(Newly Diagnosed) Confused about food, glucose testing, overwhelmed...

[Taishi_Ci]

Hi Everyone! I am so thankful to have found this forum. We were just diagnosed a few days ago and, as you know, this has been a lot to process. I'm sorry this post is so long, but obviously my brain is a bit overwhelmed.

*Taishi is part of a 7 cat household* After about a month of lethargy/not acting like himself, we took Taishi to the vet on Sunday (7/11/21) where he was diagnosed with feline diabetes. His blood sugar at the time was around 500, but all of his other bloodwork came back great. I did not feel our vet was very helpful or reassuring. He told us to start calling around to find Lantus/Glargine and to expect to pay up to $200/month for it. He said we could no longer free feed Taishi (he has been free fed kibble his entire life) and only feed him twice per day, 12 hours apart. He didn't provide any suggestions for which food to switch him to. When I told the vet we had 7 cats and weren't sure how to tackle the feedings he had no suggestions. We were sent home with instructions to start him on 2U Lantus 2x per day, only feed him at meal times, and to buy an AlphaTrak 2 blood glucose monitor. I felt devastated, lost, and couldn't sleep because I was worrying about him. Now that I've had some time to read through the forum, I have some questions I hope you all can help me with (because my vet is not really helpful at all...)

How much wet food do I feed him?
We immediately switched to Fancy Feast Naturals (he was previously eating Purina Beyond Naturals Chicken). However, we have no idea how much he should be eating. We have no experience "dosing" food, since we've always free fed dry. I googled formulas for calculating how many calories a kitty needs, and it sounds like he should be eating about 300 calories/day. However, the Fancy Feast only has 40-45 calories per can. Does this mean he should be eating 6 - 7 cans per day?? The first day of wet food we only gave him 2 cans, because I didn't even think to check. The next day we gave him 4 and, although he eventually ate them all, he didn't finish the last 2 of the day all in one sitting. Should we try to feed him more today? He is currently 11 lbs, but used to be 13 (not sure what period of time he lost that weight in, but I'd rather he was at least 12 lbs). We at first thought Fancy Feast was an affordable option, but if it costs $6-$7 *per day* we will likely need to switch him to Friskies (which doesn't seem like a *horrible* option and it's about $40/month as opposed to up to $200/month). I've gathered from the forums that the advice to only feed 2x per day isn't good, and that he should have access to food throughout the day. How do you do this wet food?? It's not realistic for us to offer him food all day every couple hours.

Difference between Human & Pet Glucometers?
Taishi has not started insulin yet. We ended up ordering from Mark's Marine Pharmacy because it was far cheaper than anything local here, but it won't arrive for up to 10 days. At the direction of our vet, we purchased an AlphaTrak 2 glucometer. We are planning on attempting the "Tight Regulation" method when we start giving him the insulin. However, over and over I see mentioned that numbers being provided in the forums are for a test done with a *human* monitor. Will everything be off since I'm using a pet specific monitor? Why is a human monitor being referred to so often? Should we buy a human monitor?? I was terrified about testing him, but I did it last night and it was so easy... I don't even think he realized I did it. His numbers were down to 375 (still bad, but better than the 500 he was at the vet).

Did you ever "get your life back"?
This is an extremely selfish question, but have any of you been able to enjoy the things you once did while caring for a diabetic cat? My husband and I have always been "go where we want, do what we want, whenever we want". I know that part of our life is over, but I'm hoping that, once Taishi is regulated, we can find a way to get a bit of our life back. My husband and I both work at home (yay) but we travel *a lot*... often internationally. I assume the best thing to do is to start searching for a very experienced pet sitter to care for Taishi when we're gone? Where would I even start that search? Should someone be with him 24/7 in case he goes hypo, or would it be okay for someone to check on his 2x/day if he's stable? We were not expecting this sudden dramatic change in our lives/schedules and I've dealt with really selfish "our freedom is gone" feelings. Mostly just looking for empathy in that regard :-/

Thanks in advance for reading and listening. I know I have a lot to learn and am so glad this resource exists <3

 

[Bron and Sheba (GA)]

Hi Taishi and caregiver…please tell us your name

How much wet food do I feed him?

