Need help with BG regulation & food/dose info

[Heather M]

Hi all.

I read a forum discussion that I found from my google search and I KNOW this is the right place for me. HELP!

My cat Taffy was diagnosed (with my suspicions true) as diabetic a few months ago. He is - WAS a BIG boy. Maine coon. His highest weight was probably 24lbs.

He is now about 13. Which has dropped since I have determined I’ve basically been starving him trying to follow my vets advice.

I currently have 2 types of insulin in the fridge. The first: prozinc , the second: humulin n. We started with prozinc and my doc switched it to humulin n because they GAVE me a bottle they had so I didn’t have to order another after 1.5 months of prozinc not working.

By not working I mean he still tests very high levels. He is more lively, energetic, PLAYING again- all good things. But his levels remain high. So she had me switch. I think this was unnecessary?

He is currently getting two doses of about 2.5 units of u100 humulin n insulin. He is fed at 705 every day and shot at right about 730-740 depending when he is done eating.

He has been prescribed science diet wd and currently eats that- mostly only dry.

I fed him this mixed with friskies turkey meat bits wet food tonight after reading my first forum I found on this. He ate the whole thing (one 5.5 oz can and 1/2 cup dry WD.

My doc REFUSED to let me feed him more than twice even though I explained he was starving. She said he had to adapt to it to help regulate levels with BG being so high. He wasn’t and I tried to fight her on it but listened anyways.

So can I feed more often meals? At least one more on my lunches?? More possibly??

For reference, I have a home test kit and he has consistently tested high. Tonight at 630 he tested at 679 after I found his food thrown up on the floor when I got home. It was still wet, so recently I assume. I fed him at 705. Shot at 730. Will be testing at 830 for +1 test.

I googled and found the humulin n peaks at 4 hours. Not sure how to interpret that or what it means, but I saw it in the other discussion. Is this where his level will drop the lowest in response to the insulin?
I will test +2 and +4 tonight and I know he will hate me for it!!

I’m just tired of seeing him hungry and skinny.

The humulin n we got was set to expire so it is actually officially “open” expired after 9/30/19. I need to determine whether to continue with humulin or reorder prozinc. The prozinc I have was opened 7/8/19 so I’m not sure the open bottle shelf life? I believe it was 3 months in which almost done at 10/8/19.

I need to know which to get or another recommended? If prozinc I can switch back and use my bottle for now. But I don’t want to switch before I know for sure.

Finances are tough but flexible.

So I need:
Food advice of food, amount, and feeding schedule for a healthy ~17 pound cat (this is what I want him to get back to at least)

Insulin advice of kind - prozinc preferred because I have it still and it’s affordable but I’m flexible. I don’t think he needed to switch I think I just needed better doctor advise on feeding/etc to better regulate. Basically I think it was the doctors fault not the insulin not working.

By the way, he is about 10.5 years old. But acting so much more playful and happy since we got him diagnosed

I have friskies meat bits and friskies gravy sensations and some other cat food on hand- because I have other cats too. Taffy has only gotten science diet WD for way too long.

Thanks in advance

 

[Margie and Jackson]

Lantus is the insulin many prefer because it often seems to help cats achieve remission, in other words, it helps them heal so they can produce their own insulin and don’t need shots. Many of us buy it from Canada. The favorite pharmacy is Marks Marine in B.C. Their website has prices, if you want to compare.
I just want you to know there are options.

Nobody would recommend prescription food. Expensive and low quality! There is a list of low carb foods in the stickies too. I feed redbarn and tiki cat, which are both under 5%.

I feed Jackson a ridiculous number of times per day, because it seems to help him feel better. My vet approved this. Lantus acts differently than other insulins, so maybe there is a reason to feed most food 2 times a day on Prozinc. Look for more info on the Prozinc forum. That might answer your questions.

 

[Panic]

My doc REFUSED to let me feed him more than twice even though I explained he was starving.

