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Sandjules & Mama Cat

Sandjules & Mama Cat

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Hi, all. I'm new to the board, though I've been reading for a while. Thanks to the organizers and those who continue to give advice. This can be a very scary and uncertain time.

Mama Cat is approximately 10 years old and has been on Vetsulin since May 2018. We took her in initially for the usual reasons ... drinking and peeing a lot ... just generally not looking well. We started low, but are now up to 3U twice a day. Each time we have taken her to the vet for testing throughout this time, the numbers have come back "normal." I'll find the paperwork and load the numbers later. She was last tested by them in October 2018, when we took her in for a Cushings test. I suspected Cushings (playing web doc of course), because she is ALWAYS hungry and the hair on the places where they shaved her for blood tests has never grown back. The Cushings test came back negative.

I am posting to this board because she really doesn't seem well at all ... she eats fine (more on that next), but she won't gain weight and some days she just looks more ragged than others (I'm sure you know what I mean). And there's the hair thing mentioned above. She doesn't tolerate going to the vet well at all, so we have made the decision to start testing her ourselves, something we sort of started before, but without the spreadsheet and really tracking.

As with most of newly diagnosed cats/pet owners ... the vet immediately started us on the DM food, wet and dry. She was okay with that for a while, lost tons of weight (she was very obviously overweight), but now she won't eat it at all, even with the probiotics sprinkled on. After much research, reading of the boards, and deliberation, we've taken her back to Friskies pate. She loves it and eats well ... still no weight gain, which after reading your boards, means she's probably not regulated.

I'm wondering now if we're not doing something right with the shots - giving them in her scruff ... but I think we'll wait on making any adjustments to food and methods until we have a few days of measurements as a baseline.

I have linked to the spreadsheet in my signature - hopefully I've done it correctly. We're just on the first day testing and only done 3 times so far ... before feeding and insulin, and +1, +3. I forgot to pickup the DM dry so we will just do her next test tonight pre-food/insulin and maybe before bed. I'm hearing the DM dry is bad for diabetic cats (so why do the vets push it?), so would really like to find a quality, low-carb dry.

Thanks for any guidance you can give.
 
Welcome! I'm a newbie as well. Hopefully the more experienced members can help you out. From what I have read, many vets just don't have that much knowledge regarding diabetes in cats and so push the dry DM food because that is what they have been taught. There is a food chart on the main health board that will help you navigate which food may be best for your kitty. They recommend avoiding dry as it is bad for their urinary tract as well as the fact most have too many carbs. Some will leave frozen wet out so they can graze on it later in the day when you are not home or have a timed feeder. As for the shots, try to alternate the spot. If you give them in one spot for a long time, they will build up a fat pad that reduces the ability to absorb the insulin. I switch between the hips, behind the shoulders and the scruff. Some do the sides as well, but I think my cat would bite me if I did it there.
 
Good call going with Friskies. The only way to know how regulated she is is to home test. I have a video in my signature showing how I test my cat CC at home.
 
Hi, I finally got some testing in today. She had a really low number pre-pm feeding ... 105. Should I not give her her shot - or test her again before I decide. I know I may not get a response by the time I need to decide ... but thought I'd ask anyway.
 
Sandjules & Mama Cat said:
Hi, I finally got some testing in today. She had a really low number pre-pm feeding ... 105. Should I not give her her shot - or test her again before I decide. I know I may not get a response by the time I need to decide ... but thought I'd ask anyway.
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If you have time to stall, don't feed and wait up to an hour
 
Hi and welcome to FDMB. Kudos for deciding to take control of the testing for Mama Cat. That will no doubt give you a much better and more accurate picture of how she is doing. You've received good advice already. Glad Janet was here to advise against shooting tonight.

I did notice though that Mama Cat's BG went down to 78 today around nadir and that is a fair bit lower than we would recommend especially since you are using a pet meter. You do not want Mama Cat going below about 125 or 130 at nadir. I would suggest tomorrow, provided your fasting pre-shot test is between 225 and 250, that you reduce Mama Cat's dose to 2.75u or 2.5u if you are using the pen to inject or do not have half unit markings on your syringes. If your syringes do not have half unit markings, we recommend getting some so you can make finer dose changes. The other option is to get U100 syringes which can be used for even finer dosing adjustments with the help of a conversion chart. Walmart Relion 3/10ml, 31g 5/16th needle syringes have half unit markings, are used by a lot of members here and reasonably priced.

We strongly recommend testing before every shot and trying to get at least one mid cycle test per cycle. All readings are helpful but readings between +2 and +7 tend to highlight the most active period in the cycle. On the night cycle, it helps to make it a habit to take a reading before bed every night so you have some idea what Mama Cat is doing through the night when many cats go even lower than they do during the day.

