New member: advice on feeding a cat with urinary crystals

Status
Not open for further replies.
ZeusGoose

ZeusGoose

Member Since 2022
Hi! Our cat, Zeus, was diagnosed a little over a month ago and we are doing our best to get him regulated and healthy. Our vet currently has him on a freestyle libre glucose monitor and he’s getting 4 units of lantus every twelve hours.

Zeus has been on a prescription diet for urinary crystals for approximately 6 years now. We feed him prescription Science Diet c/d urinary care food.

We’ve been going through the literature here and one of the things we noted is that switching to a wet food is better. We’ve purchase some of the c/d prescription wet food and are feeding him that currently but the cost is… prohibitive. I’m sure everyone here understands the financial strain the initial diagnosis causes.

We would like to try him on the c/d dry food again to help us minimize some of the cost. We are unsure if this is advisable so we were hoping for some advice from people who may have a better understanding/more experience with it than us. We are also discussing this with his vet.

Any advice would be much appreciated
 
Welcome I can tag a few members about what food is good for urinary crystals.
4 units seems like a high dose to start with using lantus
If you can first fill out what we call our signature that would be good

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine tap on the tap up top and tap on 2020 you will see more tests because on 2022 tab there isn't much because Tyler is in remission now

We also use a spreadsheet to track our cat's BG numbers to see how the insulin is working and how low it's dropping and in case you need any advice , if you are interested in setting one up just ask , we have a member who will be happy to do it for you


We don't increase insulin by whole units, we increase or decrease by 0.25 units at a time so you don't skip over a good dose for Evey
Are you using U-100 syringes with the half unit markings, it's easier when you have to adjust the dose by 0.25 units.
They come in half unit increments but still make it easier when adjusting by 0.25 units


We don't base how much insulin we give going by the Pre Shots (AMPS)
or the PMPS we base the dose of insulin on how low the BG is dropping



Part of that process is getting a feel for basic concepts:
  • Onset - the length of time before insulin reaches the bloodstream & beginslowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
You can read about Lantus here , and the 2 dosing methods that you would choose to follow, they will tell you when an increase or decrease is needed
Be right back

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Read all the yellow stickys

About our spreadsheet
The spreadsheet is easier than it looks we track our cats BG to see how the insulin is working and how low she's dropping so we can follow along in case you need help with dosing

Just some info about it look at mine at the end of my signature it says Tyler's spreadsheet to get a look at it, you can look at anyone's spreadsheet

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers


If you want to try and set it up here the link, if you need help just ask we have a member who will be glad to set it up for you
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
 
ZeusGoose said:
Hi! Our cat, Zeus, was diagnosed a little over a month ago and we are doing our best to get him regulated and healthy. Our vet currently has him on a freestyle libre glucose monitor and he’s getting 4 units of lantus every twelve hours.

Zeus has been on a prescription diet for urinary crystals for approximately 6 years now. We feed him prescription Science Diet c/d urinary care food.

We’ve been going through the literature here and one of the things we noted is that switching to a wet food is better. We’ve purchase some of the c/d prescription wet food and are feeding him that currently but the cost is… prohibitive. I’m sure everyone here understands the financial strain the initial diagnosis causes.

We would like to try him on the c/d dry food again to help us minimize some of the cost. We are unsure if this is advisable so we were hoping for some advice from people who may have a better understanding/more experience with it than us. We are also discussing this with his vet.

Any advice would be much appreciated
Click to expand...
@tiffmaxee

@Bandit's Mom

@Suzanne & Darcy

@Sienne and Gabby (GA)

@Wendy&Neko
 
Welcome. I have experience with this. Max was on CD too long. He blocked and a vet pierced his bladder when he was around 5. He He had surgery and I almost lost him. He was on Hills CD far too long. It’s high carb. I switched to canned food and added water and he never blocked again. Wet food is far better than dry. Max preferred the dry but it makes no sense to feed a cat with crystals dry food. He wasn’t diabetic then and preferred wet that was in pieces. Once diabetic he adapted easily to pates.
 
Hello and welcome!

Like Elise said, Hills C/D is too high in carbs for a diabetic cat. A low carb canned diet is good for his diabetes and also for crystals. The urinary tract is kept healthier due to the extra water flowing through it that doesn't give the crystals much time to form. If you haven't already, you may also want to check out this excellent website on feline nutrition by a vet, Dr. Lisa Pierson and specifically this page on urinary tract issues in cats:
https://catinfo.org/feline-urinary-tract-diseases/

It's good that you are monitoring him with a Libre. A switch to a low carb food can significantly impact a kitty's BG numbers and greatly reduce the need for insulin. So any transition in diet when already on insulin, has to be made gradually and with careful monitoring of the BG (with home testing). We have had cats that have gone off insulin with just a change from high carb kibble to a low carb canned diet.
 