Guess what you're the caretaker not him. <: You are his advocate and you absolutely should be feeding him MULTIPLE times a day. Most of us give 4-8 meals a day or free feed. During the day and during the night. Invest in an auto feeder if you don't already have one (most of us use PetSafe 5).

It's possible he's being overdosed which is why you're getting this ridiculously high numbers, most of us use a Google spreadsheet to keep track of blood sugar. Could you show us any numbers? And how many units he's taking per cycle?

Like Margie said there's a lot of food options. Most of us use Fancy Feast Classics or Friskies Pate, but there's plenty of other options. I also use 9 Lives wet which is a fairly common grocery store brand.

 

[Heather M]

I don’t have many results of his on hand easily- I’ve been calling and reporting to doc a few times so I will have to get numbers from them tomorrow. Haven’t been writing down. For now I have this from when I first started home testing. This was his levels with 2 u40 units of prozinc. Today he tested at 679 after I saw he got sick and threw up- test was at 630 pm before his 7 feeding. He at at 7 got shot at 730 and now at 840 he tests at 481. He has been on humulin n for about a month now and he gets 2.5 units in a u100 needle. As I mentioned, I believe this medicine has “open container” expired.

 

[Heather M]

I would’ve expected that store wet foods would be too high of carbs for diabetic cats? Is that what I need? Low carb high calorie? Or backwards?

I Will go through this bag of science diet mixed with wets and then not reorder. I didn’t approve of science diet before as a brand. When he got diagnosed I figured I was stuck with it being made for diabetic cats and him needing special stuff.

 

[Panic]

I probably wouldn't worry too much on the calorie bit and moreso the carbs. Anything under 10% is fine for diabetics, 5% and under is desirable. There's lots of grocery store brands that fit that description.

HERE is the chart Margie was referring to. It's extensive, but just read the first 4 and last 3 pages, everything in between is just listing a breakdown of nearly all wet foods. You'll find Fancy Feast Classics, Friskies Pate, Tikicat, 9 Lives Meaty Pate, Weruva, among others, all fit the criteria.

When I tried switching to Fancy Feast my vet flat out told me I wouldn't be able to regulate my girl on it, but I showed her this chart and she did her own research before agreeing with me. You don't have to get permission from your vet though, even though it's nice to have.

 

[Panic]

It may help if you get a little notebook and start writing down Taffy's BG numbers. We all use spreadsheets here but we also use log books since it's good to have hard copies. I think it will be easier too for you to refer to times at +1 or +3, rather than 7:02 or 8:41. We're all in different time zones here and it's often easier to read that your cat is in his third hour (+3) post shot versus "I gave at 7 AM and its now 10:30". My log book looks something like this:

10/1/2019 AMPS 252
+3 211

...so on and so forth xD

 

[Margie and Jackson]

I would’ve expected that store wet foods would be too high of carbs for diabetic cats? Is that what I need? Low carb high calorie? Or backwards?

I Will go through this bag of science diet mixed with wets and then not reorder. I didn’t approve of science diet before as a brand. When he got diagnosed I figured I was stuck with it being made for diabetic cats and him needing special stuff.

Tons of brands are lower carb than the prescription food, believe it or not. I couldn’t believe the ingredient list on the purina dm I was given to feed Jackson. He was quite fragile when I adopted him and I had to wean him slowly onto a better brand that was also half the price.

 

[Red & Rover (GA)]

You really need a new vet.

You can switch back to the Prozinc. A bottle lasts between 3-4 months if it has been kept refrigerated. If it has been kept in the door of the fridge, it might last a little less. Tagging @MrWorfMen's Mom about Prozin and dosing.

Feline diabetes is a marathon, not a sprint. It takes time to find the correct dose.

It is more expensive at the outset, but Lantus is inexpensive if you order from Canada. A lot of people here do. A box of 5 Lantus pens runs about $150 and should last you a year.