Any low carb wet food is suitable for diabetics. Look around and find an affordable one.
Have a look through this list https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
I would have thought three FF cans a day should have been enough for a cat around 11lb. I would suggest feeding the 2 main meals before the shots and then 2 snacks around the +3and +6 mark each cycle. Is that doable? It is important that diabetic cats eat well.
Also if you have got rid of the dry food, the 2 units twice a day is too much insulin. If there were no ketones at diagnosis, I would reduce the dose to 1 unit twice a day.

Difference between Human & Pet Glucometers?

Both meters can be used. The pet meter reads higher then the human meter,
Most of us use the human meter here because our dosing methods are based on the human meter numbers and it is much cheaper to run.. It is the test strips that cost the money. Pet meter strips are around a $1 a strip whereas human meter strips are much cheaper. I would look at the ReliOn meter from Walmart.

Did you ever "get your life back"?

The first few weeks are always the hardest. It will become routine for you and hopefully Taishi’s BGs will settle down and he will become regulated. This won’t happen in the first few weeks, unless you are very lucky. Most cats take a bit longer than that as insulin is a hormone not a medicine like an antibiotic which fixed the problem in a few days.
Definitely start looking for someone you can trust and train up to look after him. If they can stay at your place that is best but a lot of people have someone come in twice a day. A young student could learn to test and understand what is needed. If you have friends that have older teenage kids, that might be a possibility. Or ask at the vets if there is anyone who does that. If you could sort that out early on, that would be much easier and better for you than a last minute scramble.

If you have decided to do the TR, can you pop that into the signature please.
When you get the insulin, you will need to test before every insulin dose and at least once during every cycle to follow the TR.
Lantus dosing is based on the nadir or lowest point in the cycle, not the preshot number. So it is important to get that test in during the cycle. If you look at some of the other spreadsheets you will see others test at different times during the cycle. If the BG has dropped a lot, then you will need to test again. If in doubt, always post and ask for help until you get the hang of it. Change the subject line to reflect the question.eg BGxx please help. Then we are alerted.
Keep asking lots of questions. We are happy to help.
Bron

 

[Taishi_Ci]

Sorry I didn't include my name. Clearly not thinking straight. I'm Jessie, Taishi's mom

Thank you so much for the reply! I also thought 3 cans/day would be okay, but when I looked at the calorie counts on the FF naturals, I was shocked by how low they were (probably because they're no or extremely low carb). Taishi has already wolfed down 3 cans today and it's not even dinner time yet Not sure if we're starving him or he's just extra hungry because his blood sugar is out of control. He's so lethargic and the vet said his body is probably starved for nutrients, so I want to feed him as much as he wants... but he's also eating us out of house and home haha

When you get the insulin, you will need to test before every insulin dose and at least once during every cycle to follow the TR.
Lantus dosing is based on the nadir or lowest point in the cycle, not the preshot number. So it is important to get that test in during the cycle. If you look at some of the other spreadsheets you will see others test at different times during the cycle. If the BG has dropped a lot, then you will need to test again. If in doubt, always post and ask for help until you get the hang of it. Change the subject line to reflect the question.eg BGxx please help. Then we are alerted.
Keep asking lots of questions. We are happy to help.
Bron

THANK YOU for mentioning this. To clarify, we would be deciding whether or not to give him the shot based on his mid-cycle number, not the number from right before his shot? How would that work with his AM dose (since we won't be testing BG in the middle of the night)? I thought I'd read through so much, but I completely missed this part. I need to read more carefully. So much to learn!

I've started putting feelers out for an experienced pet sitter already. I don't see us traveling much (or at all) over the next couple months, but I want to be prepared ahead of time. Hoping there is a vet tech (or student) close by looking to make some extra money

 

[JanetNJ]

He told us to start calling around to find Lantus/Glargine and to expect to pay up to $200/month for it.

HI! Welcome! The good news is he prescribed a really good insulin for your cat. He is wrong about the cost. ask for a perscription for the pen version of it. Heres' the really good news. You can order it from canada for about $189 for a years supply of 5 3ml pen size (you can use a syringe with the pens just like a mini vial. https://rxcanada4less.com/ (eta... Oh i see you discovered them already! Great!)