Diane Tyler's Mom said:
Welcome I can tag a few members about what food is good for urinary crystals.
4 units seems like a high dose to start with using lantus
If you can first fill out what we call our signature that would be good

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine tap on the tap up top and tap on 2020 you will see more tests because on 2022 tab there isn't much because Tyler is in remission now

We also use a spreadsheet to track our cat's BG numbers to see how the insulin is working and how low it's dropping and in case you need any advice , if you are interested in setting one up just ask , we have a member who will be happy to do it for you


We don't increase insulin by whole units, we increase or decrease by 0.25 units at a time so you don't skip over a good dose for Evey
Are you using U-100 syringes with the half unit markings, it's easier when you have to adjust the dose by 0.25 units.
They come in half unit increments but still make it easier when adjusting by 0.25 units


We don't base how much insulin we give going by the Pre Shots (AMPS)
or the PMPS we base the dose of insulin on how low the BG is dropping



Part of that process is getting a feel for basic concepts:
  • Onset - the length of time before insulin reaches the bloodstream & beginslowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
You can read about Lantus here , and the 2 dosing methods that you would choose to follow, they will tell you when an increase or decrease is needed
Be right back

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Read all the yellow stickys

About our spreadsheet
The spreadsheet is easier than it looks we track our cats BG to see how the insulin is working and how low she's dropping so we can follow along in case you need help with dosing

Just some info about it look at mine at the end of my signature it says Tyler's spreadsheet to get a look at it, you can look at anyone's spreadsheet

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers


If you want to try and set it up here the link, if you need help just ask we have a member who will be glad to set it up for you
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
Click to expand...
Thank you so much for the thorough response!

Our vet started him on 1 unit of insulin for a week and then began bumping him up to 4 as his BG did not appear to be responding based on his glucose curve from his freestyle libre. I have only been increasing the dose at the behest of the vet, I believe he may be accelerating the process a bit because his libre only lasts 14 days.

I'm working on the spreadsheet now but it may take me a bit to get it fully up to date.

I've read about the dosing for Lantus and SLGS vs TR and I'm not certain what category we fall into right now. I'm sending the vet graphs each day of his daily glucose curve and he calls me to check in every day and tells me whether to keep the dose the same or increase. I will discuss these methods with him when I speak to him next.
 
Bandit's Mom said:
Hello and welcome!

Like Elise said, Hills C/D is too high in carbs for a diabetic cat. A low carb canned diet is good for his diabetes and also for crystals. The urinary tract is kept healthier due to the extra water flowing through it that doesn't give the crystals much time to form. If you haven't already, you may also want to check out this excellent website on feline nutrition by a vet, Dr. Lisa Pierson and specifically this page on urinary tract issues in cats:
https://catinfo.org/feline-urinary-tract-diseases/

It's good that you are monitoring him with a Libre. A switch to a low carb food can significantly impact a kitty's BG numbers and greatly reduce the need for insulin. So any transition in diet when already on insulin, has to be made gradually and with careful monitoring of the BG (with home testing). We have had cats that have gone off insulin with just a change from high carb kibble to a low carb canned diet.
Click to expand...
Is the C/D wet food also too high carb? We have several cans left but I don't want to give it to him if it's going to hurt more than help.
 
ZeusGoose said:
Is the C/D wet food also too high carb? We have several cans left but I don't want to give it to him if it's going to hurt more than help.
Click to expand...
Dr. Lisa's list says 23-28% carbs.

upload_2022-9-30_22-37-3.png
 

Attachments

  • upload_2022-9-30_22-37-3.png
    upload_2022-9-30_22-37-3.png
    76.6 KB · Views: 234
The link to Dr. Lisa's page that has information on crystals is what I would have sent you, as well. She's a vet with a very active interest in feline nutrition. As others have noted, part of why your kitty is needing 4u of insulin is that C/D, both canned and kibble, are very high in carbs. Her philosophy with anything urinary tract is water, and lots of it!
 
ZeusGoose said:
Thank you so much for the thorough response!

Our vet started him on 1 unit of insulin for a week and then began bumping him up to 4 as his BG did not appear to be responding based on his glucose curve from his freestyle libre. I have only been increasing the dose at the behest of the vet, I believe he may be accelerating the process a bit because his libre only lasts 14 days.

I'm working on the spreadsheet now but it may take me a bit to get it fully up to date.

I've read about the dosing for Lantus and SLGS vs TR and I'm not certain what category we fall into right now. I'm sending the vet graphs each day of his daily glucose curve and he calls me to check in every day and tells me whether to keep the dose the same or increase. I will discuss these methods with him when I speak to him next.
Click to expand...