He is currently getting two doses of about 2.5 units of u100 humulin n insulin. He is fed at 705 every day and shot at right about 730-740 depending when he is done eating.
He has been prescribed science diet wd and currently eats that- mostly only dry.
I fed him this mixed with friskies turkey meat bits wet food tonight after reading my first forum I found on this. He ate the whole thing (one 5.5 oz can and 1/2 cup dry WD.
My doc REFUSED to let me feed him more than twice even though I explained he was starving. She said he had to adapt to it to help regulate levels with BG being so high. He wasn’t and I tried to fight her on it but listened anyways.
So can I feed more often meals? At least one more on my lunches?? More possibly??

Yes, you want low carb food. Fancy Feast Classics (pate) and Friskies pate are fine and affordable. The other Fancy Feast and Friskies formulations are too high in carbs. (They will, however, come in handy if you find Taffy in a hypo situation.)

Unregulated cats cannot make full use of their food. That is why they are always hungry. As Taffy becomes regulated, his food needs will drop.

And yes, feeding at shot time and mini meals throughout the day and night are much better for him.

Insulin dosing is based on how low the cat goes during a cycle. It is good that you are getting some tests in tonight so you can get some idea of the duration of Humulin N. For some cats, Humulin N lasts longer than 4 hours.

 

[Heather M]

You really need a new vet.

You can switch back to the Prozinc. A bottle lasts between 3-4 months if it has been kept refrigerated. If it has been kept in the door of the fridge, it might last a little less. Tagging @MrWorfMen's Mom about Prozin and dosing.

Feline diabetes is a marathon, not a sprint. It takes time to find the correct dose.

It is more expensive at the outset, but Lantus is inexpensive if you order from Canada. A lot of people here do. A box of 5 Lantus pens runs about $150 and should last you a year.



Yes, you want low carb food. Fancy Feast Classics (pate) and Friskies pate are fine and affordable. The other Fancy Feast and Friskies formulations are too high in carbs. (They will, however, come in handy if you find Taffy in a hypo situation.)

Unregulated cats cannot make full use of their food. That is why they are always hungry. As Taffy becomes regulated, his food needs will drop.

And yes, feeding at shot time and mini meals throughout the day and night are much better for him.

Insulin dosing is based on how low the cat goes during a cycle. It is good that you are getting some tests in tonight so you can get some idea of the duration of Humulin N. For some cats, Humulin N lasts longer than 4 hours.

I am in the US. So I am not sure of the availability of Lantau, but I will switch back to pro zinc for now. He was prescribed 2 units of u40 insulin shots with prozinc originally. I believe I should switch back to that and that dose starting in the morning.

I absolutely LOVE the foods list after reviewing. This makes it so much easier to compare and understand. Look forward to getting wet food tomorrow that will work better for him! Will probably look into another decent dry food to supplement the wet food to mix each meal once I finish up the dry stuff I have.

 

[Panic]

You will want to purchase Lantus from Canada if you decide to switch in the future. It's outrageously expensive here in the US.

I think there's only one or two acceptable dry foods (you won't find any on the food list). One is Young Again, it's pretty expensive I've heard. Of course remember to mix the new food with his current to help the transition ^-^ His BG will lower with the lower carb food so make sure you're testing every day. Hopefully Linda (MrWorfmans' Mom) can suggest a new dose for you!

 

[Heather M]

Gosh thank you all so much for your help already! I am so excited to get a handle on this for my Taffy!! Thank you, thank you!

 

[Red & Rover (GA)]

Young Again needs to be ordered online from the company. I believe they will send you a sample to try. Some cats have poop issues with it.
There is also Dr. Elsey's Clean Protein dry.
I'm not in the U.S. so I'm not sure about these.

Cheaper Lantus from Canada:see THIS post for more information.

 

[Idjit's mom]

Welcome Heather and Taffy. Heather, Taffy is a beautiful kitty and we will all do our best to help you take good care of him.

First, please create a signature so that we all can see Taffy's info right away when you post. It's the grey text that is attached to each post and it will save lots of repeated questioning and answering about insulin, diet etc.

Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what he eats/any other meds or health issues he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.

