New to Forum - Help with Dosing and Food

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Tupelo

Tupelo

Member Since 2021
Hi Everyone,

So glad to find this forum (First Post). We are new to Cat Diabetes. Sherlock is a Siberian/Maine Coon mix, who is 6 years old. Weighs 21.7 pounds (these are large cats).

We are up to 4 units of Insulin, and while we are seeing improvement his numbers are still not good. Currently feeding him soft meat/kibble mix, but seriously considering going all wet food, particularly as the Vet does not want to increase his dosage (at 4 units now, wanting to go to 5).

The Vet wants to run some more blood work, and is advising there might be a liver issue, since the Insulin is not as effective as he had hoped. However it feels like right now we are throwing darts at a board.

I have tried to fill out the spreadsheet - no idea of I did it right. For the testing we started at 8AM (reading before food/shot) and then monitored to 8PM, taking a reading every 2 hours.

Looking to get some help, as we have an otherwise healthy cat and would really like to get him to remission. We also want to prevent his brother (Watson - a Tuxedo cat - no blood relation :)) from going the same path. As such we may cancel Kibble all together, as it appears most have done.
 
Hi there Adam good job setting up your signature and spreadsheet
Are you giving Lantus twice a day every 12 hours?
Let me explain how the SS works
When you test at 8AM Sherlock's BG number would go in the AMPS (AM Pre Shot) cell (Square)
Also put in the date to the left of the AMPS
Then if you test 2 hours after that , that number goes in the +2 cell
Test 3 hours later that number will go in the +3 cell and so on until it's time for his night time shot of Lantus
You will test him at 8 PM put that number in the PMPS ce!! (PM Pre Shot)
If you test 2 hours after that his number goes in the +2 cell
Just like you would do in the morning

Do not feed 2 hours prior to testing in the morning or night
We like to feed small meals during each 12 hour cycle

Did your vet start him on 2 units, that's a pretty large dose to start him on
Besides that we never increase by whole units, we increase or decrease by 0.25 units at a time.
You most likely are missing a dose that would work for him
Most of us feed Fancy Feast Pate which are either 2 or 3 percent
Kibble is high in carbs

I will give you the link to read about Lantus and the 2 dosing methods
Also the food link

I am going to tag some members who might be able to tell you which dose you probably should have started him on

Believe me the members here know more about diabetes than most vets do
If it wasn't for them I never would have gotten my cat into remission

Are you using syringes with half unit markings?

Oh you can look at any members spreadsheet to get an idea how it works
It's at the end of everyone's posts

Here is the link to read all about lantus
https://felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

Link how the spreadsheet works
https://felinediabetes.com/FDMB/threads/how-to-use-the-spreadsheet.241653/


Food chart link
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

By the way Sherlock is adorable
 
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@Wendy&Neko

@Sienne and Gabby (GA)

@Chris & China (GA)

@tiffmaxee

@Bandit's Mom

Hi Ladies I'm trying to help Adam @Tupelo out with his kitty Sherlock
First off he was putting his 8 AM test in the +8 column
I explained how the SS works
Looks like the vet started him on 2 units of Lantus ,then increased by whole units ,now up to 4 units

If someone could look at his SS and maybe tell him how many units he should be giving
One thing if you click on his World tab he has a lot more readings on that, they are not showing up on the US tab
He does have his signature set up and what he's eating
Adam is from Canada

Thank you ladies
I did the best I could with explaining everything but you all explain it better than I do
 
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Thanks so much for your reply. The Vet recommended that we start at 2 units, hence the numbers on the spreadsheet (just verified again). We have gone up one unit on his recommendation, and then tested.
 
Tupelo said:
Thanks so much for your reply. The Vet recommended that we start at 2 units, hence the numbers on the spreadsheet (just verified again). We have gone up one unit on his recommendation, and then tested.
Click to expand...
Is that 2 units twice a day
Did you read everything I gave you?
Let's wait and see what the members have to say
Do you have syringes with half unit markings
Take a look at my SS Tyler's SS he's in remission right now
You can look at my 2020 info also just tap on 2020 up top on my SS
I know the strips for the alpha trak are pretty expensive, most of us use/a human meter to save money because you will be doing a lot of testing in the beginning
If you are interested I can tag some Canadian members to see what they use
 
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Not sure if the spreadsheet is working properly either. All our numbers are on the "World" tab, but it shows green
Diane Tyler's Mom said:
Is that 2 units twice a day
Did you read everything I gave you?
Let's wait and see what the members have to say
Do you have syringes with half unit markings
Take a look at my SS Tyler's SS he's in remission right now
You can look at my 2020 info also just tap on 2020 up top on my SS
Click to expand...

