Food struggles, hospitalization, and insulin

Status
Not open for further replies.
JennC & Diago

JennC & Diago

Member Since 2018
Hi All -

I'm newer to the group and posted a different post if you are interested in a little history about Diago. Recently diagnosed on 2/1/18, we attempted to switch to fancy feast classics, went well for almost 2 weeks. He then wouldn't eat anything for over a day. Had diarrhea from antibiotics and we woke up to a LOT of bloody vomit on Saturday, Feb 17th. Vet hospitalized him for fluid and antibiotic therapy. He isn't sure why he threw up the amount of blood he did on Saturday but thankfully hasn't gotten sick since. Prior and after the diagnosis, he eats Science Diet Hairball control very well. He does not eat wet food, we've tried Hills W/D and Fancy Feast classics. I know the carb content is high on his dry food but I want to make sure he eats.

We started glucose testing and the vet basically said all I'm going to do is drive myself crazy by continuing. My question is what is everyone's advice about his situation on food. I know he should be on wet food but I also need him to eat so we can give his insulin and try and regulate. Should I keep him on dry for now, should I keep a little extra food down so he eats a little after his insulin in the AM/PM (he's used to grazing). After he is consistent with eating begin testing his glucose again just to see where we are with the insulin levels and glucose? Should I only allow him to eat what he will prior to injection and then withhold food again until the PM? I'm just trying to figure out what will work for him right now given his recent hospitalization. Thanks in advance!
 
JennC said:
We started glucose testing and the vet basically said all I'm going to do is drive myself crazy by continuing.
Click to expand...
We would disagree with this for sure.

JennC said:
I know he should be on wet food but I also need him to eat so we can give his insulin and try and regulate.
Click to expand...
He needs to eat - that's top priority. The GI issues might well have been from the antibiotics and not the Fancy Feast. For now give him what he'll eat and keep down while you work on your BG testing skills. I'd do that now - practice makes perfect and you'll be able to track his Bg as he recovers as well as based on what/how much he's eating.

JennC said:
should I keep a little extra food down so he eats a little after his insulin in the AM/PM (he's used to grazing).
Click to expand...
Yes, do. Just remove all food for 2 hours before the pre shot BG tests. Vets often say feed only twice a day but that doesn't work well for most cats.

All of the advice I can give is predicated on you being willing to carry out that basic home BG testing routine. It's the only way you can possibly know how he's reacting to food and insulin.
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
 
Last edited:
Thank you so much! I'm a little frustrated with my vet's response as well. I also mentioned about changing him to wet food and he said he doesn't recommend wet food at all that it's just not good for any dog or cat. He also decided on Monday to give 3U of insulin at 7:15 AM without testing his BG first, he then checked the BG at 10:30 AM and it was 472. I did mention that he could be stressed being there and he agreed but was shocked to hear that number given he had an extra unit of insulin that morning. I asked why he decided to give an extra unit and he didn't have a good response.

I will begin testing again to keep track. Trying to get the house to some sense of normalcy again.
 
  1. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  2. do extra tests on days off to fill in the response picture
On these two items, do I test with his food still down at bedtime, or pick up after his PM dose of insulin? Same question for #2, is this with his food down?
 
JennC said:
  1. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  2. do extra tests on days off to fill in the response picture
On these two items, do I test with his food still down at bedtime, or pick up after his PM dose of insulin? Same question for #2, is this with his food down?
Click to expand...
The only time you dont want him to eat is for 2 hours before you test & dose. All the other tests during the day/night he can eat.
 
JennC said:
  1. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  2. do extra tests on days off to fill in the response picture
On these two items, do I test with his food still down at bedtime, or pick up after his PM dose of insulin? Same question for #2, is this with his food down?
Click to expand...
Aside from the 2 hours before the pre shot BG test you can leave food down, feed small meals or whatever the routine is. These extra tests are to capture his response to a dose as he follows his usual routines.
 
