New diabetic/KTA/possible CKD cat mom looking for some advice and support

[Meredith Bear’s Mom]

Hi everyone! Thank you for having us. Bear is my foster-to-adopt sugarcat. We picked him up two weeks ago from a neglect situation. He is 11 and toothless. He was diagnosed with Diabetes and DKA and has been hospitalized twice since we've had him. He is also struggling with a kidney infection and possible CKD (we'll know more when we see the specialist in a few weeks). He is a super happy guy despite it all, running around and meowing! He currently has on a Freestyle Libre which has been super helpful in monitoring his levels. The past two days his BG drops to about 60 around midnight and then spikes to 500+ from 7AM-12PM. He started on 2 units of Vetsulin 2x a day, then switched to Glargin 1 unit 1x, and now is on .5 of Glargin 2x a day. He is going for a vet follow up on Monday and then sees an IM Specialist on the 19th.

I just started a spreadsheet and will be continuing to use that. I have a few questions and am wondering if someone can assist me?

1. According to recent monitoring, Bear normally has a fairly high BG level from around 7:00 AM - 12:00 PM (he gets .5 of a Glargin unit with breakfast at 7:15 AM). His BG then proceeds to start to drop around 12:00 PM or so, he gets dinner another .5 unit of Glargin at 7:15PM. His BG proceeds to and get pretty low (50-80 BG) around 11:30 PM, when I then supplement with food/treats. Should I avoid giving him food and treats during the day?

2. Someone suggested that I get a ketone and regular glucose monitor. What kind should I buy? How often should I check Ketones? The vet said he does have DKA.

3. After his initial diagnosis, Bear was given Purina Pro Plan Diabetic Management wet food. In reading through and on the Facebook group I see there are some alternate food options that might be good for him, especially since he might have CKD. Is this food okay to continue feeding for now, or should I switch to something else immediately?

4. What is a good high-calorie food to have on hand for when his BG drops?

5. Could his consistent high BG be because of his current kidney infection? (He's been on antibiotics for about 10 days now) How worried should I be that it is over 500 and stays that way for quite some time?

I'm sure I have more questions, but this is all I can think of for now. Lots going on in my head. Thank you in advance!

 

[Bron and Sheba (GA)]

Hi and welcome to the forum. I will answer you shortly but at the moment I can’t see your spreadsheet. Can you have a look and see if you need to give permission for others to view please?

 

[Meredith Bear’s Mom]

Hi and welcome to the forum. I will answer you shortly but at the moment I can’t see your spreadsheet. Can you have a look and see if you need to give permission for others to view please?

Hi! Thank you! I just updated my permissions - please let me know if that worked. Today is my first day finding this site and the spreadsheet so there is not much there at the moment. I also added another question I have just FYI Thank you for responding to me!

 

[Bron and Sheba (GA)]

Yes I can see it now thanks Meredith.
I will post this and then answer your questions. I’m glad you found us. We will be able to help you.

 

[Bron and Sheba (GA)]

First of all, what a beautiful boy and so lucky to have found you. Thank you for adopting him!
Before I answer your questions I want to talk about DKA and what you need to be doing now that he is at home.

• you need to give one and a half times as many calories as he/she normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If your kitty won’t eat the low carb food, feed him whatever he will eat as eating any food is better than not eating,
• Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, dont feed and test again in 20 minutes and post and ask for help.
• Test daily for ketones. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all. You will need a bottle of Ketostix from Walmart or a pharmacyhttps://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf and follow the directions on the bottle.
• Give antinausea medication if needed
• Give appetite stimulant if needed after the antinausea medication
• Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
• Ask the vet about subQ fluids
• Set up a spreadsheet and test the BG frequently
• Post daily with updates and ask for help as often as needed.
• Make sure if your kitty has any infection that it is being treated with an antibiotic and you complete the course. If he doesn’t seem better with the antibiotics tell the vet, you may need a different antibiotic.

