? Dosing advice - big drop after diet change

shelaghc

shelaghc

Very Active Member
Jester's BG has been in the low 300s a lot lately. After a week on 1.25U, the vet and I agreed he should go up to 1.5U which I did Friday evening.

With his extremely low weight still being an issue, his vet consulted with a feline diabetes specialist at the University of Pennsylvania in the Philly area.

The first thing we're trying is a complete change in his diet to Royal Canin Selected Protein - the duck and rabbit flavors. At first I figured, after seeing the carb content, no biggie since it's not far off from the Friskies he usually eats.

But at +4 today, he dropped down to 114. I fed him just a little and his +6 was 123.

He's already eaten about two 5.9 ounce cans of the RC - he'd been eating three 5.5 ounce cans of Friskies and was still constantly begging for food. The target for the RC is 1.25 cans daily.

Question right now - his BG at 45 minutes before his insulin was 256. Should I still give him 1.5U this evening considering how far down he went this morning?
Thanks
 
Hi! So the new food is lower carb than the Friskies or higher? Is he eating fine? I know that's been an issue for him before.

He didn't really get into unsafe numbers today. Have you already fed him or are you taking a PMPS right at +12? My guess is that he's going to come up a bit more and probably be pretty close to what his AMPS is. I'd say you can probably give the same insulin amount as long as he eats since he was really over 50 points away from being unsafe. Does he get a snack at night too?
 
Rachel said:
Hi! So the new food is lower carb than the Friskies or higher? Is he eating fine? I know that's been an issue for him before.
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Frankly I'm nervous out of my mind that Jester will reject this stuff, but for today he's eating with gusto.
The RC is 15/16 carbs depending on which flavor.
Friskies is 13/14 - not a lot different. That's why the big drop was so startling.
And Jester's been ravenous lately - at one point he had been eating 4 cans of Friskies in a day.

I went *very* briefly to another vet.

Since his weight wasn't going up, this vet was treating it like unregulated diabetes. She wanted me to reduce that to no more than 300 calories - which would have been 2.5 cans. It took nearly a month to get him down to 3 cans and we've been there for another month.

Things didn't work out at that practice so I went back to the one we had been going to before, but to a different vet there.

At 3 cans he cries constantly begging for food. I haven't had the guts to even try to go lower.

Rachel said:
He didn't really get into unsafe numbers today. Have you already fed him or are you taking a PMPS right at +12? My guess is that he's going to come up a bit more and probably be pretty close to what his AMPS is. I'd say you can probably give the same insulin amount as long as he eats since he was really over 50 points away from being unsafe. Does he get a snack at night too?
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He was crying for food again so I called the 45 minute prior his PMPS and gave him some food.
He's had his insulin now and I'm going to give him mini-meals all evening except for a couple of hours before his next BG.

Frankly I can't afford to keep giving him three cans of this stuff a day - it's over $3 per can at the vet until I can start getting it through Chewy.
Besides that, the cans are bigger. I figure 2.6 cans will be the equivalent of 3 cans of Friskies.

We're supposed to try this for two months to see how things go. The goal would theoretically be 1.25 ca ns a day for weight gain, at least according to the tech at RC.
 
Ouch! That's expensive. I hope it's less $$ at Chewy! Have you got your order in with them already? I hope the new food helps Jester's weight. Remember that if he does reject it, you should be able to return it if needed so you can at least get your money back. I think there are other high protein foods out there we can help you find if he does end up rejecting it. Let's hope not!
 
Rachel said:
Ouch! That's expensive. I hope it's less $$ at Chewy!
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$2.63 per can unless I do autoship.
Then it's $2.46. And the first shipment would be 30% off. I'm planning to save that one for a pretty big order since you can't repeat that deal.
Rachel said:
Have you got your order in with them already?
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Not yet. This all happened over the weekend and I need to get a prescription. First I need to see if he'll eat the stuff for more than a few days.
After that I'll order from Chewy.

Rachel said:
I hope the new food helps Jester's weight. Remember that if he does reject it, you should be able to return it if needed so you can at least get your money back. I think there are other high protein foods out there we can help you find if he does end up rejecting it. Let's hope not!
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The vet from Philly had several ideas for treating Jester's health issues. I just wish I could have been part of the conversation.
 
I'm curious why the vet wants you to limit his food if the goal is to have him gain weight? Did they explain the reasoning for that? It seems like if he's supposed to start gaining, wouldn't feeding him more help with that? I understand that feeding him more of this food would be way too expensive, I'm just wondering what the vet was thinking when telling you to reduce his intake?
 
Djamila said:
I'm curious why the vet wants you to limit his food if the goal is to have him gain weight? Did they explain the reasoning for that? It seems like if he's supposed to start gaining, wouldn't feeding him more help with that? I understand that feeding him more of this food would be way too expensive, I'm just wondering what the vet was thinking when telling you to reduce his intake?
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Because he was eating four cans a day and not gaining weight.

Even after six months of two to three cans of Friskies a day he was losing, not gaining.
The speculation is that it was keeping him from being regulated.
 
I'll mention this because I've been wondering about it with my guy. Maybe Jester isn't properly digesting all that food - ie., his enzymes are below par. Without enough of the proper digestive enzymes he can eat a lot but it won't be properly digested so he won't be able to absorb enough to put on weight.

