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Skyynett

Member Since 2022
Hello everyone!

Would like to start off by apologizing for the length of my post! I have been in a deep dive of info for these last couple of days and would greatly appreciate your guidance.

Nellie was diagnosed with FD on 3/15/22 after a bunch of tests. She is around 9yo and roughly 9lb (more on that later). The vet put a freestyle Libre monitor on her on 3/18, and I started her on Lantus (1 unit twice a day) Friday PM.

TBH, I haven't been getting a lot of guidance from my vet, he told me not to worry about the glucose numbers that I see when I scan the Libre and that I should give her the Lantus 30 min after her meal in the AM and the in the PM. So I give her a 3oz can at 8:30am and give her the shot at 9am and then repeat in the PM. Question 1: is the 30 min waiting period what most people do here? also, I start the clock when I put the food down as she usually eats it over a period of 10 min, not 30 min after her last bite.

Before her diagnosis, Nellie was eating a 3oz can of (usually, from what I can tell) LC wet food at 8:30, 5pm, and 10pm. She also got free fed dry food (Nulo indoor kind), although I've been weaning her off the last several weeks and got her down to only 2-3 tbl spoons at night so she wouldn't wake us up. I've struggled with her diet the entire time I've had her as she tends to get some bad diarrhea (always ON her) when she has anything chicken or beef flavored. So her food is typically seafood flavored since that is was usually sits best with her. I've been reading the forum and seems like some people only do these flavors once a week. Question 2: Is a primarily only seafood flavor diet bad for a cat? I try to introduce other proteins like rabbit and duck maybe twice a week as that sits well with her. but a lot of alternative protein types can get really pricey, and I don't want to upset her stomach with too many changes in food flavors. She gets the same amount, but different brands/flavors bc any flavor too many days in a row and she starts to reject/stop eating it. She was anorexic when I first got her from the shelter in 2016 so I'm super sensitive about her not eating.

The vet said to twice a day feedings, but also said that she does not need to lose weight and I should keep her stable. She's been 9lbs most of her life, dipping into 8lb when she has anorexic episodes (hasn't in a while now that food has been figured out). In Oct she vet for a check up and was 10lb and getting round in the belly, started weaning off of dry food and now last week she was at 9.1 lbs. I got a baby scale coming tomorrow so that I can monitor her weight at home. He said I could try doing twice a day feedings but can switch to 3 times a day like before her diagnosis if she loses weight or seems hungry. Ive been doing 2x day since starting lantus and give her a pouch of fancy feast broths between her shots since she seems really hungry all of the time. Question 3: should I continue feeding her twice a day or go to 3x (one at 830, one around 3, one at 830pm)? Does feeding her outside of right before getting shots mess with the treatment?
Question 4: do I need to make sure she eats the entire 3oz can before I give her a shot? is half the can eaten ok? I check her sensor readings beforehand.

I have Royal Canin Glycobalance and Purina DM on order and I was going to try to slowly introduce these to her. Honestly, feeding her these two types of diets exclusively is just not feasible for my budget. If she seems to like one of them, I will try to at least feed her them twice a week. Question 5: these are the foods that she enjoys and gets regularly, do they fit the proper LC?
Tiny Tiger - pate and grave varieties in seafood
Purina Beyond Arctic Char
Purina Beyond Alaskan Cod
Tiny Tasters in duck (for snack)
Pro Plan Senior in seafood
Pro Plan seafood varieties

I asked my vet how many of his patients w/ diabetes go into remission, and he said around 15-20% (I'm a new patient, havent been with him only saw him last week when I was bringing her in for test). I guess what I'm wondering is how many of you disagree with what the vet tells you in terms of treatment? He said that the 1 unit was most likely too low but we want to go low first and slowly increase, but he also told me not to worry about the numbers and that he would monitor from the Libre website/app. I bought ReliOn meter today in case the Libre falls off for whatever reason (did a comparison - see spreadsheet, it was 50 lower than the Libre). He told me to get Alpha Trak, but I'm returning it since I see the protocols on this forum were built using human numbers (and the freestyle libre is a human monitor anyway). Question 6: Can I really change the dosage without the vet telling me first to change it? he did not mention the TR or the SLGS methods of treatment. Everywhere online it says to consult with my vet before any changes, so I guess im just nervous about starting anything without explicit instructions from the vet!