According to recent monitoring, Bear normally has a fairly high BG level from around 7:00 AM - 12:00 PM (he gets .5 of a Glargin unit with breakfast at 7:15 AM). His BG then proceeds to start to drop around 12:00 PM or so, he gets dinner another .5 unit of Glargin at 7:15PM. His BG proceeds to and get pretty low (50-80 BG) around 11:30 PM, when I then supplement with food/treats. Should I avoid giving him food and treats during the day?

Lantus onset is usually around the +2 mark. That is when the insulin starts to work. So it is normal to see the BG (blood glucose ) start to drop. It is possible that the 0.5 units is too high a dose but I would need to see more data before suggesting a drop in dose and because of the DKA we want him to have as much insulin as is safely possible. It is insulin and food that keeps the ketones from forming. So I would feed him a small snack (a teaspoon or two of low cat food) at +2 +4 +6 and +8 and we can see how that goes. If he drops under 50 he needs a reduction in dose but we really want to keep him on as much insulin as is safely possible at this point because of the DKA..

Someone suggested that I get a ketone and regular glucose monitor. What kind should I buy? How often should I check Ketones? The vet said he does have DKA.

You can either check the urine for ketones like I have suggested above or you can buy a meter that tests for both glucose and ketones. Some of these meters are the Nova Max Plus, Precision Xtra blood and ketone meter and Abbott also has a good meter…
You need to be checking daily foe ketones at the moment and if any are showing, more often. When you test if you could put the result in the remarks column of the SS, we can then see it. Thanks.

After his initial diagnosis, Bear was given Purina Pro Plan Diabetic Management wet food. In reading through and on the Facebook group I see there are some alternate food options that might be good for him, especially since he might have CKD. Is this food okay to continue feeding for now, or should I switch to something else immediately?

I would swap to a low carb wet food which is low in phosphorus. I will give you a link.. look for foods that are under 250 mg phosphorus/ 100kcals in the chart.
Food chart

What is a good high-calorie food to have on hand for when his BG drops?

Look at the food chart above and select some suitable foods.
low carb under 10% but most feed around 4-7% carbs
Medium carb 11-16%
High carb 17% and above
Here is a link to the hypo kit and other information and that will tell you about carbs to get. Please set up a hypo kit.
HELP US HELP YOU

Could his consistent high BG be because of his current kidney infection? (He's been on antibiotics for about 10 days now) How worried should I be that it is over 500 and stays that way for quite some time?

He is dropping low at times and I think he is bouncing from these low numbers. It is very normal for newly diagnosed cats to bounce…I will explain that below. So the high numbers are most likely from bouncing. But do follow up on the kidney infection because it is really important that that infection is cured. The recipe for DKA is not enough insulin, not enough food and an infection or inflammation so to stop further ketones forming and DKA developing we need to ensure that those three things are actively address at all times…does that make sense.?So I would keep testing and we can see how the BG is going. If he drops under 100 I would feed him extra low carbs snacks to try and stop it dropping further. If it drops under 50 you need to give him a high carb snack and test again in 20 minutes. Post and ask for help.

Bouncing: from the Basics, new to the group.

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

I would post daily or more often and I will watch for any updates. Ask as many questions as you like, we are very happy to help you.
Bron

 

[Diane Tyler's Mom GA]

Welcome Bear is soooo adorable
weruva has low carb and low phospherous wet food
With weruva foods
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts.
https://weruva.com


For diabetic cats and cats that have elevated kidney values
You want to feed low phosphorous wet food

When you go to the weruva site and click on one of the pics of the food , click on Detailed Nutrition information that is under guaranteed analysis to the left
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS

Here is a list that one of our members posted ,if Bear likes pates

I don't know if the BFF play weruva pate is on the list your looking at or not. I wrote down the protein carbs & phosphorus #s in a notebook.
BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 129%
BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5%
Phosphorus 129%
BFF play chicken cherish
Protein 31%
Carbs 5%
Phosphorus 135%
BFF chicken & turkey tiptoe
Protein 31%
Carbs 5%
Phosphorus 136%
BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5%
Phosphorus 149%
BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 154%
BFF play chicken & duck destiny
Protein 32%
Carbs 5%
Phosphorus 165%
BFF play chicken & beef best buds
Protein 33%
Carbs 5%
Phosphorus 171%
Don't know if your kitty likes pate but here is the list of the BFF line.