We adjust the dose by how low the kitty is dropping, are you only going by curves?
We test our cats every day at AMPS then maybe around +2, +4 and +6
Them PMPS then same as above
Then you want to test at different times such as +3, +5, +7
You want to scatter them around like filling in pieces of a puzzle
I have never used the Libre, most of us test with a human meter
We adjust the dose by 0.25 units
Do you have the U-100 syringes with half unit markings

If you are interested in testing with a meter let me know and I'll send you some info
 
Diane Tyler's Mom said:
We adjust the dose by how low the kitty is dropping, are you only going by curves?
We test our cats every day at AMPS then maybe around +2, +4 and +6
Them PMPS then same as above
Then you want to test at different times such as +3, +5, +7
You want to scatter them around like filling in pieces of a puzzle
I have never used the Libre, most of us test with a human meter
We adjust the dose by 0.25 units
Do you have the U-100 syringes with half unit markings

If you are interested in testing with a meter let me know and I'll send you some info
Click to expand...
I’m not choosing the insulin dose at all. My vet checks each daily curve and tells me what dose to give him that day. I asked about using a sliding scale for insulin dosing and he cautioned me against “chasing numbers” and advised that we would determine a regular dose based on these curves.

The libre tests his glucose something like every ten minutes so I have data for every hour except for the occasional glitch. It’s very expensive so I’d prefer to use a human glucometer in the future as we are pretty much tapped out on funds at this point. We definitely cannot afford another libre, but we also weren’t given the option of choice for it either.

My syringes are u-100 but they do not have half unit markings.

I’m definitely interested in a testing meter. I have a contour next that I don’t use anymore from when I had gestational diabetes, I’m not sure if it’s suitable or not (or even if the strips would be affordable out of pocket). I’ll take whatever literature you can throw my way.
 
Last edited:
ZeusGoose said:
I’m definitely interested in a testing meter. I have a contour next that I don’t use anymore from when I had gestational diabetes, I’m not sure if it’s suitable or not (or even if the strips would be affordable out of pocket). I’ll take whatever literature you can throw my way.
Click to expand...
Hi Taylor
About testing
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

A video one of our members posted, she is using a pet meter ,strips too expensive
A human meter is just fine, most of us use human meters ,that's what our numbers are based on

Go to Walmart and get the Relion Premier Classic for 9 dollars
17.88 for 100 test strips
VIDEO: How to test your cat's blood sugar
 
ZeusGoose said:
I’m in the US, sadly. So insulin prices were definitely tough to swallow.
Click to expand...
What are you using the vial
many members use the generic lantus
Just have your vet write it for glargine

Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year !
Just keep them in the fridge middle shelf ,they will have an expiration date on them
Its generic lantus

Or this one
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1

Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens

just insert the syringe into the pen and draw out the insulin.


You said you don't have the U-100 syringes with half unit markings
Here you go
https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct



We use the pens just like a vial , just stick the syringe in the gray rubber stopper and draw out your insulin
Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen!
syringe-in-pen-pic-jpg.45006


Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

The reason we don't use the needles that would go in the pens is because you can only dial the pens by whole units
With the U-100 syringes with half unit markings we can adjust by 0.25 units at a time

30-unit-insulin-syringe-markings.jpg


Here's a coupon for ordering from ADW Diabetes the ones I listed above

DIA10
adw-coupon-dia10.jpg
 
Last edited:
You can also get the syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
This is what the packaging looks like: either box
They won't say it half unit on the box but the are . open then and look before you leave the store, can't be ordered on line , need to go into the store
:
upload_2021-9-5_23-18-9-jpeg.62508
 
Diane Tyler's Mom said:
many members use the generic lantus
Just have your vet write it for glargine

Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year
Its generic lantus

Or this one
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1

Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens

just insert the syringe into the pen and draw out the insulin.


You said you don't have the U-100 syringes with half unit markings
Here you go
https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct



We use the pens just like a vial , just stick the syringe in the gray rubber stopper and draw out your insulin
Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen!
syringe-in-pen-pic-jpg.45006


Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

The reason we don't use the needles that would go in the pens is because you can only dial the pens by whole units
With the U-100 syringes with half unit markings we can adjust by 0.25 units at a time

30-unit-insulin-syringe-markings.jpg


Here's a coupon for ordering from ADW Diabetes the ones I listed above

DIA10
adw-coupon-dia10.jpg
Click to expand...
Seriously, thank you so much for these resources. I’ve been feeling quite overwhelmed just parsing through the boatloads of information on here. I’m very thankful for your willingness to point me in the right direction.
 