That is two units twice a day. 8AM and 8PM are the dosing times. I have been reading everything (not sure I understand however) - my numbers on the spreadsheet are on the "World" Tab. Our Syringes are U-100 with Half unit markings.
 
Tupelo said:
Not sure if the spreadsheet is working properly either. All our numbers are on the "World" tab, but it shows green


That is two units twice a day. 8AM and 8PM are the dosing times. I have been reading everything (not sure I understand however) - my numbers on the spreadsheet are on the "World" Tab. Our Syringes are U-100 with Half unit markings.
Click to expand...
Oh yes I see that you have a lot of readings on the World tab, they should be transferring over to the US but they are not. I will tag
@Chris & China (GA)

@Bandit's Mom
Chris and Bhooma the color scale is off also
To see why they are not
 
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Waving "hello" from BC. :)

It looks like you are doing a curve just once a month? If you are going to get rid of the kibble - and I strongly recommend that, it's too high in carbs for a diabetic, you will need to be testing more frequently. Though not as frequently as a curve day. We strongly recommend testing before each shot, to make sure it's safe to give insulin, and getting some spot checks in the middle of the cycle to see how low he goes on that dose. Going to a more appropriate food will make a big difference in the amount of insulin needed. And if he does drop due to the food change, you want to catch that with testing.

It is possible that even with the change in food, he will still need 4 or more units of insulin. A cat needs however much insulin they need. My girl topped out at 8.75 units.

Which soft meat food are you giving? There are lots of commercially available low carb wet or raw food options in Canada.
 
Wendy&Neko said:
Waving "hello" from BC. :)

It looks like you are doing a curve just once a month? If you are going to get rid of the kibble - and I strongly recommend that, it's too high in carbs for a diabetic, you will need to be testing more frequently. Though not as frequently as a curve day. We strongly recommend testing before each shot, to make sure it's safe to give insulin, and getting some spot checks in the middle of the cycle to see how low he goes on that dose. Going to a more appropriate food will make a big difference in the amount of insulin needed. And if he does drop due to the food change, you want to catch that with testing.

It is possible that even with the change in food, he will still need 4 or more units of insulin. A cat needs however much insulin they need. My girl topped out at 8.75 units.

Which soft meat food are you giving? There are lots of commercially available low carb wet or raw food options in Canada.
Click to expand...

Right now we have Royal Canine Adult and DM. Looking at the ingredients though I think we are going to switch. We assumed it was good quality, but now I am not so sure. Looking into Tiki Cat which appears to have better ingredients/no by products.
 
Tupelo said:
Right now we have Royal Canine Adult and DM. Looking at the ingredients though I think we are going to switch. We assumed it was good quality, but now I am not so sure. Looking into Tiki Cat which appears to have better ingredients/no by products.
Click to expand...
The Royal Canin Glycobalance (wet and dry) and the Purina ProPlan DM (Dry and Savory Selects) are too high in carbs for a diabetic cat. The Purina Pro Plan DM canned is 6% carbs but it's expensive and not great quality. Tiki Cat has low carb canned variants that you could transition Sherlock to.
https://www.felinediabetes.com/FDMB...-luau-aloha-friends-and-velvet-mousse.248242/

The change from high carb food to low carb can make a big difference to Sherlock's numbers. We have had cats go off insulin from a food change. So please make the transition gradually and with enough testing to see how low his numbers go with the food change so that you can adjust his dose accordingly, if needed.

Diane Tyler's Mom said:
Oh yes I see that you have a lot of readings on the World tab, they should be transferring over to the US but they are not. I will tag
@Chris & China (GA)

@Bandit's Mom
Chris and Bhooma the color scale is off also
To see why they are not
Click to expand...
I will need edit access to make the changes to the SS. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.
 
Tiki Cat is a much better quality option and cheaper. The vet "prescription" (aren't really prescription, that's just marketing) aren't the greatest ingredients. Many cats actually get tired of the taste of DM over time.
 
Trying the new food today, but super picky is not eating it. We are going to do a measurement at 8PM to see what his numbers are at, before we give a shot. We have already seen them be lower with the removal of kibble.

How does everyone here get a picky cat to change wet food?
 
I should also say if the numbers are lower then expected, we may not give him a shot tonight - since we won't be up to watch him. That ok?
 