 

[chuckstables]

Hi everyone! Thank you for having us. Bear is my foster-to-adopt sugarcat. We picked him up two weeks ago from a neglect situation. He is 11 and toothless. He was diagnosed with Diabetes and DKA and has been hospitalized twice since we've had him. He is also struggling with a kidney infection and possible CKD (we'll know more when we see the specialist in a few weeks). He is a super happy guy despite it all, running around and meowing! He currently has on a Freestyle Libre which has been super helpful in monitoring his levels. The past two days his BG drops to about 60 around midnight and then spikes to 500+ from 7AM-12PM. He started on 2 units of Vetsulin 2x a day, then switched to Glargin 1 unit 1x, and now is on .5 of Glargin 2x a day. He is going for a vet follow up on Monday and then sees an IM Specialist on the 19th.

I just started a spreadsheet and will be continuing to use that. I have a few questions and am wondering if someone can assist me?

1. According to recent monitoring, Bear normally has a fairly high BG level from around 7:00 AM - 12:00 PM (he gets .5 of a Glargin unit with breakfast at 7:15 AM). His BG then proceeds to start to drop around 12:00 PM or so, he gets dinner another .5 unit of Glargin at 7:15PM. His BG proceeds to and get pretty low (50-80 BG) around 11:30 PM, when I then supplement with food/treats. Should I avoid giving him food and treats during the day?

2. Someone suggested that I get a ketone and regular glucose monitor. What kind should I buy? How often should I check Ketones? The vet said he does have DKA.

3. After his initial diagnosis, Bear was given Purina Pro Plan Diabetic Management wet food. In reading through and on the Facebook group I see there are some alternate food options that might be good for him, especially since he might have CKD. Is this food okay to continue feeding for now, or should I switch to something else immediately?

4. What is a good high-calorie food to have on hand for when his BG drops?

5. Could his consistent high BG be because of his current kidney infection? (He's been on antibiotics for about 10 days now) How worried should I be that it is over 500 and stays that way for quite some time?

I'm sure I have more questions, but this is all I can think of for now. Lots going on in my head. Thank you in advance!

Hi! Welcome. Thank you for being such an amazing person to adopt a neglected/abused cat. I'll answer to the best of my ability

1.) The freestyle libre can be unreliable in cats below about 100 mg's/dl from what I've heard around here. Just be aware of that. It also will likely take some time for everything to stabilize. As for food; if his blood sugar is consistently dropping then giving them a snack is a good idea. It helps with sam at night to stop him from dropping too low.

2.) I'd test for ketones daily in your situation until he only has trace levels consistently for say a couple of weeks.

3.) Someone already gave an answer, so I won't chime in.

4.) Someone also already answered this. The problem I've had with sam is he won't eat any of the high carb wet foods I tried. So to make my own high carb wet food I mix some corn syrup with his normal wet food, works fine in a pinch.

5.) Sam was at 580 mg's at time time of his diagnosis despite not having eaten in over 12 hours, so those levels aren't insane or anything. It's possible that he is bouncing back from the lower levels. If a cat has blood sugar levels below what their (often tempermental) liver is used to, then the liver starts releasing glucogen which spikes blood sugar incredibly high. Sam for example went down to the 50's-60's the other night. The next morning he was at 370 or so. This will continue for some time as the body becomes used to lower blood sugar levels. In a cat with DKA the liver might see a blood glucose of just 150 as being "too low", so when he gets "too low" for his liver at night it might start pumping out sugar.

