How do I proceed????

Dena

Dena

Member
Hi Everyone!

My 12 year old cat Cosmo was diagnosed with diabetes in August. He has been free fed dry kibble (Blue Buffalo) his whole life.

Upon diagnosis my vet wanted me to start feeding Cosmo a prescription diabetes food, get Cosmo on a feeding schedule, and give him insulin shots twice a day.

Cosmo shunned the prescription food, didn't like it at all. He ended up going 3 days without eating anything!!! Very stubborn cat. So vet said to have Cosmo go back to his dry kibble so at least he will eat.

Cosmo is currently on 2 units of ProZinc twice a day. I have successfully gotten Cosmo on a feeding schedule with his dry kibble. After finding Dr. Pierson's website and reading everything, I would like to see if I can switch Cosmo over to a wet food and see if his diabetes will go into remission.

Here is my issue though - when I asked my vet about doing this and checking Cosmo's glucose at home my vet told me that pet owners should not be doing that at home. He said I need to bring Cosmo in every time I need his glucose checked. The vet won't even talk to me about how to home test and possibly getting Cosmo off insulin. The vet told me to switch Cosmo over to the wet food and then after two weeks bring Cosmo in to get his blood sugar checked. After reading the information on Dr. Pierson's website this scares me because I'm afraid of insulin overdose if we wait two weeks.

I've watched the videos and read all the information on how to test at home, but here are my questions -

1. Since Cosmo has been on Insulin since August, is it too late to try to switch him to wet food and see if he will go into remission?

2. Would switching to wet and trying home testing be a good next step (I don't want to stress Cosmo out by doing this if there isn't a chance he can go into remission due to being on insulin for too long now)?

3. If I do start home testing, what are the parameters for normal blood sugar for a cat? What are the parameters in each stage to lower his dosage so I avoid insulin overdose?

4. I know the vein in the ear is the preferred testing site for cats, but Cosmo has very dark ears. I can't see a vein at all. Can I test him in his paw pad instead?

I greatly appreciate any help anyone can offer.
 
Hi Dena,
I am no expert but everything I have researched and all the excellent advice on this site would be to switch to wet food. I had a bit of an issue myself and ditched the vet and all dry food for Tiki Cat Puka Puka Luau... looks like straight up chicken and Fancy feast fish and shrimp. Both no carbs. If you are going to switch do it gradually so his digestive system gets accustomed to the change. As for home testing it’s a definite. Had I made insulin changes or given a “normal” dose at times without a BG # -I would have had several HYPO issues!! My Little has dark ears as well so I shaved the edges to see clearer... lol yep ...Venus to the rescue. I know you are feeling overwhelmed and testing sounds scary but it does get easier. I still get nervous sometimes but for the most part I come in stealth and she knows she gets a treat after Again I am fairly new here but these wonderful people have saved me from a nervous breakdown and have definitely given better advice than my vet. I’m sure one or more of them will chime in as they are much more qualified than me but I wanted to make sure you didn’t feel alone. They can also direct you on how to set up a spreadsheet to track Cosmos BG levels if you decide to home test which again I strongly recommend. Give those wet foods a try.. they have worked for me. We are kibble free!
 
Thank you Lisa. I really appreciate the support. I feel like I did back when Cosmo was first Dx in August. I am overwhelmed!!! I wish I would have known all this back then, then maybe I could have found a wet food he liked and he wouldn't have had to go on insulin at all. I really hope its not too late. Cosmo has gotten to where he tolerates the insulin injections very well, but I give him a treat afterwards so he knows he gets that. The BG home monitoring is really scary and all this is overwhelming. I'm so worried about changing his food with the possibility of insulin overdose. My vet is no help at all and I live in a small town, so he is our only choice. The next closest vet is a 50 minute drive. I'm hoping I can figure out how to do the BG home testing and save myself some sanity in the process. I already have purchased the AlphaTrak so just need to figure out how to do this to get started.
 
Dena said:
Thank you Lisa. I really appreciate the support. I feel like I did back when Cosmo was first Dx in August. I am overwhelmed!!! I wish I would have known all this back then, then maybe I could have found a wet food he liked and he wouldn't have had to go on insulin at all. I really hope its not too late. Cosmo has gotten to where he tolerates the insulin injections very well, but I give him a treat afterwards so he knows he gets that. The BG home monitoring is really scary and all this is overwhelming. I'm so worried about changing his food with the possibility of insulin overdose. My vet is no help at all and I live in a small town, so he is our only choice. The next closest vet is a 50 minute drive. I'm hoping I can figure out how to do the BG home testing and save myself some sanity in the process. I already have purchased the AlphaTrak so just need to figure out how to do this to get started.
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I have a video in my signature showing how I test my cat CC at home using an Alphatrak. There's definitly a learning curve, but after a couple weeks or will be much easier.
 