@Tupelo
Hi Adam I see Sherlock dropped to 56 today at +4
That's a really big drop. Did you feed him any med or high carb food then
Did you test him again to see if his BG went up
It's very important to do this
I don't know if you read the dosing methods for Lantus, I gave you the links above

I am pretty sure with that 56 today you need to reduce to 1.75 units depending if his
BG is high enough to give tonight.
I'm going to tag a few members to make sure you need to reduce
Please post when you are not sure what to do
Such as a new thread
? His Name , BG AMPS or PMPS which ever one it is shot or not shoot
Something like that
Is there any reason you are not testing more during the day and night cycle?

Are you still feeding kibble?
Also on your spreadsheet in the US please put no shot in the U column for 7-9, you can get rid of in the US cell where it says #value in the +1 cell

I see you didn't shoot, saw it in the World

One more favor when you read a post from someone please hit the like word so we know that you read it
I see Bhooma
@Bandit's Mom fixed your SS
Thank you Bhooma

@Wendy&Neko

@Bandit's Mom

Please look at his SS ,Shouldn't Adam reduce to 1.75 if high enough to shoot tonight
Thank you ladies
 
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A favour to ask. I see you didn't shoot last night and put "no shot" in the +1 cell. Could you move that to the Units column? We use either NS or Skip or No Shot to indicate you deliberately skipped. With a blank, we aren't sure if it wasn't fill in by mistake or on purpose.

1.0 unit was a good call tonight. You want to get some insulin in him, so he doesn't end up so high in the morning. But the smaller dose will help reduce the 4.0 unit depot, which is clearly too much insulin.

How is his appetite today? He eat anything?
 
Wendy&Neko said:
A favour to ask. I see you didn't shoot last night and put "no shot" in the +1 cell. Could you move that to the Units column? We use either NS or Skip or No Shot to indicate you deliberately skipped. With a blank, we aren't sure if it wasn't fill in by mistake or on purpose.

1.0 unit was a good call tonight. You want to get some insulin in him, so he doesn't end up so high in the morning. But the smaller dose will help reduce the 4.0 unit depot, which is clearly too much insulin.

How is his appetite today? He eat anything?
Click to expand...
Hi Wendy do you think I should remove my suggestion to reduce to 1.75 tonight? #17

I see he shot 1 unit
@Wendy&Neko
 
Wendy&Neko said:
A favour to ask. I see you didn't shoot last night and put "no shot" in the +1 cell. Could you move that to the Units column? We use either NS or Skip or No Shot to indicate you deliberately skipped. With a blank, we aren't sure if it wasn't fill in by mistake or on purpose.

1.0 unit was a good call tonight. You want to get some insulin in him, so he doesn't end up so high in the morning. But the smaller dose will help reduce the 4.0 unit depot, which is clearly too much insulin.

How is his appetite today? He eat anything?
Click to expand...
I have made the move.

His appetite is good...just won't eat the new soft meat. Continuing to feed him the DM Royal Canine, as that is what he will eat.
 
The Vet wants us at 3 units, but I disagree and in discussion with my Wife we have gone to 2 units. As of today, he will be completely kibble free, so we don't want to get too high with Insulin, while the diet changes.

We had a bit of a breakthrough today - he ate the Tiki Cat Chicken (chowed down on it in fact) which is great. We were hoping to get him off the Royal Canine and it looks like we have found a food that he will eat now. Now with no Kibble, and a high protein food, we should start to get a better idea of what his dosing should be.

We hope remission is around the corner :)
 
Good to hear that he likes the Tiki Cat, Adaam it's very important to get a test in before you go to bed , you are only seeing half the picture on how the insulin is working for him.

I don't know if both you and your wife work , is it possible to get a few more tests in during the day cycle to see how low he's dropping especially since you stopped the kibble as of today
On 7-9 in the morning did you test? The cell is empty

For instance you can test at +3, at +6, at +9
Next day test at +2, at +5 , at +7
Same goes for night time
It's like filling in the pieces is a puzzle

Also do you have any medium and high carb wet food in case he drops to low and you need to bring his BG up

On 7-10 when you got the reading of 56 did you feed him anything to bring his BG up, and keep testing



@Tupelo
 
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You should have medium and high carb foods on hand such as

Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs
Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs

Or any one that's on the food list, doesn't have to be Fancy Feast

Good to have these on hand, it's really only the Gravy you would need to feed him, or just a teaspoon of the food.

Food chart link
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Diane Tyler's Mom said:
Good to hear that he likes the Tiki Cat, Adaam it's very important to get a test in before you go to bed , you are only seeing half the picture on how the insulin is working for him.