Can you get a graph form of the blood sugar? You should be able to download it. Should look like this

Keep up the hard work. You're doing an incredible job, and I really respect you guys for fostering and adopting this cat. Keep it up! Sending you good thoughts and prayers

 

[Bron and Sheba (GA)]

In a cat with DKA the liver might see a blood glucose of just 150 as being "too low", so when he gets "too low" for his liver at night it might start pumping out sugar.

@chuckstables a diabetic cat does not have to have or have had DKA to bounce from a BG number like 150. If any diabetic cat has been in high numbers for a time, it is possible his body will react if the BG drops lower to a number that his body perceives is too low (such as 150). And then he dumps the glucogen and counter regulatory hormones in to his system and the BGs skyrocket. These bounces can last for up to 6 cycles.

Also you said “I'd test for ketones daily in your situation until he only has trace levels consistently for say a couple of weeks.” We don’t want to see any ketones in the urine at all. So we recommend testing daily until at least a couple of weeks after negative ketones in the urine, then reducing them to 2 nd daily.

 

[Meredith Bear’s Mom]

First of all, what a beautiful boy and so lucky to have found you. Thank you for adopting him!
Before I answer your questions I want to talk about DKA and what you need to be doing now that he is at home.

• you need to give one and a half times as many calories as he/she normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If your kitty won’t eat the low carb food, feed him whatever he will eat as eating any food is better than not eating,
• Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, dont feed and test again in 20 minutes and post and ask for help.
• Test daily for ketones. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all. You will need a bottle of Ketostix from Walmart or a pharmacyhttps://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf and follow the directions on the bottle.
• Give antinausea medication if needed
• Give appetite stimulant if needed after the antinausea medication
• Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
• Ask the vet about subQ fluids
• Set up a spreadsheet and test the BG frequently
• Post daily with updates and ask for help as often as needed.
• Make sure if your kitty has any infection that it is being treated with an antibiotic and you complete the course. If he doesn’t seem better with the antibiotics tell the vet, you may need a different antibiotic.

Lantus onset is usually around the +2 mark. That is when the insulin starts to work. So it is normal to see the BG (blood glucose ) start to drop. It is possible that the 0.5 units is too high a dose but I would need to see more data before suggesting a drop in dose and because of the DKA we want him to have as much insulin as is safely possible. It is insulin and food that keeps the ketones from forming. So I would feed him a small snack (a teaspoon or two of low cat food) at +2 +4 +6 and +8 and we can see how that goes. If he drops under 50 he needs a reduction in dose but we really want to keep him on as much insulin as is safely possible at this point because of the DKA..


You can either check the urine for ketones like I have suggested above or you can buy a meter that tests for both glucose and ketones. Some of these meters are the Nova Max Plus, Precision Xtra blood and ketone meter and Abbott also has a good meter…
You need to be checking daily foe ketones at the moment and if any are showing, more often. When you test if you could put the result in the remarks column of the SS, we can then see it. Thanks.



I would swap to a low carb wet food which is low in phosphorus. I will give you a link.. look for foods that are under 250 mg phosphorus/ 100kcals in the chart.
Food chart


Look at the food chart above and select some suitable foods.
low carb under 10% but most feed around 4-7% carbs
Medium carb 11-16%
High carb 17% and above
Here is a link to the hypo kit and other information and that will tell you about carbs to get. Please set up a hypo kit.
HELP US HELP YOU


He is dropping low at times and I think he is bouncing from these low numbers. It is very normal for newly diagnosed cats to bounce…I will explain that below. So the high numbers are most likely from bouncing. But do follow up on the kidney infection because it is really important that that infection is cured. The recipe for DKA is not enough insulin, not enough food and an infection or inflammation so to stop further ketones forming and DKA developing we need to ensure that those three things are actively address at all times…does that make sense.?So I would keep testing and we can see how the BG is going. If he drops under 100 I would feed him extra low carbs snacks to try and stop it dropping further. If it drops under 50 you need to give him a high carb snack and test again in 20 minutes. Post and ask for help.

Bouncing: from the Basics, new to the group.