JanetNJ said:
I have a video in my signature showing how I test my cat CC at home using an Alphatrak. There's definitly a learning curve, but after a couple weeks or will be much easier.
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Thank you SO MUCH Janet!!!! That video was pur-fect! :) Really shows how to do the testing and has really taken the anxiety away from doing this for me. I am going to go set up Cosmo's spreadsheet and test him now. Still don't know what numbers I'm looking for or anything, but would like to start getting the hang of home testing. Thank you so much for doing that video and sharing it!!!
 
Get a new VET! Knowledge is power. My cats were raised on Costco Kirkland kibble for 12 years and I feed them Ffriskies, 9 lives and Special Kitty from Walmart. They barely look at the kibble now and demand the wet food and very loudly!! LOL.... I'm hopefully on the way to remission with the biggest change being the way I feed Simba. BTW I am using a human Reli-on Meter and strips and found them very accurate as compared to the vets Lab measuring.
 
Dena said:
Thank you SO MUCH Janet!!!! That video was pur-fect! :) Really shows how to do the testing and has really taken the anxiety away from doing this for me. I am going to go set up Cosmo's spreadsheet and test him now. Still don't know what numbers I'm looking for or anything, but would like to start getting the hang of home testing. Thank you so much for doing that video and sharing it!!!
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Your welcome.... I'm glad you found it helpful.

Normal on a human meter is 50-120 and on a pet meter it's 68-150. Of course a diabetic cat it's typical to see numbers much higher than that. You don't want your cat going lower than the normal range as it's very dangerous.
 
I have the AlphaTrak so that helps with the numbers. I am going to try to talk to the vet tomorrow to see if he can help me figure out how to adjust Cosmo's insulin as his numbers change. I'm not sure what the parameters are for giving each unit of insulin. If he doesn't want to talk to me about it then I will have to find out the information from somewhere else. I did create Cosmo's spreadsheet and have it linked in my signature now. All ready for me to start testing him. :)
 
Oh and I also like the idea of not using the lancet pen. Cosmo is skittish on his own, so that noise would freak him out. I will just use the lancet as you have suggested. It was hard to see in your video how you did it, but do you just do a quick poke of the lancet on the ear?
 
Dena said:
Oh and I also like the idea of not using the lancet pen. Cosmo is skittish on his own, so that noise would freak him out. I will just use the lancet as you have suggested. It was hard to see in your video how you did it, but do you just do a quick poke of the lancet on the ear?
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Exactly. See? Tiny little drop. Then dip one of the edges of the test strip where the little black dot protrudes out into the drop.
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No lancet device for me either. Much easier just make sure when you switch the food you TEST before shots. The food will have an effect on BG levels and the “normal” dose may become too much. One thing I learned from these wonderful people is higher is better than too low so you will need to see how he responds to the food change and adjust the insulin accordingly. You’ll get this.. I was a nervous wreck and now just half a nervous wreck. It does get better with time as you will gain your own sense of what to do in your specific situation.
 
JanetNJ said:
We can help you with any dosing questions. Have you read our info on ProZinc yet?
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Okay, I will get him started on the new food and then ask if I have any dosing questions. What info on ProZ are you referring to? Over on the ProZ insulin group board? I'll go look. I need to find out how often I'm supposed to test too.
 
Dena said:
Okay, I will get him started on the new food and then ask if I have any dosing questions. What info on ProZ are you referring to? Over on the ProZ insulin group board? I'll go look. I need to find out how often I'm supposed to test too.
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I went in and found the info on ProZ you were referring to. I have read all that, but I am still trying to wrap my head around the actual steps to go through.
 
Dena said:
Okay, I will get him started on the new food and then ask if I have any dosing questions. What info on ProZ are you referring to? Over on the ProZ insulin group board? I'll go look. I need to find out how often I'm supposed to test too.
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Definitely test preshot, and then try to get one test mid cycle to see how low he goes. On weekends or days off you can try to get a few others here and there when you can. I get preshots and then a before bed test at 4 hours past the evening shot. One days off I get day readings too.
 
Hi Dena! You've gotten wonderful info already (thanks Janet for that video you made...it's helped so many people!). Yes, there is a ton of info we have on here...the stickies at the top of this board will be a great help to you. However, you'll probably have to read them several times over (I did when I first got here!) to really take the info in. We redid them several years ago and several folks who are on the board now were in on that process so please ask if you have ANY questions.

Food change, no it's not too late! The chances of remission are highest earlier, but we've had cats on here go into remission after YEARS, so it can definitely be done. As said before, you want to go slowly to avoid any GI upset. I also wouldn't change food until home testing. BG can drop a LOT from just wet food, so you want to be ready to catch that and lower insulin if needed.

As for insulin dose well...there is no set of prescribed rules for what dose to give based on numbers. It depends so much on the cat and the owner's level of experience. For now, I would say no shot under 220 (I know you're not new at the diabetes, but new at the home testing and that's our rule for new folks as they and we learn their cats patterns). What you WANT to see is a smile curve. Basically you want to see something like yellow numbers (in the 200s) for preshot and then blues or dark greens at nadir (mid cycle). If you're getting that, we usually know you're at a good dose, but REMEMBER that the dose needs can and do change. There's no magical dose you can just sit at forever usually (wouldn't that be nice though!).