I don't know if both you and your wife work , is it possible to get a few more tests in during the day cycle to see how low he's dropping especially since you stopped the kibble as of today
On 7-9 in the morning did you test? The cell is empty

For instance you can test at +3, at +6, at +9
Next day test at +2, at +5 , at +7
Same goes for night time
It's like filling in the pieces is a puzzle

Also do you have any medium and high carb wet food in case he drops to low and you need to bring his BG up

On 7-10 when you got the reading of 56 did you feed him anything to bring his BG up, and keep testing



@Tupelo
Click to expand...
I should have been using the notes section a little more. I believe we gave him some kibble.

We are going to try to do more testing.
 
We are running low on Test Strips for the Alpha Trak - do we need to buy their product or is there another testing strip that is compatible?
 
Tupelo said:
We are running low on Test Strips for the Alpha Trak - do we need to buy their product or is there another testing strip that is compatible?
Click to expand...
From what most of the members have said you should not use any other test strips other than the Alpha Trak strips.
I know it's getting expensive I used to use the Alpha Trak in the beginning
I switched to a human meter, most of us use them. That's what our numbers are based on here
Do you live in the US
We use the Relion Prime from Walmart its 9 dollars
17.88 for 100 test strips no coding necessary
Curious why did you give 2.5 units
With that 104 reading this morning please try and get more tests in today
Just want to be sure you said he's off kibble completely as of yesterday, if so please remove it from your signature

Can you also go to your spreadsheet and up top please put lantus where it says insulin and the meter you are using right now and date diagnosed Thanks
 
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@Wendy&Neko
Hu Wendy , I hope you don't mind I tagged you, I did only because you answered my tag in the beginning
Can you take a look at his SS, I'm just a little worried he shot 2.5 units this morning with a AMPS of 104, I told him it's very important to get more tests in during each cycle. Said they would try and do more testing
When he got that reading of 56 I asked him if he fed anything and continued to test
He said he
I believe we gave some kibble
I don't know how much more I can help him ,
Thank you Wendy
 
You don't need to buy the AlphaTrak, most of us use human meters. In Canada, the Freestyle Lite is a popular model, the company that originally made the AT also made it. So similar small blood drop needed. Bonus, the Freestyle is a lot cheaper! And available in most store pharmacies. Some people in the east buy at Shoppers Drug Mart and use the points. Shoppers is too expensive in BC, so I bought elsewhere. Do shop around the pricing, sometimes test strips are on sale. Some people buy test strips on eBay.

For Sherlock's safety, please reduce his dose back to 2.0 units. 2.5 units is taking him way too low on the AT. Ideally I'd actually suggest 2.25 units - you eyeball that between the 2 and 2.5 unit line. But you can try 2.0 units first if that's easier and see how he does.
 
Wendy&Neko said:
You don't need to buy the AlphaTrak, most of us use human meters. In Canada, the Freestyle Lite is a popular model, the company that originally made the AT also made it. So similar small blood drop needed. Bonus, the Freestyle is a lot cheaper! And available in most store pharmacies. Some people in the east buy at Shoppers Drug Mart and use the points. Shoppers is too expensive in BC, so I bought elsewhere. Do shop around the pricing, sometimes test strips are on sale. Some people buy test strips on eBay.

For Sherlock's safety, please reduce his dose back to 2.0 units. 2.5 units is taking him way too low on the AT. Ideally I'd actually suggest 2.25 units - you eyeball that between the 2 and 2.5 unit line. But you can try 2.0 units first if that's easier and see how he does.
Click to expand...

I guess we don't understand the spreadsheet? I thought if we had him in the Green Numbers that is where we want to be (at his Nadir)? We will be sending the numbers into the Vet today. Plan on doing a Curve day either tomorrow or Friday (waiting on more test strips before we can start).
 
Spoke with the Vet today. He concurs that we should reduce the dosage to 2 units and the monitor for Clinical Signs (no more ear pricks for now - be nice to let his little ears heal). We will be dropping to 2 on his 8PM shot.
 
Upper green is good, too low green is hypo range. That's why the spreadsheet switches to lime green below 68 on the AT. It's a "pay attention" and feed higher carbs number.

I disagree with your vet on the no testing. If you hadn't been testing lately, you wouldn't have caught the fact that the dose was too high and he was in hypo range. Not all cats show signs when they are in low numbers.
 
We now seem to have a new problem, and wondering if is related. Plan on doing a curve day tomorrow, as we feel the insulin might need adjusting. Sherlock has developed diarrhea. So far today, his stool has been very loose. He was acting normal, but is now hiding.

Appetite is good. He finished all his meals today. Does not appear to have a temperature.

I should also say he was constipated for a while first, before switching over to loose stool. It might be the food as that is the biggest adjustment (Tiki Cat Chicken, and Chicken and Quail).
 
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