ZeusGoose said:
Seriously, thank you so much for these resources. I’ve been feeling quite overwhelmed just parsing through the boatloads of information on here. I’m very thankful for your willingness to point me in the right direction.
Click to expand...
You're very welcome ask as many question as you want
I'm sorry I can't help out with the food, I would have no idea what kind of wet food you could feed if your cat has crystals.
I see some members suggested to switch to a low carb wet food
Here is our food chart ,you want to look for food that is 6% carbs ,preferably less

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Last edited:
@ZeusGoose
ZeusGoose said:
I’m not choosing the insulin dose at all. My vet checks each daily curve and tells me what dose to give him that day. I asked about using a sliding scale for insulin dosing and he cautioned me against “chasing numbers” and advised that we would determine a regular dose based on these curves
Click to expand...
@ZeusGoose
Oh my lord I see you have your spreadsheet set up and have recorded Zeus's numbers
I'm bgoing to tag a few members for you , you need to reduce the dose
Your vet doesn't know what he/she is talking about
Ladies can you please look at Taylors SS, her vet started her with 1 unit then increased to 2 units, then 3 units, then 4 units, this poor kitty dropped to 40 last night

@tiffmaxee

@Bron and Sheba (GA)

@Suzanne & Darcy

@Wendy&Neko

@Christie & Maverick

@Bandit's Mom
 
Last edited:
With Max, any wet food I was told was fine and it was. Tanya’s list has carbs for many foods and is more up to date than the other lists. It’s a bit hard to use but more current.
 
tiffmaxee said:
With Max, any wet food I was told was fine and it was. Tanya’s list has carbs for many foods and is more up to date than the other lists. It’s a bit hard to use but more current.
Click to expand...
Elise can you please look at her SS her vet doesn't know what he's talking about see post #23
This poor kitty dropped to 40 last night
 
4 units is too much insulin. I see he got to 40 last night. Since you are feeding a higher carb food, anything under 90 means his insulin dose needs to be reduced. I'd get those 1/2 unit marked syringes as soon as you can so you can go back to 2.5 units. Even the 3.0 unit dose down to 70, meaning that was too high a dose as well.
 
Diane Tyler's Mom said:
@ZeusGoose

@ZeusGoose
Oh my lord I see you have your spreadsheet set up and have recorded Zeus's numbers
I'm bgoing to tag a few members for you , you need to reduce the dose
Your vet doesn't know what he/she is talking about
Ladies can you please look at Taylors SS, her vet started her with 1 unit then increased to 2 units, then 3 units, then 4 units, this poor kitty dropped to 40 last night

@tiffmaxee

@Bron and Sheba (GA)

@Suzanne & Darcy

@Wendy&Neko

@Christie & Maverick

@Bandit's Mom
Click to expand...
This has been really stressing me out. We’ve already changed vets once during this process because of similar issues but now we do not have money to change vets again just yet. I expressed my concerns about how low he dropped but they made me leave a message and will get back with me on Monday. I withheld evening insulin when he dropped to 40 because this just does not feel right to me.

His libre expires in 3 days and I’m terrified with this dosing regimen he’s gonna get hypoglycemic. I’m working on getting a regular glucometer but again… money. Can’t get blood from a stone right now.

We’re also researching a different wet food to switch him to that’s lower carb. We are thinking fancy feast classics at this point. Hubs is working overtime like a madman right now to try and get enough money for all these changes.
 
Wendy&Neko said:
4 units is too much insulin. I see he got to 40 last night. Since you are feeding a higher carb food, anything under 90 means his insulin dose needs to be reduced. I'd get those 1/2 unit marked syringes as soon as you can so you can go back to 2.5 units. Even the 3.0 unit dose down to 70, meaning that was too high a dose as well.
Click to expand...
Thank you! I’ll do that as soon as I can. Gotta scrounge up some funds but we are hurrying.
 
Start with lowering his dose down to 3.0 units. For Zeus's safety, stop giving the 4.0 unit dose. If you start feeding a food that is lower carb, he will need even less insulin.
 
Libre does have a customer assistance program where I get my sensors for $37.77 each. google libre 14 day trial. sign up online and don't say its for a cat. They will only give the discount to humans. I've had no issues getting mine. There is also a facebook group for libre pet users. You still need a blood meter as libres aren't always accurate. I have another cat with a history of crystals. A lot of what causes the crystals is not enough fluids in the diet. I have two water fountains running. Dry food also causes crystals. I usually give can cat and will mix in a little water.
 
You can get 1 free Libre sensor. Presently you get the Libre 2 sensor and soon it will be the Libre 3 sensor. However, for US areas this offer is not available to "residents of Massachusetts, or US territories (other than Puerto Rico)".
There are different websites for different countries. The US website is: https://www.freestyle.abbott/us-en/myfreestyle.html
Say you ae a caretaker and give correct age of the cat as long as it is at least 4 years.
 
Status
Not open for further replies.
Back
Top