Thank you, I'm sure more questions will be a comin'. I really appreciate any guidance given.

Best,
Nellie's mom
 
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Question 1: is the 30 min waiting period what most people do here? also, I start the clock when I put the food down as she usually eats it over a period of 10 min, not 30 min after her last bite.

I usually put Taz's first meal down between 8:10-8:15, and then give him his insulin at 8:25. I think they tell you 30 minutes to make sure that your cat has food in their system before insulin is given, but Lantus is more forgiving than a quick acting insulin is.

Question 2: Is a primarily only seafood flavor diet bad for a cat?

I was told that seafood should never be the main flavor they eat. It's ok every now and then but too much can cause thyroid issues.

Question 3: should I continue feeding her twice a day or go to 3x (one at 830, one around 3, one at 830pm)? Does feeding her outside of right before getting shots mess with the treatment?

Most people here advise against only 2 meals a day. I am lucky and my guy lives to eat any chance he gets. I found that the longer between meals he had to wait, the more stressed he was and it caused him to vomit stomach acid as it approached his meal time. He now eats small amounts 10 times a day and I've noticed that his numbers have improved quite a bit since starting this. Make sure not to give food 2 hours before meal time, or it will influence the preshot readings.

Question 5: these are the foods that she enjoys and gets regularly, do they fit the proper LC?

There's a food list at the top of this forum page (https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/) that lists most food varieties and their carb %. You want foods with less than 10% carbs. I personally feed cheaper brands (friskies or fancy feast), as do a lot of other members.

I guess what I'm wondering is how many of you disagree with what the vet tells you in terms of treatment? He said that the 1 unit was most likely too low but we want to go low first and slowly increase. Question 6: Can I really change the dosage without the vet telling me first to change it?

My vet was against me increasing insulin and was happy with Taz's numbers ranging from 150-350. As others told me, vets would rather keep them in higher numbers, than to work towards remission. Many members here have accomplished remission, so they definately know their stuff here. I don't know if we'll ever reach remission but Id still like Taz to be within safe numbers. My vet thinks that Taz is still getting 1 unit twice a day, but he's actually getting 1.75 twice daily. I know Taz is doing much better on a higher dosage, and I like his numbers being lower than what my vet was comfortable with. It's extremely scary to put your faith into what you read on here when your vet doesn't agree. But I also understand that while vets treat diabetes, most don't actually monitor it as much as what you'll probably do. My vet told me to spot check glucose a couple of days a week. I check Taz 4-6 times most days. I know his numbers far better than my vet does.
 
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should I continue feeding her twice a day or go to 3x (one at 830, one around 3, one at 830pm)? Does feeding her outside of right before getting shots mess with the treatment?
The routine is test, feed and shoot…all within 10 15 mins if using Lantus.

do I need to make sure she eats the entire 3oz can before I give her a shot? is half the can eaten ok? I check her sensor readings beforehand.
As long as you know she will eat the food, you can shoot while she is eating. Lantus doesn’t onset for about 2 hours so as long as she eats well by then you will be fine. Also feed a couple of snacks every cycle……best during the first 7 hours after the shot and don’t feed for the 2 hours before the pre shot BG,

Can I really change the dosage without the vet telling me first to change it? he did not mention the TR or the SLGS methods of treatment. Everywhere online it says to consult with my vet before any changes, so I guess im just nervous about starting anything without explicit instructions from the vet!
What I would do is set up the spreadsheet, which you have done….but we can’t access it……you need to give us permission to see it then save it. Then when we have you sorted out with a dosing method and the Ss up and running , we can send you over to he Lantus page where you can get lots of help with dosing and all your questions answered. We have very experienced people here who can help you with dosing.
Most of us here do not ask the vet about dosing changes. As long as you are home testing the BGs you are in control and will learn in time what to do. In the meantime ask here for dosing advise.