He said we could no longer free feed Taishi (he has been free fed kibble his entire life) and only feed him twice per day, 12 hours apart. He didn't provide any suggestions for which food to switch him to.

Well he's right that you can't free feed kibble. Get rid of that kibble. haha Most here feed fancy feast classic or friskies pate foods. You can feed any time, except at least 2 hours prior to the preshot test. I fed breakfast, lunchtime, dinner, and before bed. the 12 hours apart thing is an old fashioned idea that isn't really practiced anymore. I've been working from home the past year, but when i am at work full time, I would sometimes set up a timed feeder to open mid day to offer a fresh snack. Another option is to freeze a portion if you aren't home so that it gradually defrosts for later.

We immediately switched to Fancy Feast Naturals (he was previously eating Purina Beyond Naturals Chicken). However, we have no idea how much he should be eating.

Most fancy feast flavors are 85-90 calories per can. The rule of thumb is ABOUT 20 calories per pound of ideal weight, but uncontrolled diabetics often need more, so unless he is overweight i would let him eat as much as he wants.


GREAT JOB GETTING YOUR FIRST HOME TEST DONE!!! YOU should feel very proud. I used an Alphatrack, but most here do use a human meter because it's a lot cheaper. either is fine. The human meters run a little higher, but they are similar at lower numbers. the numbers you will get from your alpha will be more in line with what your vet would get.

I assume the best thing to do is to start searching for a very experienced pet sitter to care for Taishi when we're gone? Where would I even start that search? Should someone be with him 24/7 in case he goes hypo, or would it be okay for someone to check on his 2x/day if he's stable? We were not expecting this sudden dramatic change in our lives/schedules and I've dealt with really selfish "our freedom is gone" feelings. Mostly just looking for empathy in that regard :-/

I totally get this. WE still went on vacations but boarded the cat at the vet... it just became part of the budget for our trip. When we went away we would tell the vet to give her a dose that was a little less then she normally got so that if she was nervous and didn't eat enough she was safer.

Life sometimes happens. While it's ideal that the shots are 12 hours apart, sometimes life happens. If you are an hour late here and there, it is what it is. sometimes if I knew I was going to be out late I would move the morning shot a little and then the night shot wouldn't be as far off. You have to find a balance.

 

[Bron and Sheba (GA)]

How would that work with his AM dose (since we won't be testing BG in the middle of the night)?

I would suggest getting a before bed test in every night. This will usually give you an idea of how the cycle will go. If the BG is about the same or lower than the preshot BG, it is likely to be an active cycle, meaning it will likely drop down a decent amount before coming back up. If this happens, I would recommend setting the alarm and taking the BG a few hours later to ensure he is safe. Leaving him some food out is also a good idea at night.
When I said the dose is based on the nadir….we look at more than one cycle. So if the BG drops below 50 on the TR method you drop the dose by 0.25 units. In the beginning you hold the dose for 5 to 7 days to let the depot fill unless the BG drops under 50. Once the depot is full, the dose can be increased every 3 to 5 days depending on the BG. We will help you with that until you learn to manage on your own.
Your main jobs in the beginning will be testing before every shot and at least once during every cycle, feeding before the shot and during the cycle and watching for any signs of low BG such as extreme hunger, unsteadiness, twitching. If this happens test the BG.it should t happen if you are testing but it is food to know what to look for.
Until the BG is more under control, he will be hunger, because he is not able to utilise all the nutrients in the food until he is getting insulin the and it is bringing down the BG.

 

[Sienne and Gabby (GA)]

To clarify, we would be deciding whether or not to give him the shot based on his mid-cycle number, not the number from right before his shot?

You always want to test before giving insulin. If your pre-shot number is too low, you may want to stall or do something other than giving insulin. The pre-shot tells you whether it's safe to shoot. The mid-cycle (or other tests) tell you whether a dose reduction is indicated.

There is a great deal of information about using Lantus, dosing, etc. on the Lantus board in the sticky notes at the top of the board. You may want to start doing more reading so you feel more familiar with the insulin you're using.