Feeling overwhelmed

[MyraB]

Hi my name is Myra. Our kitty is Claire. She is 10 years old and we love her dearly. She was diagnosed with diabetes on 4/15/21 - drinking a lot, peeing a lot, weight loss, and hair loss. Bloodwork showed high sugar (I just sent a request to have a copy of the blookwork sent to me).

I feel overwhelmed. I'm nervous to go against the vet or do anything without asking/telling him first. I really want to do what's best for Claire, though. I have downloaded your spreadsheet and followed the instructions for adding it to my profile.

My biggest concerns right now: I don't know how we're supposed to be feeding her, because from what I'm reading, what we're doing is wrong. We immediately (4/16/21) switched to Purina DM per vet recommendation and started a strict 12-hr feed schedule. We got dry food because that's what she has always eaten. We give 2oz every 12 hrs (8:30). We give her about an hour before taking it up. She's been eating about 1-1 1/2 oz per feeding. Prior to this she free-fed. She doesn't seem too bothered by the new schedule, but she is ready to eat when it's time.

We have an appointment just to check Claire's sugar on 5/6/21. I just ordered your recommended testing supplies (ReliOn meter, lancing devise, testing strips, and ketone test strips) They do not know I'm about to start checking it at home. This is my other biggest concern, I need help with knowing how/when to do this, please.
We are not using insulin, yet. I think the sugar count on 5/6/21 is to determine if we need to start. After downloading your spreadsheet, I realized that it isn't applicable to us, yet. Is there a way I can/should track her levels even though we are not using insulin? (Hopefully, we can bypass the insulin altogether!)

She is not taking any meds and has been a healthy cat (although, before this bout of sickness she was overweight). On 4/15/21 she weighed 9.8 lbs. Not a bad weight, but a significant weight loss for her (I do not know her weight before). Other than the initial concerns (drinking a lot, peeing a lot, weight loss, and hair loss) her behaviors are normal.

I appreciate any help you can offer. Thank you!

 

[Bron and Sheba (GA)]

Hi Myra and welcome to you and Claire
You have come to the best possible place for help and support. It is overwhelming in the beginning but we can help you with everything. There is a lot to learn but you are already part way there.

First of all, well done buying the glucose meter, strips, and ketone test strips! Fantastic!
You don’t need your vets permission to home test. It is the only way to ensure Claire is safe if you are giving insulin, and it is important to keep track of the BG (blood glucose) while you are finding out if she is a diabetic.
One thing.....as soon as you get the ketone strips, Collect a urine sample and test the urine for ketones. Did the vet mention ketones when you were there?
If you have not started insulin, it is a good idea to test the urine daily, because diabetic cats are more prone to ketones and if insulin is not being given, that is an added risk.
Waiting until the 5/6 is a long time to wait to check. Check the urine daily.

Regarding the food......I would swap over to a low carb wet food if you can. Purina DM dry is higher carb and you need a food that is 10% or under carbs.
Now is a good time to do the swap before any insulin is given. I will post a link to suitable foods.
There is no need to only feed twice a day....that is old thinking.
We recommend feeding a meal before the insulin dose and then a couple of snack during the first half of the cycle. ( a cycle is 12 hours). If she has lost weight, let her eat more often if she is asking for it. It’s important she eats well. That also helps keep ketones away.
So when you get the testing equipment, test Claire, then feed her, then give her a couple of snacks over the next 6 hours. Do another test around +3 which is 3 hours after the main meal.
Also do this for the evening cycle as that is just as important.
Put all the data you collect into the spreadsheet you have uploaded (well done with that) . We will be able to tell you if she needs insulin.

It is common for diabetic cats to loose weight because they can’t utilise all the nutrients in the food. She will regain all the weight once her BG levels are regulated.

Here is a link to suitable foods. look for foods that are 10% or under carbs....wet/canned foods
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Here is a link to home testing links
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Keep asking questions and please start posting daily once you start testing so we can help you. Below is where you test on the ear.
Bron

 

[MyraB]

Bron, I am sincerely thankful for your response!

A few follow-up questions:
-The vet did not mention ketones. Is there a certain time of day I should be testing for ketones? What do I do if they are present?
-Do I need to make the switch to wet food gradually or is it okay to go straight from dry to wet?
-Where do I post daily testing?

Thank you!

 

[Bron and Sheba (GA)]

Bron, I am sincerely thankful for your response!

