4/11 - stabilized AM+6 240 + New member intro - Zokni

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Zsofi & Zokni

Member Since 2020
Update: I've been monitoring his BG all day and it keeps dropping. He hasn't had a peak at all. Now it's 80 at +11... I don't know if I should shoot in one hour

Hi everyone,

I've been following this forum more or less since February of this year.

A bit about us:
Zokni is 8 years old, he is naturally a pretty large cat. He used to be overweight, some years ago probably around 22 pounds. He first lost weight when he had teeth problems, but this got resolved, around 4 years ago when they treated him (he now has 3 teeth left but he's doing great with that). I got separated 1,5 years ago and he stayed at my ex. I don't want to bore you with ALL the details, but I can't really say when he's state deteriorated, he eventually lost a lot of weight and developed neuropathy in his back legs, so the vet diagnosed him in January and was switched to Royal Canin diabetic dry food.
I transfered him into my care and started him on Lantus, 1.5 units in February. After the first check up, the vet increased it to 3U. I read about wet food and asked the vet but she insisted on the RC dry food. Nevertheless it was good, he started gaining weight at that point. Now he's at his best, if not a bit already on the chubby side, I have not been able to control his portions, due to my own weakness when he was begging.

Anyway, I recently decided to home test and look into the wet food topic. It was a bit tedious, as none of the brands in the tables I found were available in Spain, but did my own conversions, I figured even based on the manufacturer's figures, it would be better than nothing. Long story short, I got the new food yesterday and to check if Zokni would like it, I offered him a can of wet food at dinner. He devoured it. I also gave him dry food, because I was afraid of the sudden change, considering his pretty high dosage of insulin.
I also got the Aviva BG meter yesterday, so I tried doing a curve today but my first attempt at the AMPS 7am did not succeed (I had no idea how much blood would be needed, ruined like 5 strips between trying my blood and his and was finally interrupted by my 4 year old). However all the following tries were surprisingly easy. He doesn't love it, but will submit to it and I have already 2 measurements :) It's so much easier than I thought...

Btw, for the neuropathy, I started giving him (human but without xylitol) methylcobalamine almost immediately as I'm vegetarian and always have some at home. His state at the time was: incredibly weak legs - almost no muscle but he managed a jump onto the bed about 1/2 the time with the help of his claws. I ordered the cat B12 (zobaline I think?) but due to Covid19, I think it's still in transit. During the first weeks/months, he was improving slightly but wasn't amazing either. One day this week I noticed he's running around like crazy, jumping up with ease about 3 times as high as the bed... So thank you all a lot for this advice, it was literally life changing for Zokni. (My vet tried to convince me to stop it but...you know :))

Regarding the advice I need:
He loves the wet food but should I switch him cold turkey and if yes, how should I lower the insulin before even his first 100% wet meal? You'll see that his BG levels are not extremely high, I'm really afraid he will drop too much... We're on quarantine here and it's easter, no way I would find a vet to help...
Or should I rather give him a combination of wet and dry to begin with? Just to ease the transition on his body?
I'd love to hear your thoughts or how you did it!

Rgds
Zsofi

PS: I've attached some pictured of his evolution since January to right now
 

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WELCOME CLOSET FDMB'er ;):bighug:
These ARE all good questions! Please hold on for good answers. You are already doing a good job but I know the experts here can help you fine tune your handling of this disease.
Ditching the dry is good ! But it must be done slowly and with much testing.
Hang in there more help is coming!
 
Hi Zsofi and your extra sweet cat Zokni. We have a couple of people that live in Spain.

I think the insulin dose is too high right now. Even with only giving Zokni a little bit of wet food, his numbers are getting really low. How long ago was that +10 test?

Regarding the advice I need:
He loves the wet food but should I switch him cold turkey and if yes, how should I lower the insulin before even his first 100% wet meal? You'll see that his BG levels are not extremely high, I'm really afraid he will drop too much... We're on quarantine here and it's easter, no way I would find a vet to help...
Or should I rather give him a combination of wet and dry to begin with? Just to ease the transition on his body?
A slower transition to the wet food, can ease any digestive upset. So gradually changing the food from dry to wet may help with that.

I'm concerned that the dose is too high, even before you start the food transition. Not sure how low the dose should be. I'm thinking 1U to 1.5U of the lantus insulin. I'm thinking more on the low end of that, the 1U.

What wet food did you get for Zokni?
We have a food chart for the UK, and many of these foods are available in Spain or by mail order.
UK and European Food Chart

@Gill & George is the only member I can think of at the moment that lives in Spain.
 
Hello Zsofi and Zokni!

I agree, that dose is going to be too much going forward-- it's likely too much now, and if you are switching to low carb food, doubly so.