I’m going to give you a couple of links to read which have useful information in them…. continue to ask lots of questions:)
HELP US HELP YOU……….and make sure you have a hypo kit set up!

HOMETESTING LINKS AND TIPS

FOOD CHARTS
 
thank you so much @SaraMV and @Bron and Sheba (GA) ! I so very much appreciate the guidance.

I'll take a look at other types of proteins and check the food list. I just need to get a couple cans of HC and the my hypo kit will be finished.

I redid my signature after editing the spreadsheet's permissions. You should be able to see it now but let me know if you can't.

Side note - waiting on syringes that have half-unit markings on them. I know there aren't any 0.25 markings, so I'm guessing when you increase or decrease by this amount, you eyeball it on the half unit syringes?
 
Side note - waiting on syringes that have half-unit markings on them. I know there aren't any 0.25 markings, so I'm guessing when you increase or decrease by this amount, you eyeball it on the half unit syringes?

Unfortunately yes. Kind of hard to explain, but I find it's easier if the next half/full unit marking is in the middle of the black plunger. I'll try to find a pic.
 
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Yes I can see the SS now thanks!
With Lantus, you hold the initial dose for 5 to 7 days to let the depot fill unless the BG drops under 90 if doing SLGS method or under 50 if doing TR protocol, in which case you would reduce the dose by 0.25 units.
INSULIN DEPOT read about the depot here.

I used a magnifying glass when I drew up the insulin and made sure I was in a good light.

Here are the two dosing methods….tight regulation (TR) and start low go slow (SLGS) DOSING METHODS
Have a look at the two methods and see which one you think would suit you more. The TR is more aggressive but will get results quicker.
You need to be feeding only a wet low carb diet to be able to do the TR and testing at least 4 times a day. Keep asking questions.
 
With Lantus, you hold the initial dose for 5 to 7 days to let the depot fill unless the BG drops under 90 if doing SLGS method or under 50 if doing TR protocol, in which case you would reduce the dose by 0.25 units.

Can I get clarification on this? If they drop below those numbers.... do they need to drop below those numbers daily, several times, or just once in order to decrease? Or does it depend on what the other numbers are when they aren't nadiring?
 
Can I get clarification on this? If they drop below those numbers.... do they need to drop below those numbers daily, several times, or just once in order to decrease?
If your kitty is under 1 year since diagnosis you only need the one drop below either 90 (SLGS) or 50 (TR) to earn a reduction. I see you are using an alpha track meter so the reduction number for TR using alphatrack is 68 @SaraMV
 
If your kitty is under 1 year since diagnosis you only need the one drop below either 90 (SLGS) or 50 (TR) to earn a reduction.

I was just curious because we're doing SLGS and Taz was at 91 a couple of days ago. I don't know what his lowest was because his 91 was an hour after he usually nadirs.
 
I was just curious because we're doing SLGS and Taz was at 91 a couple of days ago. I don't know what his lowest was because his 91 was an hour after he usually nadirs.
He would need to drop under 90 for a reduction. As he’s done it once on that dose he will probably do it again sometime soon so be on the lookout. Did you see the information I added above about the alpha track meter reduction number for TR?
 
He would need to drop under 90 for a reduction. As he’s done it once on that dose he will probably do it again sometime soon so be on the lookout. Did you see the information I added above about the alpha track meter reduction number for TR?
I just now saw it, thank you. If using an Alphatrak, what would be the number if using SLGS? Still 90?
 
49823063143_3437e9e997_o.jpg
 
Yes I can see the SS now thanks!
With Lantus, you hold the initial dose for 5 to 7 days to let the depot fill unless the BG drops under 90 if doing SLGS method or under 50 if doing TR protocol, in which case you would reduce the dose by 0.25 units.