JennC said:
Thank you so much! I'm a little frustrated with my vet's response as well. I also mentioned about changing him to wet food and he said he doesn't recommend wet food at all that it's just not good for any dog or cat. He also decided on Monday to give 3U of insulin at 7:15 AM without testing his BG first, he then checked the BG at 10:30 AM and it was 472. I did mention that he could be stressed being there and he agreed but was shocked to hear that number given he had an extra unit of insulin that morning. I asked why he decided to give an extra unit and he didn't have a good response.
Click to expand...
If you like him as a vet for everything else look past that. He's not the only vet who's poorly versed in treating feline diabetes or in pet nutrition. We can help you with insulin dosing.
 
Kris & Teasel said:
If you like him as a vet for everything else look past that. He's not the only vet who's poorly versed in treating feline diabetes or in pet nutrition. We can help you with insulin dosing.
Click to expand...
Yeah, I do like him for almost everything else, I just want a healthy life for Diago and with the vet's advice I don't feel like we would get there.
 
JennC said:
HA! That's no joke. :) He also had feedback about reading online..."not everyone's educated". :banghead: I wanted to say well the advice I'm receiving online is much more than what I've received from someone who is educated.
Click to expand...
My vet got to the point of telling me to go somewhere else to get Rufus regulated. He has underlying issues, but her issue was me asking questions and asking to do things different then what she was used to. I told her about things on this board and ideas for different directions to go. She replied "I have a degree, they don't." Um, ok. You probably know more then I do, and these people probably don't have medical degrees, but these people have LIVED with diabetic cats. Out of the 5 vets that I have been to only 1 has recommened and encouraged home testing. 2 of these vets have diabetic cats and don't home test. WTH? How do they know when and if the dosing needs to be changed?
 
Sean & Rufus said:
My vet got to the point of telling me to go somewhere else to get Rufus regulated. He has underlying issues, but her issue was me asking questions and asking to do things different then what she was used to. I told her about things on this board and ideas for different directions to go. She replied "I have a degree, they don't." Um, ok. You probably know more then I do, and these people probably don't have medical degrees, but these people have LIVED with diabetic cats. Out of the 5 vets that I have been to only 1 has recommened and encouraged home testing. 2 of these vets have diabetic cats and don't home test. WTH? How do they know when and if the dosing needs to be changed?
Click to expand...
I'm glad I'm not the only going through it. I completely agree with you about listening to others here who are living with their kitties condition and are finding what helps them to live a healthy life after their diagnosis. :)
 
JennC said:
Should I keep him on dry for now
Click to expand...

Something else you can try is the new lower carb dry foods .....now there are still lots of good reasons to continue to work towards feeding wet food only, but in the meantime, they might help.

The only two dry foods that are appropriate for diabetics are Dr. Elsey's Clean Protein (available at Chewy.com) or Young Again Zero (available only at their website)

Both companies will send samples if you call and ask for them
 
Chris & China said:
Something else you can try is the new lower carb dry foods .....now there are still lots of good reasons to continue to work towards feeding wet food only, but in the meantime, they might help.

The only two dry foods that are appropriate for diabetics are Dr. Elsey's Clean Protein (available at Chewy.com) or Young Again Zero (available only at their website)

Both companies will send samples if you call and ask for them
Click to expand...
Perfect! I'll give them a shout. Thank you!!
 
JennC said:
I'm glad I'm not the only going through it. I completely agree with you about listening to others here who are living with their kitties condition and are finding what helps them to live a healthy life after their diagnosis.
raw
Click to expand...

A lot of us have gone through this, most vets no matter how good they are in other aspects don't know much about feline diabetes, and are not very much willing to change, mine ( who is a great vet in every other aspect and great surgeon by the way )treated me like I was some kind of freak because I wanted to test, like if I liked doing it, which I don't but is necessary, eventually he gave in to letting me do it my way ( I think he decided to let the crazy lady do it if she wants to ) and just asked once in a while how's he doing? I would answer fine I'm monitoring his dose.