If you haven't yet checked out the guide to using Vetsulin, HERE is a link to the document.
 
Hi, Linda ... thanks. I don't have syringes with half markings, but feel comfortable doing 2.5 until we can get some if I need to give that does. Unfortunately it was unusual that I was home today and could do a mid-day test and we're out of town this weekend, so can't do it again this weekend. I will test tonight and first thing in the morning; and tomorrow evening before feeding again. Poor thing has lost so much weight - we really need to get her regulated. Appreciate the help.
 
Don't be afraid to give Mama Cat more food and to feed her multiple meals a day. Diabetics can't efficiently use the food they consume so they are always hungry and lose weight. While Mama Cat may have needed to lose some weight initially, if she is still losing, increase the amount of food you are feeding her and just keep an eye on her weight so she doesn't go beyond an ideal weight again.

If you are going to be away for a couple of days, it might be a good idea to reduce the dose of insulin slightly while you are away. Lets see what the readings look like the next day or so and we can help you decide on a safe dose for your absence.

Lots of folks can't get tests midday but if you can shift shot times to be able to get a +1 or +2 before heading into work or grab a test when you get in from work, it helps. We are really data driven so just try to test when you can.:D
 
Thanks, I agree ... I will feel like I have more control and can help her when I know what's really happening. I just regret I was so blindly trusting of the vet's recommendations for the DM dry/wet. Well ... moving on. I would love to use an automatic feeder, but her "Baby Cat" would eat it all. LOL
 
Hi, everyone. I tested Mama again this morning before and 1 hour after her shot (311/165). Those numbers are in her spreadsheet. I wasn't too alarmed by the 311 since she was at 220 last night around 10 p.m. with no nighttime shot. Based on what I've been reading on these boards her numbers are coming down too fast? I won't be able to test her mid-day as I'm at work, but will test her tonight before her evening shot. Thanks as always for your help.
 
That is definitely a very large drop for one hour post shot. She may be an early nadir cat (around +3/4) but as I mentioned last night, the dose needs to be reduced to 2.75 or 2.5u and I am not clear on why you gave the 3u dose again this AM. I cannot stress enough that the 3u dose is too high given the low of 78 yesterday. I trust you left food out for Mama Cat to eat in your absence.
 
Hi, Linda. The range you used for your recommendation of the reduced shot was 225-250. Her morning reading was 311. While you may be very confident in your decision making based on the glucose readings, monitoring is very new for us and I had to make a judgement call and didn't feel comfortable reducing it when I knew I wouldn't be home to retest her.

I tested her again when I got home tonight and she was back up to 343 so I gave her 3u after feeding. No, I didn't leave food out ... there are other cats who would probably eat it before she could get to it. Food is used to bring the sugar up, right?

I will try to test her again tonight before bedtime to get more readings. Unfortunately we won't be home for the next 3 days so I won't be able to test until Monday. At least her ears will get a break.
 
Sandjules & Mama Cat said:
The range you used for your recommendation of the reduced shot was 225-250.
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I see now how you would have interpreted what I wrote. Let me re-phrase.

If Mama Cat's pre-shot BG is 225 or higher, then I'd suggest giving a dose of 2.75u. If BG is lower than 225 at pre-shot, then you can consider giving a reduced shot or skipping for the cycle if BG is very low. A 78 nadir on a pet meter is too low for a cat on Vetsulin. You really don't want BG dropping much below about 125 at nadir on a pet meter.
 
I don't remember where I read it on the forum, but I think I heard that the nadir lets you know the dose of insulin (whether to raise or reduce) and the AMPS and PMPS tells you if it is safe to give. It is hard sometimes being new and having very little information to make a judgement call. Vetsulin hits hard and fast which might cause her to bounce higher to compensate. The food switch will also lower the numbers. If you won't be able to test for a few days, I would lower the dose so she doesn't go hypo. It is better to run a bit high than too low. You mentioned that the vet started the dose off low and raised it to 3 over time. Did they do curves? Can they give you the paperwork? Some folks got the paper work and the curves were not done properly. I know my cat tests higher at the vets due to stress. They may have raised a unit at a time rather than by .25 and risked skipping over the ideal does.
 
Hi, BBelshan. My vet did do curves and kep saying she was in the acceptable range with the dosage, but the visits did definitely stress her big time so I wouldn't doubt that it was overly high. And she was on both DM wet and dry at the time. I have the paperwork somewhere, but since I'm testing myself now, I'd rather just go with what I see.