Hi Bron and Sheba - I am looking at the different methods and trying to decide which one to start with. Do I reduce the dose if she tests at these numbers at any point in her cycle, or just if they appear at her AMPS and PMPS? I have the Freestyle Libre so it is easy to get readings. Trying to start testing regularly with the ReliOn but for the spreadsheet's sake, it is the Libre numbers as long as it stays on.
 
Hi Bron and Sheba - I am looking at the different methods and trying to decide which one to start with. Do I reduce the dose if she tests at these numbers at any point in her cycle, or just if they appear at her AMPS and PMPS? I have the Freestyle Libre so it is easy to get readings. Trying to start testing regularly with the ReliOn but for the spreadsheet's sake, it is the Libre numbers as long as it stays on.
oops actually I think you answered this already - I see above you mentioned to SaraMV it is just once and the dose is reduced at the next time of injection.
 
oops actually I think you answered this already - I see above you mentioned to SaraMV it is just once and the dose is reduced at the next time of injection.
Bron was talking about the dosing methods to Sara and if they were a newly diabetic ( under a year ) or if long term (more than a year)
As Bron said above
You reduce the dose if the BG drops under the number at any time in the cycle.

@Skyynett
 
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Hi @Skyynett welcome to the club, I'm pretty new here myself

Just wanted to chime in and say hi, I don't have a lot of advice but I can speak to the following the vet thing -- we were told to only feed every 12 hours and don't bother with home testing. We ended up switching vets but even our new vet isn't telling us how much to dose, we are following Tight Regulation. We did discuss it with our vet though and she basically admitted we were way more on top of the situation with Hendrick than she could ever hope to be. The vets office can see our spreadsheet and the last recommendation was to stay at 2 units.

2.75u ended up being a breakthrough dose for Hendrick and since we arrived at 2.75u he has been doing amazing with his numbers in the range of a normal non-diabetic cat a lot of the time! So thats my own personal experience with the experts here and working with my vet.
 
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hi @Hendrick's mom and dad ! and thanks @Diane Tyler's Mom ! yeah the more I try to talk to the vet about this, the less confidence I have...

I've been leaning towards starting on TR but those low numbers scare me! I'm trying to get better at testing. She is handling it well, minimal disgruntled noises and then some freeze dried treats but man I get nervous.

I'm trying to finish my hypo kit but I am out of luck trying to find HC food! I checked the Fancy feast gravies, tuscany, and other flavors from the cat food list against the nutritional info on chewy since Lisa indicated they are HC but the numbers I am getting are MC borderline LC. Am I not doing it right or did they change their formulas since the 2017 sheet was published? Any MC and HC food you recommend? I do have Karo syrup and honey as backups.
 
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 in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart.
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Check out all of the 9 lives on this
https://docs.google.com/spreadsheet...fEUz9YmzMGMxkmcBk6uRR0/htmlview#gid=113878384
 
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thanks @Diane Tyler's Mom - I feel like I am definitely doing the calculations wrong. When I try to calculate the carbs in these based on the info manufacturer's website, here is what I get:

Hearty Cuts With Real Chicken & Fish in Gravy -
Protein - 8%, Fat 2%, fiber 1%, moisture 82%, ash 3.5% taurine 0.05% - add up and subtract from 100 get 3.45% carbs. Dr. Lisa on her list has it at 24% carbs!

similar numbers with the fancy feast cans too. I definitely will trust Dr. Lisa's and your advice over my calculations, I'm just going a little nuts trying to figure out how to accurately calculate carb content in food moving forward/why my calculations are so different than what is on the spreadsheet. Does anyone here ever run into this problem as well?
 
thanks @Diane Tyler's Mom - I feel like I am definitely doing the calculations wrong. When I try to calculate the carbs in these based on the info manufacturer's website, here is what I get:

Hearty Cuts With Real Chicken & Fish in Gravy -
Protein - 8%, Fat 2%, fiber 1%, moisture 82%, ash 3.5% taurine 0.05% - add up and subtract from 100 get 3.45% carbs. Dr. Lisa on her list has it at 24% carbs!

similar numbers with the fancy feast cans too. I definitely will trust Dr. Lisa's and your advice over my calculations, I'm just going a little nuts trying to figure out how to accurately calculate carb content in food moving forward/why my calculations are so different than what is on the spreadsheet. Does anyone here ever run into this problem as well?