I've been adding digestive enzymes to Teasel's meals since his health crisis in June/July. I can't prove it but I think they're helping him. There are many brands on the market and they aren't very expensive. This is the one I use:
https://naturvet.com/product/digestive-enzymes-powder/
 
Kris & Teasel said:
I'll mention this because I've been wondering about it with my guy. Maybe Jester isn't properly digesting all that food - ie., his enzymes are below par. Without enough of the proper digestive enzymes he can eat a lot but it won't be properly digested so he won't be able to absorb enough to put on weight.

I've been adding digestive enzymes to Teasel's meals since his health crisis in June/July. I can't prove it but I think they're helping him. There are many brands on the market and they aren't very expensive. This is the one I use:
https://naturvet.com/product/digestive-enzymes-powder/
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Thanks Kris.
I'll mention it to the vet. I think this food is also supposed to address those kinds of issues.
Jester seemed to be satisfied with a little less this morning and that's encouraging.
 
I'm fascinated.
Despite the slightly higher carbs in the RC canned stuff, Jester's BG is actually going down.
 
Okay, now I'm impressed.

Jester ate nearly a full 5.9 ounce can of medium carb prescription Royal Canin. Yesterday morning I reduced his insulin from 1.5U to 1U because his AMPS was under 200.

PMPS was back in the 200s - no surprise - as was his AMPS today.

I was nearly an hour late getting home and his PMPS at the thirteenth hour was nothing like a high number comparatively speaking - 244.
Still giving him 1U and a big meal of that RC food - nearly a full can.

And his non-fasting +3 was 146....

He still had a mini-meal coming so I gave him that. Obviously Jester is feeling weird because of the lower BG.

I really need to get about six hours of sleep, but I'm not going to bed until I've checked him at about +5 just to be safe.
 
Rachel said:
Hoping he stays in these nice lower numbers!
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AMPS today, although admittedly it was a +11 AMPS because Jester got his insulin late last night, was 180.

Dropped his dosage this morning to .5U and his PMPS was 226.

However, it's good news / bad news.

Understandably Jester was having some diarrhea because I switched him over cold turkey.
The good about the food is that on Day 4 he's still eating it quite happily. Indeed, he seems to be satisfied with less and was far less anxious today to start eating.

Bad news is that he's still having diarrhea on Day 4. Anyone know how long it takes a cat's system to get used to completely new food?

Other bad news:
Royal Canin has no more of this prescription food and doesn't know when they'll get it back in. Chewy is already wiped out of every flavor.
I raced to PetSmart to grab a case of rabbit and the vet's office has a case of the duck for me.
But the price is *way* higher than I would have paid with Chewy.
$63 from Chewy for a case; $68 from PetSmart; $73 from the vet.

RC hasn't been able to get a supply of the deer, duck, and rabbit meat in as high a quality as they need to make the stuff.

Now I'm going to be scrambling to buy a bigger supply to last a while for *way* more than I anticipated and will be hoping I can even manage to get it.

On top of that, we're still in the "let's see how much good it does him" stage.....
 
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Jeez! It's always something isn't it? I really hope RC can get the food back in stock soon...I'm sorry you're having to deal with that. I remember when I was buying food for the cats and we had recalls and I was completely panicking about finding them the food they ate!!!! It's just one more stress no one needs.

I'm not sure how long it would take for the new food...I think it's really an ECID thing. My cats have been switched cold turkey before and had no problems. I've also done a slow switch when we moved to raw. Can you get a probiotic in him? That might help with the diarrhea. I think S. Boulardii is a good one. Do you have any of his old food still? Might try mixing the two for a bit to see if that helps too...not sure if that will work or if he'll eat it, but it could be worth a shot?
 
I think I'm going to give this as pure a try as I can for now. Checked the litter box when I got home from work and it seems like his body is starting to get used to the new food.

BTW, +11 this evening on .5U was 161.

And, while he's happy to eat whatever I give him, he seems less frantically hungry.

I just paid about $140 for two 24 can cases of that food. In just over a week I'm going to weigh him and see if he's gained anything.

If he has, it'll be worth every penny and I'll give up anything I need to to keep buying it for him as long as he lives.
 
A little higher today - AMPS was 153, but I decided to withhold dosing again.

We'll see where we are tonight.

His body has finally gotten used to the new food so it's mildly possible that his BG will start going back up.
 
AMPS 125

When do I start counting the days for remission?

If he's gaining weight, this is a win-win.
 
Hmmm...that's a tough one. We usually say 14 days without a shot is remission, but he's still in higher numbers than we would normally see for a kitty going into remission. Usually we want them 120 or lower for the 14 days. I'd say that you want to keep testing even after the 14 days for a bit to see if he stays low.

The new food is still a hit? Are you able to get it? I remember you said you couldn't find any recently.
 
Rachel said:
The new food is still a hit? Are you able to get it? I remember you said you couldn't find any recently.
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He's still enjoying the food. Had to put out about $140 for two cases that could last a maximum of 24 days, but more likely about 20 days.

Chewy expects to start getting it in again in a week or so. I don't relish the thought of trying to find other sources if it doesn't become available soon.

Rachel said:
I'd say that you want to keep testing even after the
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Can I reduce testings to once a day? I can't imagine his BG going up dramatically under the circumstances.
 
shelaghc said:
Can I reduce testings to once a day? I can't imagine his BG going up dramatically under the circumstances.
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It's really up to you, of course, but the standard approach is to continue testing twice/day for the 14 days. Cats fall out of their honeymoons all the time, restart insulin, and then get there in their own time. But you can do whatever you think is best for Jester.
 
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