MrWorfMan's Mom ....thanks for the clarification. Since I don't have the syringes with lower increments, would you think 2.5 is okay instead of 2.75? By the way, started testing again this morning. She is at 132 before feeding so I will not give her a shot. I assume the food will take it up, but I also assume any dose of insulin will take it too low?
 
Yes, a 2.5u dose would be better than keeping the dose too high and having Mama Cat's BG going too low on 3u. Good decision not to give insulin this morning.
I'm finding it interesting that BG is so low at the end of the cycle which with Vetsulin is a bit unusual. Now that you are back home, if there is any way you can get some mid cycle tests in, focusing on the +3 to +7 period of time, it should be possible to see what the nadir (lowest point in the cycle) is. Even though you didn't give insulin today, a test to see what Mama Cat's BG is mid cycle (+5 or +6 for instance) would be good information to have.
 
MrWorfMen's Mom ...

I tested her mid-day, around the 7 hour mark from when she last ate. It was 198. By the way, I did run a test with the solution that came with our kit. It came out within the range indicated on the test trip vial. I did also give her a small amount of wet food as a snack after. I assume her numbers will continue to rise some and she'll be in the 200s by dinner time. I'll test her again (poor cat) before feeding tonight around 6. Likely it'll be over 225 so I'll assume 2.5u, unless it's less than 225 and I may go lower. Thanks again.
 
Can you put a "0" or "skip" in the dose cell for this morning so we know you skipped the shot? Otherwise anyone helping and looking at the spreadsheet won't know if it was a skip or just missing info on the SS unless they read through all the posts. Thanks.;)

Given no shot this morning, that 198 by +7 is pretty impressive. If you continue to have to skip shots due to low pre-shot readings even with the dose reduction to 2.5u, it might be necessary to lower the dose even more so that you have a dose you can shoot twice daily. Dosing once daily doesn't work well and leaves kitty in a bit of a roller coaster of lows and highs that makes them feel punky. Let's see how Mama Cat does on the lower 2.5u dose and whether that helps to even things out a bit for her. :)
 
That's great that she is not too high given the missed shot this morning. It would be very useful to try to get a test in every night cycle. Many cats go lower at night than they do in the day and grabbing a test before bed lets you know whether it's going to be an active cycle or not and whether you may need to leave a little extra food out for snacking. It also fills in the picture of how well the insulin is working for the kitty. If you only test during the day cycle, you are only seeing half the picture. Given how low Mama Cat went the other day, I'd try to get that before bed test just to be on the safe side. ;)
 
Hi ... went ahead with the bedtime test. I probably would have given her a snack anyway, but glad I saw the number. It was 85, which was a huge drop. I gave her a small serving of some Freshpet chicken morsels. This is the first time I have bought this food ... thought it would be a good snack. From reading around the site, many people use it the same way.
 
So glad you got that before bed test. These little critters can and do surprise us. On your AT2 meter, you really don't want Mama Cat dropping lower than about 100 to 115 during the cycle especially if you will not be available to monitor through the cycle. I'd be inclined to drop the dose even further to 2.0u just to be safe and see if that doesn't even out the cycles a bit so you can consistently shoot twice daily and keep Mama Cat a little more level through the entire 24 hours each day. Her AMPS may be up a bit as a result of that fairly quick drop last night but that is just a bounce and it will pass in the next few cycles so don't worry. A higher BG today doesn't mean she needs more insulin. :)
 
Good morning. I wasn't able to get a test before she ate this morning, but did get one before the shot, 30 mins after she ate. Her BG was 179 so I was concerned about giving her even 2u given how far her BG has been dropping. I decided to skip again and try 2.0u tonight, since I'm sure she'll be back up by then. I won't be able to get home for a mid-day test today, but definitely will before she eats tonight.
 
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Sandjules & Mama Cat said:
Good morning. I wasn't able to get a test before she ate this morning, but did get one before the shot, 30 mins after she ate. Her BG was 179 so I was concerned about giving her even 2u given how far her BG has been dropping. I decided to skip again and try 2.0u tonight, since I'm sure she'll be back up by then. I won't be able to get home for a mid-day test today, but definitely will before she eats tonight.
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I suggest you drop her to 1.0 u and go from there. It's easier to raise the dose in 0.25 u increments (eyeballed) than skipping/panicking when she drops like a stone. Give the 1.0 u dose for, say, 4 cycles and if the numbers in the +3 to +7 range are still high blues or above, increase to 1.25 u. Repeat as needed.
 