Regarding the food honestly to avoid further discussions with him I blamed the food change on Babu (a cat being a cat ) and just said he didn't liked the dry food he recommended ( I of course didn't even gave it to him) and he would only eat the wet ( that I had selected from DrLisa's list but he did not knew this
raw
;) )
 
Veronica & Babu-chiri said:
Regarding the food honestly to avoid further discussions with him I blamed the food change on Babu (a cat being a cat ) and just said he didn't liked the dry food he recommended ( I of course didn't even gave it to him) and he would only eat the wet ( that I had selected from DrLisa's list but he did not knew this
raw
;) )
Click to expand...
Love it!
 
JennC said:
Yes, we stopped testing for a few days but I'm back at it. His levels are still high. He won't eat the wet food and after his hospitalization I'm just trying to make sure he eats, which he is eating his dry
Click to expand...

Good for you the most important thing is that he eats.

He may relate the food he was eating just before his hospitalization with feeling sick so it may take a while for him to like it back or you may have to change it for a new one altogeher
 
Veronica & Babu-chiri said:
Good for you the most important thing is that he eats.

He may relate the food he was eating just before his hospitalization with feeling sick so it may take a while for him to like it back or you may have to change it for a new one altogeher
Click to expand...
We've tried Fancy Feast chicken classics which he nibbled at for almost two weeks, until he stopped eating altogether. I tried other flavors and he smells them but never takes a bite. He will of course eat his Science Diet hairball control without much issue, however, his numbers just aren't that great. This morning they were 441 and this evening 503. I know we're new to testing, insulin dose and food. He almost didn't eat tonight which I was afraid of since his BG was 503, but he finally ate his dry food. I did increase his insulin dose to 2.25u since he was 503 and plan to test at +2 hours after this PM dose. Any suggestions?
 
Have you ordered some samples of those low carb dry foods Chris recommended in her post above (#14)? If he's been unwell and appetite has been a problem you might have to put the food switch on the back burner for now. Get your BG testing and spreadsheet data logging up and running. We can help with insulin dosing and you might need a higher dose for now because of what he'll eat. It's important to get his BG down to better levels to avoid ketone development.

If the dry hair ball control food is what he eats now it's probably high carb and contributing to high BG. Try increasing to 2.25 u tomorrow AM. You'll have to eyeball this on your syringes and it'll be harder if you don't have half unit marks. I suggest you make up a reference syringe using coloured water drawn up to your best estimate of 2.25 u and use it as a guide for drawing up that dose of insulin.
 
JennC said:
I did increase his insulin dose to 2.25u since he was 503 and plan to test at +2 hours after this PM dose. Any suggestions?
Click to expand...
Your spreadsheet is showing a dose of 2 u. Keep the 2.25 u dose AM and PM tomorrow and aim for those essential pre shot tests as well as one in the +4 to +6 range if you're home. If not, get a bedtime test tonight and tomorrow night. Plan on doing more tests on the weekend.
 
Kris & Teasel said:
Your spreadsheet is showing a dose of 2 u. Keep the 2.25 u dose AM and PM tomorrow and aim for those essential pre shot tests as well as one in the +4 to +6 range if you're home. If not, get a bedtime test tonight and tomorrow night. Plan on doing more tests on the weekend.
Click to expand...
I updated the spreadsheet, I meant to list 2.25 instead of 2. :facepalm: I'm planning to call those companies tomorrow to request a sample. Tomorrow I work from home so I'll be able to get a BG tonight at +2 the PM dose and then do the +4 and +6, range tomorrow after the AM dose and again at bedtime. Another user mentioned: The Science Diet Hairball Control dry food appears to be 30% carbs, so I'd like to switch him asap if he would only be cooperative lol.
 