To be honest I have never used the calculators , I have always gone by Dr Lisa's chart, Tyler has been in remission since 1-24-21 and have always fed Fancy Feast Classic Pates and if needed used the FF Gravy Lovers

I found this posted by one of our members , hope it helps
There are a few cat food carb calculators on the web. This is one of those calculators. You plug in the values from the cat food. Keep in mind, what's on the label is generally the guaranteed analysis -- the values are given as minimums or maximums. To be more than an approximation, you need "as fed" values which are typically available only from the manufacturer. The calculator will give you a ballpark figure.

One of our members put together this post on calculating carbs.
 
thanks @Diane Tyler's Mom - I feel like I am definitely doing the calculations wrong. When I try to calculate the carbs in these based on the info manufacturer's website, here is what I get:

Hearty Cuts With Real Chicken & Fish in Gravy -
Protein - 8%, Fat 2%, fiber 1%, moisture 82%, ash 3.5% taurine 0.05% - add up and subtract from 100 get 3.45% carbs.

Couple things -- firstly, most of the time we are forced to use the GA values (guaranteed analysis) when in fact the AS-FED numbers would be more accurate but most manufacturers don't supply the As-fed. Grrrrr.


Secondly it looks like you are missing part of the calculation. That 3.45% may be an accurate percentage of the carbs in the food, but what we want to know is the CALORIES from carbs, and how much of the calories are from carbs. That's the Dr. Pierson number -- the percentage of CALORIES from carbs in the food

so in your case, you got 3.45% carbs. Now you take 3.45 and multiply it by 3.5 (calories per gram of carbs) = 12

Next we need to know how many calories per 100g, which is 58 (I used the link below for the 58 but you can do it manually by adding up calories from each ingredient like fat, protein, etc)

So now we know that for every 58 calories of this food, 12 are from carbs. That's about 21%. Why is it different from Dr. Pierson's number? She probably got the As-Fed values so hers is likely more accurate. But calculations using GA are typically close at least

I like to use this site to save time: http://scheyderweb.com/cats/catfood.html
 
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happy to help

I still can't quite wrap my head around how it is possible for the actual carb % to be low (like 3.45%) but the percentage of calories from carbs high.

I guess if a particular food isn't that high calorie to begin with, not much fat or protein, then even 3% carbs can be a much bigger piece of the "calorie pie"?

*scratches head
 
I bought ReliOn meter today in case the Libre falls off
In case you ever want to try testing freehand using the lancet by itself
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
c2b8079a-b471-4fa6-ac36-9ac1c8d6dcca-jpeg.57072
fec17d29-5ab4-44a8-912b-3a91944c3954-jpeg.57073

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up

Here is a video one of our members did
VIDEO: How to test your cat's blood sugar
 
I'm going to tag a few members to see if you should increase Nellie's dose by looking at your spreadsheet or is it too soon?
Have you decided on a dosing method yet
@tiffmaxee

@Wendy&Neko

@Bron and Sheba (GA)

@Bandit's Mom

Thanks ladies
Hi All - I think I'm going to try out TR. I am lucky enough to WFH and can monitor her closely, and her starting dose is perfect for her current weight according to the TR guidelines. Is the fact that so many of her early data is just on from the Libre going to be a problem when calculating these doses?

I'm getting a bit better at the ReliOn, and I just tested her at AM +7.5 and on the Libre she was at 209 and on the ReliOn she was at 193, first time I've seen a number under 200. She had a can of LC at the time of amps, and half a MC can at around +6. Just measured with Libre at +7 (so 30 min later) and she's up to 228.