A few follow-up questions:
-The vet did not mention ketones. Is there a certain time of day I should be testing for ketones? What do I do if they are present?
-Do I need to make the switch to wet food gradually or is it okay to go straight from dry to wet?
-Where do I post daily testing?

Thank you!

You can test for ketones anytime. If there is more than a trace present you need to tell the vet as that indicates that the insulin needs to be started. In fact, because insulin hadn’t been started, I would tell the vet even if a trace was present. In any event post and tell us. You can record it in the remarks column of the spreadsheet.
The test strip needs to be read exactly 15 seconds after you dip it in the urine against the colours on the side of the bottle. Make sure you are in a good light. Some people have trouble seeing if there is a negative or a trace result....it can be hard sometimes as it is similar. If in doubt.take a photo and cope and paste it from us to see. It has to be at the 15 second mark though.

I would do the swap over of food gradually over the period of a week, or more if needed, to prevent any tummy upsets from suddenly changing the food.

You record the daily BG tests in the SS
Open up the SS and you will see the date, then AMPS...that is am preshot. Put the result of the BG test you do before feeding the main meal in there. In the U column put a 0 which means no insulin given. Then the +1 to +11 are the hours after the insulin would normally be given, but in your case, after the main meal. You record the BGs there. So if you got a BG test done three hours after the main am meal, you would put it into the +3 column. The same for the PMPS cycle which is pm preshot. ...does that all make sense.
Any notes you put in the remarks column. It would be very helpful if you could put the times in you give all the snacks in the remarks column ..eg low carb snacks given +2 and 4 and +6 am cycle and +3 and +5 pm cycle. This will help us see how Claire is reacting to the food and if she is producing any insulin of her own.

 

[Sienne and Gabby (GA)]

Welcome to FDMB!

You are among a group who all dearly love their kitties and love everyone else's kitties almost as much as their own. In other words, you're in good company!

The food chart that Bron linked comes from a wonderful site on feline nutrition that is written by a vet, Lisa Pierson, DVM. (We refer to her as Dr. Lisa. She occasionally posts here.) There is a wealth of information on what's important to know about feeding your cat. Dr. Lisa is a big proponent of canned food for several reasons.

• Cats are obligate carnivores. They have no need for fruits, vegetables, or any of the other products (aside from vitamins and minerals) that are not proteins that are in dry food. All of the non-protein only causes a cat's blood glucose to be higher. These are the first several ingredients in the dry DM: Poultry by-product meal, soy protein isolate, corn gluten meal, soy flour, animal fat preserved with mixed-tocopherols, corn starch, animal liver flavor. The items I've bolded are why DM is high in carbohydrates.
• The animal fat that's in dry food is often why these foods turn rancid.
• Cat's have a limited thirst drive. In the wild, cats get most of their moisture from eating their prey. Dry food has very little moisture whereas canned food had a good deal of water in it. Dry DM is 12% moisture; canned DM is 78% moisture. Especially with a diabetic cat, that moisture is essential. Diabetes is hard on the kidneys and the moisture in food helps the kidneys to process waste material.

If you look on the right side of the feline nutrition page, there's a link to transitioning a cat from dry to canned food. A lot will depend on Claire and whether she decides that canned food is like sitting down to a buffet at the best restaurant in town! Some cats are truly dry food addicts.

 

[MyraB]

Thank you so much. Just checked Claire's sugar for the first time. She ate at 830am (dry Purina DM), checked sugar at 255pm. It is 274. Is that bad?
Also, did I fill out the spreadsheet correctly?

 

[Noah & me (GA)]

Hi Myra and Claire. Am I to understand your vet doesn't want you to test at home? On a Friday afternoon ten years ago my vet would not let us leave until we knew how to test, read the meter properly and then inject. I cried for a day and then did what I had to do. Eventually I could thump the chair at the same table I'm sitting at right now and Nigel would jump up for the whole procedure. Testing at home is just that, a test only. You'll feel more informed and so much better about taking care of Claire.
We also did the frantic dance we called "Oh Gawd, what did we do, is he dead?". Then my wife found this and read it out loud to me....
https://www.felinediabetes.com/FDMB/threads/letter-from-your-kitty-to-you-during-this-time.131186/
Whatever it seems like now in time this will just be an inconvenience, nothing more. Both our sugar cats are gone now, diabetes had nothing to do with it and I would do it all over in a heartbeat. So would all of us.