@Kris & Teasel Julie is using the pen right now so can only adjust in half unit increments. Given this morning's low pre-shot again, I'm inclined to agree that it might be better to knock her dose down to 1u for a few cycles and see what Mama Cat does. I'm wondering if she is going lower than we are seeing with the testing being done.
 
Hi ... actually I don't use a pen....just the U-40 syringes. I really like the idea of starting back at 1u. I'll see what her numbers look like tonight. Thanks to you both. REALLY love this group.
 
Oh my bad......but still the same issue.....no half unit markings on the syringes. You could try eyeballing it but it gets very tedious.
 
Sorry Julie. Was out last night and didn't check in 'cause I got home late. Good decision to stick with the 1u. Happy to see that lower but still shootable pre-shot this AM.
 
Absolutely not a problem ... not like everyone lives with board up all the time. But thanks.

Pre-dinner number is 255. I'm liking how she seems to be holding there from a consistency point of view anyway. I think I will stick with 1u through tomorrow evening and if she stays in the 200s, take her to 2.5. Sound ok?

Unfortunately I only have one more alphatrak test strip so probably will skip tonight and do the pre-meal test in the morning. I have an order in for more and I think they are due to come in tomorrow.
 
Sandjules & Mama Cat said:
I think I will stick with 1u through tomorrow evening and if she stays in the 200s, take her to 2.5. Sound ok?
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IF numbers are improving and they do appear to be, then you would increase dose by 0.25u or 0.5u at most so either 1.25 or 1.5u. Don't go up to 2.5u or you may totally miss the ideal dose for Mama Cat not to mention, possibly put her in danger of going too low or causing her some major bouncing which in the long run could be dangerous at worst and at best will slow down your progress at finding the best dose for her. 2.5u is definitely TOO HIGH given the readings you have been seeing.

It's difficult but best to make sure you always have strips available for your meter even if a shipment of a new supply is held up for some reason. Most of us always have a couple of vials of strips available at all times. I kept an extra vial of strips in my Hypo kit and that I swapped out every time I got a new supply of AT2 strips. That way I always had extras should I need them and they were always well within expiry dates.
 
Try to get a before bed test to see what Mama Cat is doing on the night cycle especially when making dosing increases. Getting mid cycle tests in the only way you will really know how the dose is working for Mama Cat. If you are working during the day that can be difficult and makes getting those night tests that much more important. If you are home during the day, try to grab a test anytime between +3 and +7 post shot during the day to see how low the dose is taking Mama Cat's BG.
 
While it may look like you are going backwards, there is the problem with not knowing how low Mama Cat is going during the cycle. All you are seeing right now is the readings you take before shots. Without the mid cycle information it's just a guess what is going on. The other night you got a test 5 hours post shot on the night cycle that showed Mama Cat's BG is dropping into blue numbers which is great. With the weekend upon us, I would encourage you to get some mid cycle tests tomorrow and Sunday and also to make it a habit to get a test in before bed every night. Without seeing what is happening mid cycle, all you can do is guess.......with actual readings, you can make decisions based on data you've collected.
 
The only time you need to withhold food is for the 2 hours prior to the pre-shot tests. Any other tests can be done whether kitty has snacked very recently or a few hours ago. You can always keep track in the comment column with notes like "snack @+7 am" for instance and you can include details of how much and what kind of food if kitty eats a variety. That way you and anyone helping can see if a higher number seemingly out of place might be a food bump.
 
Hi,

With my own health issues lately, testing Mama Cat has been sporadic, but I did put up some new numbers this past week. I know it may not be enough info, but have any thoughts about what I do have recorded?
 
I'm so sorry to hear you've been unwell and hope you are feeling better. That does indeed make it harder to look after our furry friends and especially to get those extra tests in so well done for what you did get. I am wondering though whether you skipped shots the 1st pm and on the 2nd of April am and pm or just didn't fill that info in yet.

I know we discussed this before......syringes so you can do 0.25u dose adjustments. Mama cat's not looking too bad but she does get some steep drops in the early part of the cycles suggesting she may be an early nadir kitty. To be honest, I'm still not sure what I'd suggest you do dose wise. The 1.5u dose is getting her to drop and she seems to have a bit more room to drop but I'd be hesitant to try an increase of more than 0.25u particularly if you are still not in a position to get regular pre-shots tests and some mid cycle tests in to see how low an increased dose is taking Mama Cat.

When you are having a hard time getting tests in, as much as mid cycle are needed to figure out dosing, the pre-shots tests tell you if it's safe to give insulin and if I was forced to choose between the 2 tests, I'd take the pre-shot test so if BG is low, you can skip the shot or choose to give a reduced dose. :)
 
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