I'm a little nervous about increasing her dose just because I thought she was already on LC but turns out it's really more of a mixture of LC and MC food now that I'm doing the proper analyses. I'm ordering LC food and introducing a little slowly since she is prone to upset tummies with the goal of being 100% LC soon. I had read that you need to be careful with the doses when changing to LC food - do I need to lower the dose or keep the same? Let me know if I should post this in the Lantus group instead.
 
dose increases are only by .25u at a time I would increase based on those numbers. I doubt MC food is contributing that much to his BG but that's just me and I am a newbie at all this, and Nellie is not Hendrick so who knows. ECID! (every cat is different)

The Lantus forum seems to be mainly about the daily threads moreso than questions like this, I'm not sure though.

I will tag some of the people who have helped me these past couple months:

@tiffmaxee @FrostD @Sue and Luci @Suzanne & Darcy @Bron and Sheba (GA)
 
I am doing primarily WFH right now too (silver lining to the pandemic) and I cannot imagine doing TR otherwise. There have been mornings I was running back and forth from my work PC to Hendrick, doing tests and offering food at +1, +2 etc to offset the insulin kicking in

if I wasn't home, it would be give insulin, leave some food in the Surefeeder and....just @#$% hope for the best? Ugh.
 
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Hi. If you are going to follow TR, add it your spreadsheet and signature. Normal BG is 50-100 so you definitely have room to increase. However the initial dose is held for 7 days to build the depot.
 
Hello and welcome. You've made some very good moves with home testing and focussing on what food your cat is eating. More details on calculating food from carbs is here:
By the way, check out the Index/FAQ document in the Health Links forum. A ton of useful/handy posts there. Another good source on feline nutrition is written by a vet specializing in feline nutrition. https://catinfo.org/ Cheaper meat alternatives you can look at are turkey and possibly lamb. Return the Glycobalance and Purina DM foods if it's too late to cancel the order. Nothing special about them but the price.

As for dosing, Bron already said to hold the initial dose 5-7 days for Lantus.
 
Thanks so much all, truly, for the info. Working my way through all of the FAQs !!

I'm going to hold this initial dose for 7 days while I get the hang of testing w/ ReliOn. The ReliOn is consistently getting lower readings than the Libre, but I know variance is normal. Just don't want to base numbers of dosing on the Libre exclusively if it's coming off soon and I need to base on ReliOn thereafter. (going to miss the easy, constant readings on Libre!)

Question - Bron mentioned she needs to be on LC wet food to start TR. Can I still start it after 7 days if she is mostly getting LC but occasionally MC since she is transitioning diets or is that not recommended?
 
I know the amount of info is truly amazing. and thank you! that sounds great
Hi I see you added TR to your spreadsheet, can you please add it to your signature also since that is what the members look at first
To do that tap on your name up top , a drop down will appear, tap in signature and add it and tap on save changed :cat:
@Skyynett
Would you like to tell us your name , Nellie is a gorgeous kitty, such a sweet face
 
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@Diane Tyler's Mom name is Laura- lovely to e meet you! And haha thanks she uses that face to her advantage frequently :)) love Tyler- always been a fan of the orange ones
Hi Laura nice to meet you too, how can you resist that face :p
I'll be following along to see how Nellie is coming along.
Thanks for adding TR to your signature
You really couldn't have found a better group of people.
If it wasn't for the members helping me Tyler wouldn't be in remission today ( knock on wood) since 1-24-21
Just keep asking questions.
Have a good night Laura , kiss that precious face of hers for me :cat:
 
@Skyynett I see you increased Nellie's dose to 1.25u yesterday morning. Lantus usually takes 2-3 days (5-7 12-hour insulin cycles) for a new dose to start to do things because of the insulin depot. I hope the new dose starts to help Nellie more soon :)
 
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