Regarding testing his blood sugar at home. This is the best way to see how the insulin is working, and critical if you are going to be transitioning him to a low carb diet. Heather, going to a low carb diet can significantly reduce the blood sugar, and if you do it suddenly and are still injecting the same amount of insulin without knowing just how the diet is affecting him, you could find yourself in a hypo (very low blood sugar) situation. Most times, the low blood sugar can be steered upward with higher carb foods etc, but if you aren't testing you don't know what's happening. Changing food while giving insulin should be done slowly, to help prevent tummy trouble, as well as lowering the BG (blood sugar) too fast.

You need to test before every shot and then again at least once during the 12 hours between shots. We need to see how low the blood sugar is going in each cycle.

Next, please set up the spreadsheet we use here and plug in whatever insulin and testing data you have to date. It's important to be able to view the history and see the patterns over the time he has been on insulin. The more data you have and can get going forward, the better we can help.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

When you set up the signature and then the spreadsheet, it's very helpful to put the spreadsheet link (eg. Tuffy's SS) at the very end of Tuffy's info, even make it bold so it stands out. The instructions tell you how to create a text link (the URL spreadsheet links can be very long and take up a lot of room and signature space is limited).
Much easier to find, just in case you have a bit of an urgent event or question and the spreadsheet data needs to be consulted. If you need help with this step or setup, we have members who can help, or do it for you.

Effective diabetic treatment involves all three components: diet/insulin/home testing. You are going to be helping Tuffy immensely by reading the information here about the insulin you are using, learning about proper diet and getting that going at home, and testing consistently to protect him and find the best dose to regulate the BG and get him feeling much better.

Keep posting, asking questions and letting us know how we can help further.

 

[MrWorfMen's Mom]

Welcome to you and Taffy! Taffy is absolutely gorgeous. Reminds me a lot of my 21 year old! You've already got a lot of great info.

Taffy obviously needs more food than your vet has been recommending and certainly not the so called prescription diet stuff the vet sold you. If I were you, I'd try to transition Taffy to an all wet low carb diet however if you need some dry in the meantime, order a sample of the Dr. Elsey's to see if Taffy likes it. Just be aware that switching to an all wet diet can have a significant lowering effect on BG and therefore switching needs to be done carefully. Gradually reducing the amount of dry food and monitoring carefully is required. Rather than continuing to feed the high carb W/D, take the bag back to the vet and tell them Taffy has decided he won't eat it anymore. You should be able to get a refund and the manufacturer will reimburse the vet. If the bag is half empty, I think they'll still give you at least a partial refund.

In the meantime, feed Taffy as much as he will eat split up in multiple meals per day. Taffy cannot process the food he is eating well and needs more calories to maintain much less regain lost weight. Once BG gets better regulated, his appetite will decrease and you can reduce his food intake accordingly to help him maintain a healthy weight.

I totally agree that ProZinc is preferable to Humulin N. ProZinc is a much better insulin for cats. Lantus is also a good insulin for cats and if you want to switch to Lantus, then ordering from Canada is the way to go. Over the long term, depending on the dose of insulin your cat needs, the Lantus can be just as cost effective if not cheaper than ProZinc. For the time being though, I'd go back to the ProZinc you have on hand.

Without any data to look at it's impossible to determine a dose for Taffy. If you can get the spreadsheet set up and plot in your readings for the last week or so, it will give us a starting point to make recommendations. If you need assistance setting up the spreadsheet, let us know. In the meantime, since you've had Taffy on Humulin N at 2.5u, you could try 2u of ProZinc initially while starting the transition to a wet diet with monitoring. I would not give insulin if BG is less than 225 or 250 since you are using the AT2 meter. If you get a reading under 90 at any point in between shots, then the dose may need to be reduced. Getting a test before every shot and at least once each cycle in the 4 to 7 hour period post shot will give us an idea of how low BG is going on that dose. Always get a test on the night cycle too as our kitties have a habit of going lower at night than they do in the day time.

Also let us know if Taffy has any history of ketones or DKA.