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

I would post daily or more often and I will watch for any updates. Ask as many questions as you like, we are very happy to help you.
Bron

Wow thank you so much for this helpful information! This is amazing. I am going to work on gathering all of these supplies today. He didn’t drop too low last night thankfully. I will post an update later today. Thank you again

 

[Meredith Bear’s Mom]

Hi! Welcome. Thank you for being such an amazing person to adopt a neglected/abused cat. I'll answer to the best of my ability

1.) The freestyle libre can be unreliable in cats below about 100 mg's/dl from what I've heard around here. Just be aware of that. It also will likely take some time for everything to stabilize. As for food; if his blood sugar is consistently dropping then giving them a snack is a good idea. It helps with sam at night to stop him from dropping too low.

2.) I'd test for ketones daily in your situation until he only has trace levels consistently for say a couple of weeks.

3.) Someone already gave an answer, so I won't chime in.

4.) Someone also already answered this. The problem I've had with sam is he won't eat any of the high carb wet foods I tried. So to make my own high carb wet food I mix some corn syrup with his normal wet food, works fine in a pinch.

5.) Sam was at 580 mg's at time time of his diagnosis despite not having eaten in over 12 hours, so those levels aren't insane or anything. It's possible that he is bouncing back from the lower levels. If a cat has blood sugar levels below what their (often tempermental) liver is used to, then the liver starts releasing glucogen which spikes blood sugar incredibly high. Sam for example went down to the 50's-60's the other night. The next morning he was at 370 or so. This will continue for some time as the body becomes used to lower blood sugar levels. In a cat with DKA the liver might see a blood glucose of just 150 as being "too low", so when he gets "too low" for his liver at night it might start pumping out sugar.

Can you get a graph form of the blood sugar? You should be able to download it. Should look like thisView attachment 65843

Keep up the hard work. You're doing an incredible job, and I really respect you guys for fostering and adopting this cat. Keep it up! Sending you good thoughts and prayers

Hi! Thank you so so much for all of this. The vet did mention the unreliability of the libre under 100. And yes, I can post a picture of the graph. Let me upload that later today thanks for your support!

 

[Meredith Bear’s Mom]

Welcome Bear is soooo adorable
weruva has low carb and low phospherous wet food
With weruva foods
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts.
https://weruva.com


For diabetic cats and cats that have elevated kidney values
You want to feed low phosphorous wet food

When you go to the weruva site and click on one of the pics of the food , click on Detailed Nutrition information that is under guaranteed analysis to the left
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS

Here is a list that one of our members posted ,if Bear likes pates

I don't know if the BFF play weruva pate is on the list your looking at or not. I wrote down the protein carbs & phosphorus #s in a notebook.
BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 129%
BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5%
Phosphorus 129%
BFF play chicken cherish
Protein 31%
Carbs 5%
Phosphorus 135%
BFF chicken & turkey tiptoe
Protein 31%
Carbs 5%
Phosphorus 136%
BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5%
Phosphorus 149%
BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 154%
BFF play chicken & duck destiny
Protein 32%
Carbs 5%
Phosphorus 165%
BFF play chicken & beef best buds
Protein 33%
Carbs 5%
Phosphorus 171%
Don't know if your kitty likes pate but here is the list of the BFF line.

Hi! Weruva was one of the brands I was looking at as I know it is also on the approved list for CKD cats. I think I will get him some of the bff foods. Thanks for posting this! So helpful!

 

[Diane Tyler's Mom GA]

Hi! Weruva was one of the brands I was looking at as I know it is also on the approved list for CKD cats. I think I will get him some of the bff foods. Thanks for posting this! So helpful!

You're very welcome

 

[Sienne and Gabby (GA)]

You've already been given a great deal of good information. I'm only going to mention one issue. Calories are not the issue if a cat is in lower than desirable numbers. You need to think in terms of carbohydrates. Carbs convert into glucose. Well, the reality is that all food -- even zero carb food -- converts into glucose it's just that the higher the carbs, the more impact the food has on blood glucose levels. So, if Bear's numbers are making you nervous, you can bump the numbers up by giving him something other than low carb food. (This is why we suggest you keep stocked with some higher carb food.)