JennC said:
I updated the spreadsheet, I meant to list 2.25 instead of 2. :facepalm: I'm planning to call those companies tomorrow to request a sample. Tomorrow I work from home so I'll be able to get a BG tonight at +2 the PM dose and then do the +4 and +6, range tomorrow after the AM dose and again at bedtime. Another user mentioned: The Science Diet Hairball Control dry food appears to be 30% carbs, so I'd like to switch him asap if he would only be cooperative lol.
Click to expand...
Yes, it would be best to get him off the hair ball food but he's still in post-illness tenuous appetite territory. That can be a recipe for ketones, which is why you want to carefully raise his dose too. He needs to eat and eat consistently. I hope the Young Again or Dr. Elsey's dry appeal to him.
 
I read your last thread. Are you testing for ketones, since it looks like your vet did not?
 
Dyana said:
I read your last thread. Are you testing for ketones, since it looks like your vet did not?
Click to expand...
No, not yet. I've read how others typically test and there's no way he'd ever let me that close while he's doing his business. The vet did give me some plastic litter last year when we were trying to pinpoint which kitty was peeing outside of the litter box. I'm planning to go to the store tomorrow to pick up a can or two of FF chicken, the keytone testing items, and probably some more glucose strips.
 
JennC said:
Awe, thank you!! I actually call him my handsome big guy, although he's not so big anymore.
Click to expand...

He is very handsome and just the right colour. :cat:

Any food is better than no food and you'll figure it out . Then the minute you have , he'll change round and eat everything he wouldn't before.
 
JennC said:
BG this AM is 466 :( 2.25 u given
Click to expand...
Don't worry - you'll get there. Can you get a test somewhere between +4 and +6? If not, how about right after you come in the door from work if it's an hour plus before PMPS? Before bed is important too. I like the way you're recording his eating on your SS.

If you can keep up a structured testing routine and keep him eating you don't have to let him linger at doses that are too low. The goal right now is to get a routine where you can test, he will eat and you log data on your SS. You'll likely go to 2.5 u on the weekend.

Are you testing his urine for ketones - or have I asked you that already?
 
Kris & Teasel said:
Don't worry - you'll get there. Can you get a test somewhere between +4 and +6? If not, how about right after you come in the door from work if it's an hour plus before PMPS? Before bed is important too. I like the way you're recording his eating on your SS.

If you can keep up a structured testing routine and keep him eating you don't have to let him linger at doses that are too low. The goal right now is to get a routine where you can test, he will eat and you log data on your SS. You'll likely go to 2.5 u on the weekend.

Are you testing his urine for ketones - or have I asked you that already?
Click to expand...
Yes, I'm working at home today so I'm definitely planning to check at +4 and +6. I'll be glad to have a better picture of how his dose is working. I was so excited today he actually ate wet food which was great. Yeah with the food tracking, I'm hoping to eventually track how much he's actually eating if we can get him over to canned. We aren't testing yet for ketones but I'm planning to pick up testing supplies later today to start. I'm really wondering wheter it's smart to try and switch him to wet food at this point, part of me says yes because I know it will help lower his numbers but I know we'll have to continue testing at +2, +4, and +6 since 2.25 or 2.5 might be too much insulin if he actually will eat wet only. I guess we shall see how it goes. Sometimes I feel like I'm trying to conquer the diagnosis in a day. :)
 
Last edited:
JennC said:
I'm really wondering wheter it's smart to try and switch him to wet food at this point, part of me says yes because I know it will help lower his numbers but I know we'll have to continue testing at +2, +4, and +6 since 2.25 or 2.5 might be too much insulin if he actually will eat wet only. I guess we shall see how it goes. Sometimes I feel like I'm trying to conquer the diagnosis in a day. :)
Click to expand...
I think the priority item at this point is to get him eating reliably, whatever he'll eat. If that doesn't happen everything else is harder. Once he's feeling better and eating consistently and you have your BG testing mojo fully operational you can tinker with food switching. It'll require extra monitoring but it'll be easier by then.