 

[MyraB]

Hi Myra and Claire. Am I to understand your vet doesn't want you to test at home? On a Friday afternoon ten years ago my vet would not let us leave until we knew how to test, read the meter properly and then inject. I cried for a day and then did what I had to do. Eventually I could thump the chair at the same table I'm sitting at right now and Nigel would jump up for the whole procedure. Testing at home is just that, a test only. You'll feel more informed and so much better about taking care of Claire.
We also did the frantic dance we called "Oh Gawd, what did we do, is he dead?". Then my wife found this and read it out loud to me....
https://www.felinediabetes.com/FDMB/threads/letter-from-your-kitty-to-you-during-this-time.131186/
Whatever it seems like now in time this will just be an inconvenience, nothing more. Both our sugar cats are gone now, diabetes had nothing to do with it and I would do it all over in a heartbeat. So would all of us.

Thank you for your encouragement! Our vet isn't against testing at home (that i know of), he just never mentioned it. We tested her today for the first time and it went surprisingly well. It felt like we cleared a hurdle. A glimmer of hope. Thank you again. I am so thankful to have found this group!

 

[Sienne and Gabby (GA)]

This is the link that deciphers the spreadsheet. If 2:55 is 6 hours after you gave Claire her AM insulin shot, then you did everything correctly. We use +hours as the number of hours after you gave a shot. We're in different time zones all over the world. The +hours becomes a common language for how to interpret where in the cycle the kitty's numbers fall. I'm in Eastern Daylight Savings zone. Bron is in Australia. It's probably Monday there. If we used clock time, it would be very confusing!

The only thing to add is the amount of insulin (units) you gave Claire. You include the insulin dose in the "U" column both in the morning and the evening.

 

[MyraB]

Testing is going well, so far. Claire doesn't seem to mind. It's been fairly quick and easy.
Tested her at 8:22pm, right before feeding her (bg 257). Offered her wet food for the first time (as well as her dry food) and she seemed to like it a lot- Meow Mix Pate Toppers. Should I take up anything that she didn't eat or leave it to free feed? I will check her bg again at 1130pm (zzzz).
I got the ketone strips, but I haven't figured out how to get a sample from her. Any advice?
Is there a specific place where I should post to have help monitoring my spreadsheet?
Thank you!

 

[Sienne and Gabby (GA)]

Getting a urine sample on a ketone strips can be a challenge. A lot depends on your kitty. Gabby would let me stick a strip in her urine stream without a problem. Other kitties can be a bit shy about their litter box use. Some folks will use a ladle or a big spoon to catch a sample. you can put fish gravel in the box -- it doesn't absorb so there's urine you can collect. Or, you can put plastic wrap over the litter so you can catch a sample that way.

The Meow Mix is 8% carb so you're good. Many cat's really like canned food. Let's hope Claire is one of them.

The members here or on the appropriate insulin support group will help you with monitoring Claire's spreadsheet. the experienced members always open a cat's spreadsheet before making comments in your thread. Case in point, please remember to include your insulin dose in the "U" column on Claire's spreadsheet.

 

[Chris & China (GA)]

Should I take up anything that she didn't eat or leave it to free feed?

She can eat when she wants so you can leave it. The only time we don't want them eating is the 2 hours immediately before Pre-Shot testing time so we get a test that's not influenced by food.

Since you're not giving insulin yet, put N.S. in the U column. That lets people know that you didn't give insulin on purpose.

 

[MyraB]

I am including Claire's bloodwork results and updated spreadsheet with bg.

Yesterday, we introduced wet food, but made the dry food available, too. We also left food out for free feeding instead of putting it away. This caused some confusion the morning, because she ate all of her dry food before morning, but I don't know when so I don't know if/how this affected her bg reading.

My plan for today is to offering only wet food
825am test
830-930am eat, put remaining food away
1130am test, put food out again
6pm- put remaining food away
825pm test
830-930pm eat, put remaining food away

Is this okay? If they introduction of wet food (and complete removal of dry) is going to help her significantly how soon will I know?

**I need help posting bloodwork pdf, please.

 

[Chris & China (GA)]

Is this okay? If they introduction of wet food (and complete removal of dry) is going to help her significantly how soon will I know?

Looks good to me!

Once she's eating nothing but low carb canned, you should get a pretty good idea of what kind of difference it makes in 3-5 days.

**I need help posting bloodwork pdf, please.

There is a "Lab" tab on your spreadsheet where you could put your bloodtest results. The "Ranges" can vary depending on which lab does the testing but you can change those if you notice. (I think the ranges already filled in are from ANTECH lab)