If you're concerned about CKD, adding a drop or two of corn syrup (Karo) or honey to a low carb, low phosphorus food will also work admirably. My cat was sensitive to the gluten in most high carb food so I added syrup/honey to her food.

 

[Meredith Bear’s Mom]

You've already been given a great deal of good information. I'm only going to mention one issue. Calories are not the issue if a cat is in lower than desirable numbers. You need to think in terms of carbohydrates. Carbs convert into glucose. Well, the reality is that all food -- even zero carb food -- converts into glucose it's just that the higher the carbs, the more impact the food has on blood glucose levels. So, if Bear's numbers are making you nervous, you can bump the numbers up by giving him something other than low carb food. (This is why we suggest you keep stocked with some higher carb food.)

If you're concerned about CKD, adding a drop or two of corn syrup (Karo) or honey to a low carb, low phosphorus food will also work admirably. My cat was sensitive to the gluten in most high carb food so I added syrup/honey to her food.

Makes total sense! Thank you!

I just ordered a ketone/glucose meter for home. Is there a resource on here that talks about how to check your cats BG at home (like how to actually take blood from them) as well as a Ketone guide? I apologize if I missed it in the basic info section! Thanks again for everything

 

[Meredith Bear’s Mom]

Hi! Welcome. Thank you for being such an amazing person to adopt a neglected/abused cat. I'll answer to the best of my ability

1.) The freestyle libre can be unreliable in cats below about 100 mg's/dl from what I've heard around here. Just be aware of that. It also will likely take some time for everything to stabilize. As for food; if his blood sugar is consistently dropping then giving them a snack is a good idea. It helps with sam at night to stop him from dropping too low.

2.) I'd test for ketones daily in your situation until he only has trace levels consistently for say a couple of weeks.

3.) Someone already gave an answer, so I won't chime in.

4.) Someone also already answered this. The problem I've had with sam is he won't eat any of the high carb wet foods I tried. So to make my own high carb wet food I mix some corn syrup with his normal wet food, works fine in a pinch.

5.) Sam was at 580 mg's at time time of his diagnosis despite not having eaten in over 12 hours, so those levels aren't insane or anything. It's possible that he is bouncing back from the lower levels. If a cat has blood sugar levels below what their (often tempermental) liver is used to, then the liver starts releasing glucogen which spikes blood sugar incredibly high. Sam for example went down to the 50's-60's the other night. The next morning he was at 370 or so. This will continue for some time as the body becomes used to lower blood sugar levels. In a cat with DKA the liver might see a blood glucose of just 150 as being "too low", so when he gets "too low" for his liver at night it might start pumping out sugar.

Can you get a graph form of the blood sugar? You should be able to download it. Should look like thisView attachment 65843

Keep up the hard work. You're doing an incredible job, and I really respect you guys for fostering and adopting this cat. Keep it up! Sending you good thoughts and prayers

I’m getting an error when I try to upload the graph pictures. Will keep trying.

 

[Diane Tyler's Mom GA]

I’m getting an error when I try to upload the graph pictures. Will keep trying.

The upload isn't working unfortunately can you copy and paste it

 

[Diane Tyler's Mom GA]

Makes total sense! Thank you!

I just ordered a ketone/glucose meter for home. Is there a resource on here that talks about how to check your cats BG at home (like how to actually take blood from them) as well as a Ketone guide? I apologize if I missed it in the basic info section! Thanks again for everything

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

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 plus you have to code it
A human meter is just fine, most of us use human meters ,that's what our numbers are based on


VIDEO: How to test your cat's blood sugar

Here is another link you can look at
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

[Diane Tyler's Mom GA]

It would be helpful if you can add more information to your signature, it's at the end of everyone's post in gray writing
Tap on this link it will explain about your signature, you can also tap on your name all the way up top and then tap on the word signature and add the rest of the information