Do test whenever you can. You want preshots for sure and then beyond that whatever other numbers you can get. Nadir is usually +5 to +7 but it can be any time really...you'll learn that as you go along. But ANY numbers you can get for now will help...even a +2 or +3 before bed or on the way out the door to work will help fill in the puzzle pieces.

As for your vet...unfortunately that's all too common. I can tell you that we all test our cats at home here and if it caused so much stress to them, you wouldn't see it nearly as much as we do:! I believe that little bribe...or treat...makes it more than worthwhile for them!

We're glad to have you here Dena though we wish you didn't need to be! Please ask all the questions you can. We want to help! And we will be happy to help you with insulin dosing...it's part of what we do!!!!
 
Thank you Rachel for all the wonderful information!!!!

I’m really trying to wrap my head around all this and get it all to make sense. I have to figure out how everything fits together in the process in order for me to understand something. So that is why I’m struggling with this because there are so many parts I don’t understand. Your response really helped fill in some of this for me, which helps a lot!!!!!

If I understand everything correctly so far I believe the process is:

1. Test
2. Give Insulin – unless number below 220 then no shot
3. Feed
4. Test anytime afterward that I can (maybe +3 and +5 to start out??)

I work from home full time, so finding the time to test and/or testing during the day won’t be an issue. Just want to find the time(s) to test that will give me the most information and benefit Cosmo the most.

I plan on starting the transition to wet food tomorrow. So that means I should start BG testing tomorrow as well, right? To make sure I’m not giving him too much insulin.
 
You could start home testing right now if you want to. Sometimes it takes a couple of tries when you're first starting, so testing tonight might be a good practice run.

And a little amendment to the order:
1. test
2. feed (Cosmo doesn't need to eat a lot - just a few bites to show that he's willing to eat
3. give insulin
4. test anytime afterward. The lowest point in the cycle is usually between +4 and +7 for most cats (although some cats are earlier or later).
 
Djamila said:
You could start home testing right now if you want to. Sometimes it takes a couple of tries when you're first starting, so testing tonight might be a good practice run.

And a little amendment to the order:
1. test
2. feed (Cosmo doesn't need to eat a lot - just a few bites to show that he's willing to eat
3. give insulin
4. test anytime afterward. The lowest point in the cycle is usually between +4 and +7 for most cats (although some cats are earlier or later).
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Pur-fect!! Thank you so much!!!! All the pieces are starting to come together. :)
 
Dena- great job getting a test this morning! And thank goodness you did. If you can, get a test mid-day today. No point in doing more than that since Cosmo didn't get insulin this morning. Then of course test again before your evening shot. The purpose of the mid-day test today is to see if that 129 this morning is just overlap from last night's shot (the insulin just lasting a little more than 12 hours), or if it's an indication that Cosmo is getting too much insulin.
 
Thank you so much!!! I'm pleasantly surprised how easy the BG test was. He tolerated it SO well too. So much better than the shots. Of course he expected a treat afterwards just like after his shots, but he was such a good boy he got one!! :)

I'm wondering if I've been giving him too much insulin. Normally after I give him his insulin shot he lays around and sleeps for a couple hours. A deep sleep where he is pretty much dead to the world the whole time. After a couple hours then he is up and active. This happens EVERY TIME after both AM and PM shots. This morning I didn't give him his shot and he is very active. No nap at all!!!! I am really surprised and wondering how many times I've blindly given him his shot when he didn't need it. :(

When you say test mid-day, do you mean about +5 after he ate this morning?
 
Dena said:
When you say test mid-day, do you mean about +5 after he ate this morning?
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That would be great.

Try not to worry about if it was too much insulin just yet. Some cats bounce around a lot, and sometimes the insulin just lasts a little longer than others, so it will take a bit more data to figure out what exactly that 129 means. Sleeping heavily after the shot is a pretty normal reaction, even when the dose is at a good level. My guy is zonked out next to me right now. In a little bit he'll be up and playing and getting into trouble, but he nearly always takes a deep nap for a little while after breakfast/injection.

I'm so glad to hear that the BG test went well! It's amazing to me that so many vets think it's going to cause all kinds of trouble when really the majority of the cats barely notice, and even grow to like them because they associate it with treats and attention.
 
Just took his BG again for the +5 and it was 116.

He was just a smiddgeon hesitant because he figured out what was coming, but afterwards he got his treat so he was fine. Doesn't take them long to figure out treats come afterwards. :)
 
They do learn fast!

Great job getting your PMPS tonight too, and that's a nice blue. Still a little high, but not bad, and too low to shoot for now. Curious to see where he's going to go from here. :)
 
Thank you Djamila! He did even better for his BG this evening for the PMPS. He knew the treat was coming and just sat there while I did it.

I'm curious to see where he is going to go too, especially now that he is eating the wet food. The longer he eats the wet food I'm curious to see what happens.

I really appreciate the feedback and support. Makes this a lot less nerve wracking. :)
 
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