We'll see where Zokni is at shot time, but he's been dropping steadily all day, so.... I agree with Deb that if he's high enough to shoot, I wouldn't shoot more than 1.0U tonight, but you might end up skipping and monitoring some more.
 
For the Feline Health forum, we use a threshold of 200 mg/dL (11.1 mmol/L) for a decision point in giving lantus or prozinc insulin. As you gather more test data, that number can be lowered.

Did you make a Hypo Toolkit, with supplies in case Zokni's BG (blood glucose) levels dropped too low.
Do you have some medium carb or higher carb food that you can give Zokni?
 
Hi and thanks for your reply!

I think the insulin dose is too high right now. Even with only giving Zokni a little bit of wet food, his numbers are getting really low. How long ago was that +10 test?

The +10 was an hour and half ago and I retested him 30 minutes ago and he was at 80. He should be getting food + shot in 30 mins.
I'll monitor him frequently for the rest of the evening, I think I can go up to PMPS+5 but I guess if he's this high, it would be better to skip and give him 1U in the morning only and try again the curve with that insulin, what do you think?

What wet food did you get for Zokni?
We have a food chart for the UK, and many of these foods are available in Spain or by mail order.
UK and European Food Chart

I got him Sheba in terrine Ocean collection which based on the chart has 5.7 carbs
I'll make sure to have a close look at this chart. I must have missed it somehow...I'm sorry for making you look it up...
 
Did you make a Hypo Toolkit, with supplies in case Zokni's BG (blood glucose) levels dropped too low.
Do you have some medium carb or higher carb food that you can give Zokni?

Hmm, I'll have to spend more time researching what are the medium/high carb food available.
Eventually, I still have a lot of his RC diabetic dry food left over, in a pinch that would work, no?
I do have also honey and maple syrup at hand.
 
He should be getting food + shot in 30 mins.
I'll keep my eyes out for you. Please post the blood glucose (BG) test number before you give any insulin or feed Zokni.

I'll make sure to have a close look at this chart. I must have missed it somehow...I'm sorry for making you look it up.
No apologies please. That UK food chart I linked for you was well hidden. You have to know where to look for it. It's within a thread, in a different forum, within a link, within another link. I know where to find things, so I was happy to help.
 
Hmm, I'll have to spend more time researching what are the medium/high carb food available.
Eventually, I still have a lot of his RC diabetic dry food left over, in a pinch that would work, no?
I do have also honey and maple syrup at hand.
Yes, the RC diabetic dry food would be high carb. But dry food takes longer to digest than wet food, so it's slower to bring the blood glucose levels back up.

Honey and maple syrup are good simple sugars, for bringing the blood glucose up fast. But they wear off quicker too. You are not at the point yet where you want to give him any honey.

My gut feeling is that you will be skipping the insulin shot at PMPS.
 
@Deb & Wink @Diane Tyler's Mom @Nan & Amber (GA)

Thank you all for your help! I was suspecting these 3U were high.
On 1.5U, the vet asked me about his drinking and litter situation. Before insulin he was drinking and peeing a lot and although at first it was improving, he was still doing it. And he has been begging for food like crazy. So they did a test and decided to increase it to 3U.
I think his peeing is under control now.
The begging not so much.
Today, he got a proper dry food portion for breakfast (probably just under his daily carb amount) and snacks, as I said a little bit of wet food at each test and he's not left me alone all day, following me and running to his bowl as soon as I move a finger...
 
Today, he got a proper dry food portion for breakfast (probably just under his daily carb amount) and snacks, as I said a little bit of wet food at each test and he's not left me alone all day, following me and running to his bowl as soon as I move a finger...
Many cats, when they feel their blood glucose levels dropping low, will seek out food. I think that is what Zokni is doing today.
 
I'll keep my eyes out for you. Please post the blood glucose (BG) test number before you give any insulin or feed Zokni.

Here we are, PMPS and he's at 72.
He's also going nuts for food right now, he must be feeling the BG drop that you mentioned in your other comment.
Should I wait some more with food?
I can only give him the dry food as a high carb alternative today, the shops are closed but I'll pick up something better tomorrow.
 
Please go ahead and feed Zokni.

That 72 is too low to give him any insulin for this PM cycle.
Skip the insulin shot.
If you are able to monitor, you should test again about 1 hour after feeding.
To make sure the blood glucose numbers are going up.

p.s. The dry food that you have is fine for feeding him right now.
 
Yep, skip tonight, start fresh in the morning!

I second the recommendation to test some more tonight, even though you didn't shoot. Depending on what you get at that +1 time, you might need to test more. Lantus is a so-called depot insulin, with a bit of each shot being "saved for later". That 3U you have been shooting means a pretty hefty depot, and you could be seeing the effects of it tonight even without an evening shot.
 