Re ketone testing: I might have posted this on your thread before but here goes anyway:
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

No, you can't conquer this diagnosis in a day. You'll read this on FDMB often: It's a marathon, not a sprint. It requires a ton of patience on your part and there'll be a lot of 2 steps forward, one step back. You'll get there. :)
 
JennC said:
BG at +4 is 39. He's eating canned food right now and a little dry.
Click to expand...
It’s wise to get a second test right away when you get an uncharacteristic number like this. This is really unexpected. You did the right thing giving him food. Test again 30 minutes after that + 4. If he’s still below 50, give another very small snack of whatever he’ll eat, wait 20-30 minutes and retest. The goal is to get him above 50 using little snacks if needed. Eventually you want him to stay above 50 without snacks. Keep the snacks small so he doesn’t get too full - a teaspoon or so at a time.

I’m around to check in.
 
Kris & Teasel said:
It’s wise to get a second test right away when you get an uncharacteristic number like this. This is really unexpected. You did the right thing giving him food. Test again 30 minutes after that + 4. If he’s still below 50, give another very small snack of whatever he’ll eat, wait 20-30 minutes and retest. The goal is to get him above 50 using little snacks if needed. Eventually you want him to stay above 50 without snacks. Keep the snacks small so he doesn’t get too full - a teaspoon or so at a time.

I’m around to check in.
Click to expand...
Just checked at the 30 minutes after +4 and it's 43.
 
JennC said:
Just checked at the 30 minutes after +4 and it's 43.
Click to expand...
OK. Do you have any Temptations treats on hand? You can try putting 4 or 5 on a tsp or so of wet food and retest in 30 minutes. You can also add a little honey or karo to a little wet food snack and retest after 30 minutes. How are you holding up? Breathing? It’ll be fine. :)
 
No, no treats. He always throws them up unfortunately but I did put a little karo syrup in his mouth and he's eating a little of his dry food now. I'm a nervous wreck, in addition to these low numbers I hit the vein in his ear and it wouldn't stop bleeding for several minutes. Thank you so much for sticking with me on this thread. :)
 
JennC said:
No, no treats. He always throws them up unfortunately but I did put a little karo syrup in his mouth and he's eating a little of his dry food now. I'm a nervous wreck, in addition to these low numbers I hit the vein in his ear and it wouldn't stop bleeding for several minutes. Thank you so much for sticking with me on this thread. :)
Click to expand...
The dry will help although it can take a bit longer to get into the bloodstream. Test in 30 minutes. I know what you mean about the bleeding when you hit the little vein. I always wrap a double layer of tissue over both sides of Teasel’s ear after a test and hold it with firm pressure for 15-20 seconds. That usually does the trick even when I hit the vein.

Deep breaths - you can do this. I’ll be following along. BTW - you can enter more than one number in a cell on your SS. You’ll have to manually colour the cell using the little paint can icon from the tool bar. It’s helpful for us to see those extra test numbers.
 
Hurray for 62! That can be the dry food and/or karo syrup. No food or syrup this time, wait 30 minutes and retest. If he holds above 50 by next test, wait another 30 minutes without food and retest. If that shows he’s above 50 wait an hour.

Congrats on getting experience dealing with low numbers! :)
 
Kris & Teasel said:
Hurray for 62! That can be the dry food and/or karo syrup. No food or syrup this time, wait 30 minutes and retest. If he holds above 50 by next test, wait another 30 minutes without food and retest. If that shows he’s above 50 wait an hour.

Congrats on getting experience dealing with low numbers! :)
Click to expand...
I was just getting ready to post. So excited to see that 62! I'll pick up all food and recheck in 30 minutes. Thank you, thank you! I can breathe again, for now...
 
Status
Not open for further replies.
Back
Top