HELP US HELP YOU

 

[Diane Tyler's Mom GA]

I just ordered a ketone/glucose meter for home. Is there a resource on here that talks about how to check your cats BG at home (like how to actually take blood from them) as well as a Ketone guide? I apologize if I missed it in the basic info section! Thanks again for everything

I have never used a ketone/glucose meter I can tag a few members to that can tell you what would be normal on them when checking for ketones and what number would be high for ketones
@Bron and Sheba (GA)

@Sienne and Gabby (GA)

@Wendy&Neko

Ladies I already gave her information on how to test and draw the blood
Thanks

 

[Sienne and Gabby (GA)]

This is a link to one of our posts on home testing. I'm not sure if what Diane posted includes what's in this link.

What the ranges are for ketones depends on how you're testing. Most people will use urine test strips unless they feel like they need an up to the minute test. The urine test strips can be purchased at any pharmacy or online. The absorbent part of the strip will turn color and you match the strip to the color code on the container. Ketone meters are similar to a glucometer. The process for testing is identical -- you have strips and a ketone meter and you get a number that indicates the degree of ketones if present.

 

[chuckstables]

@chuckstables a diabetic cat does not have to have or have had DKA to bounce from a BG number like 150. If any diabetic cat has been in high numbers for a time, it is possible his body will react if the BG drops lower to a number that his body perceives is too low (such as 150). And then he dumps the glucogen and counter regulatory hormones in to his system and the BGs skyrocket. These bounces can last for up to 6 cycles.

Also you said “I'd test for ketones daily in your situation until he only has trace levels consistently for say a couple of weeks.” We don’t want to see any ketones in the urine at all. So we recommend testing daily until at least a couple of weeks after negative ketones in the urine, then reducing them to 2 nd daily.

On the ketone strips i have trace levels is the lowest that exists, doesn’t have a lower category, probably a difference in test strips between countries. It color codes it into categories. The lowest one is “trace levels”. If you get an actual meter though then yes, you want it reading zero. If you use the dip sticks like i do then you just want it in the lowest category, whatever they decide to call that (last pack i bought said “trace/neg”, the one before said trace, and the first ones i bought had 2 extra categories, the lowest said neg). But yes; i should’ve been clearer i suppose.

I didn’t say that they HAD to have DKA to bounce. I explained what a bounce was; my point was if a cat has DKA then they’ll be used to far higher blood glucose, so the point where they bounce might be higher than a regulated cat. But thanks for the information, always welcome.

 

[Bron and Sheba (GA)]

If you get an actual meter though then yes, you want it reading zero

This is not necessarily correct. With the blood ketone meter it often reads with ketones from 0 to 0.9 or sometimes higher and there is no concern. One also needs to be looking at the cat and seeing how the cat is….is he dehydrated, vomiting, lethargic, drinking a lot, weak, breathing fast. These are all red flags.
The latest information says that once the blood ketones meters read 2.4 to 2.55 then you need to take action
More information HERE

The Ketostix that most people use have a negative, trace, small, moderate, large and larger ketone colour. Like this

So we don’t want to see any ketones at all when we test. If we do that we have to be alert and tell the vet if they are more than a trace. Also monitoring the cat to see if he is unwell as listed above is also part of monitoring for ketones/DKA.

 

[Bron and Sheba (GA)]

my point was if a cat has DKA then they’ll be used to far higher blood glucose, so the point where they bounce might be higher than a regulated cat. But thanks for the information, always welcome.