@Deb & Wink @Nan & Amber (GA)

I test at just over +1 and he got 71
BUT since I have him a bit of wet food to keep up with the transition + his regular dry food, I think he preferred the wet and chowed it down, now he’s onto the dry food, I’ll leave it out for him

thank you so much for all your effort!! I can’t believe all the work you guys put into helping other people! I’ve seen that you’ve been supporting multiple people at the same time, it’s truly amazing.

I’ll be poking Zokni some more today and tomorrow, I’ll be sure to give an update.
 
Stay safe. Please keep the spreadsheet updated.

I'm sure you 4 year old is calling for you to tuck him/her in.
thank you so much for all your effort!! I can’t believe all the work you guys put into helping other people! I’ve seen that you’ve been supporting multiple people at the same time, it’s truly amazing.
It's what we do. Paying it forward, to the next person that needs help.
 
Since Zokni has such a large insulin "depot" or storage area, from that 3U, he may continue to drop tonight. Please keep a close eye on him.

Hi!
It looks more balanced today. I've updated the speadsheet.
Basically he was 233 AMPS, dropped to 171 by +3 and it's creaping up now with 240 @+6
AMPS I gave him 1U of the Lantus. He got half dry/half wet food, but haven't finish either of them completely. For sure he's eating less than yesterday.
Let's see how his numbers evolve until the PM feed.
Should I be moving this discussion to the Lantus group for advice, now that he's not dropping so fast?
 
Should I be moving this discussion to the Lantus group for advice, now that he's not dropping so fast?
Yes, please move to the Lantus ISG (Insulin Support Group) for advice. They have a specific format for the thread title, and want you to post a new thread every day.

You should also update your thread title throughout the day, when you get new blood glucose (BG) tests. That is how people that scan and review that forum keep track of who may need help.

Also, introduce yourself in your first post over there, and link this thread from Feline Health in your first thread over in the Lantus ISG forum, for background and history for people that will help you.

Use the ? prefix on your thread if you have questions. Update your thread title and Remove the ? prefix when your question has been answered.

Think you can do that? Practice here first, if you want to, so you know how to edit your thread title and use the prefix in the thread title.
 
Or should I rather give him a combination of wet and dry to begin with? Just to ease the transition on his body?
A slower transition to the wet food, can ease any digestive upset. So gradually changing the food from dry to wet may help with that.
Although it's true that some cats digestive system cope better with a slow transition. The important issue, if the cat is already on insulin, it is usually recommended to transition to wet slowly so you don't see the cats blood sugar bottom out when you reduce the carbohydrate load, so it's a safety thing. This then allows you to adjust the insulin down in a controlled fashion.

George went cold turkey onto wet, no digestive problems and never looked back, but I did this before we started insulin.

How is he doing today on 1u??

I order all my food for cats from Zooplus.es, they are still delivering to me here in Granada, Andalucia. There's a better choice on there of quality food. I use mainly german brands that are made from prime meat protein and haven't got any nasty additives, flavour enhancers.
I've used:
Granata pet
Thrive (I have to order this now from Zooplus.de, not available on the spanish website now)
catz
animonda (good value and quality)
ferringa
Terra Faelis (also from Zooplus.de)

I found that George (also a naturally big boy) was more satisfied and happy on a wet diet, and not always begging for food like he was when he had a dry Royal canin diet, he got to a better weight for him.

I've not been on line much last month, been a bit crazy here for me. But if you need help with resources here in spain, send me a PM.
 
How is he doing today on 1u??

He's in the blues! Mostly...
Based on the many inputs from everyone here, I think there's a lot of things acting at the moment:
- the built up depot of the 3U he was getting until now
- the 1U that he's getting from now on
- the fact that I skipped again last night and 2 days before
- the transition to wet.

My plan going forward is:
- keep the 1U for now, unless something very obviously tells me otherwise
- avoid skipping any shots - I now have the emergency kit ready
- keep transitioning him over the course of the week to wet food by giving him dry food at night (to avoid going low since I won't be monitoring him as often as during the day)
- I guess once he's on wet food fully, it will be clearer how the 1U works for him truly


I found that George (also a naturally big boy) was more satisfied and happy on a wet diet, and not always begging for food like he was when he had a dry Royal canin diet, he got to a better weight for him.

Same thing for Zokni. He has almost completely stopped begging, he only starts it shortly before feeding time.
Thanks for your help regarding the food. I'm also ordering things from zooplus, so I'll check the ones you listed. It's really a big help not having to do all the research myself, it's crazy time consuming...
 
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