and Jessica]

Definitely does not need to lose any more weight! If he was my cat, honestly, I'd look to have him gain a pound or two.

I’m with you. Like I said his breed average is 14 lbs. and I hate feeling his shoulders! But vets are supposed to know best?!?!?

 

[Squalliesmom]

I’m with you. Like I said his breed average is 14 lbs. and I hate feeling his shoulders! But vets are supposed to know best?!?!?

Well, yes, they are, but...They don't always get it right, lol.

 

[Chris & China (GA)]

does the diabetes have anything to do with poor grooming and / or skin conditions?

Absolutely!! Check out China's Profile in my signature....compare her coat condition in the first and second picture (you can also see the difference in her eyes and her weight....I swear they are the same cat!!)

I totally agree about your cat's weight too....I would NOT be worried about losing any more weight!!

 

[Kerri2455]

Going back to your original question with the crazy numbers, I am home testing too but not daily. I was getting highs and super lows and then some in between and we now are playing with giving 1 unit of Lantus in the AM and none at night as his numbers were either low or normal when we tested before the evening meal. Maybe insulin once a day might work for you if you are getting low numbers either AM or PM.