That is not necessarily true. A cat gets ketones/DKA because they are not getting enough insulin, enough food and an infection or an inflammation somewhere in the body. It is not just about high numbers. The electrolytes get out of kilter and the cat needs urgent vet care to rectify this. Most often the BG is high too but not always very high and not necessarily higher than other cats who don’t have DKA. . Many cats can have really high BGs in the 500s and never get ketones. Other cats are more prone to ketones. It is a matter of ‘know thy cat’ and if your cat has ever had ketones always be alert and test for ketones if they are unwell or unregulated.
Many cats get DKA at diagnosis and may or not have had prolonged high BGs. Other cats can get DKA when they get an infection and won’t eat and the caregiver doesn’t like to give insulin because the cat won’t eat and then you have the recipe for DKA which is not enough insulin, not enough food and an infection or inflammation.
Cats bounce for three main reasons…they drop too low, they drop fast or they drop lower than they are used to. A regulated cat is very unlikely to bounce because they are regulated and used to normal Bg numbers. Post DKA a cat does have to get used to more normal numbers….some cats bounce and some cats don’t. Whether a cat is a bouncer has nothing to do with DKA but more to do with how his body perceives the drop in numbers.

 

[Meredith Bear’s Mom]

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

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 plus you have to code it
A human meter is just fine, most of us use human meters ,that's what our numbers are based on


VIDEO: How to test your cat's blood sugar

Here is another link you can look at
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

So helpful. Thank you!

 

[Meredith Bear’s Mom]

It would be helpful if you can add more information to your signature, it's at the end of everyone's post in gray writing
Tap on this link it will explain about your signature, you can also tap on your name all the way up top and then tap on the word signature and add the rest of the information

HELP US HELP YOU

I will do this tomorrow once back on my laptop! I need to do more research on TR vs SLGS. Because his dosage has been changed so frequently I’m not quite sure what to put. Perhaps the consult with my vet on Monday will help.

 

[Meredith Bear’s Mom]

This is a link to one of our posts on home testing. I'm not sure if what Diane posted includes what's in this link.

What the ranges are for ketones depends on how you're testing. Most people will use urine test strips unless they feel like they need an up to the minute test. The urine test strips can be purchased at any pharmacy or online. The absorbent part of the strip will turn color and you match the strip to the color code on the container. Ketone meters are similar to a glucometer. The process for testing is identical -- you have strips and a ketone meter and you get a number that indicates the degree of ketones if present.

Thank you! I just bought a glucose and ketone meter in one.

 

[Meredith Bear’s Mom]

This is a link to one of our posts on home testing. I'm not sure if what Diane posted includes what's in this link.

What the ranges are for ketones depends on how you're testing. Most people will use urine test strips unless they feel like they need an up to the minute test. The urine test strips can be purchased at any pharmacy or online. The absorbent part of the strip will turn color and you match the strip to the color code on the container. Ketone meters are similar to a glucometer. The process for testing is identical -- you have strips and a ketone meter and you get a number that indicates the degree of ketones if present.

Perfect, thank you! Will check it out now.

 

[tiffmaxee]

On the ketone strips i have trace levels is the lowest that exists, doesn’t have a lower category, probably a difference in test strips between countries. It color codes it into categories. The lowest one is “trace levels”. If you get an actual meter though then yes, you want it reading zero. If you use the dip sticks like i do then you just want it in the lowest category, whatever they decide to call that (last pack i bought said “trace/neg”, the one before said trace, and the first ones i bought had 2 extra categories, the lowest said neg). But yes; i should’ve been clearer i suppose.

I didn’t say that they HAD to have DKA to bounce. I explained what a bounce was; my point was if a cat has DKA then they’ll be used to far higher blood glucose, so the point where they bounce might be higher than a regulated cat. But thanks for the information, always welcome.

This is not true. Cats bounce from having a lower BG than they are used to having. Once their body gets used to more normal BG many bounce less often. The BG that triggers a bounce will often be lower as they learn that their liver need nit panic in more normal numbers.

 

[Bron and Sheba (GA)]

@Meredith Small i am sorry we hijacked your thread but it’s important that any misinformation that is posted is corrected.

I see Bear got a 97 at +10 in the PM cycle. That’s great! would you mind putting what type of glucose meter you are using into the SS please.

To do TR you need to be feeding just low carb wet food and be able to test before every shot and again at least once during each cycle. You reduce the dose if it drops under 50 and you can increase the dose after 6 cycles if needed.

With SLGS you can feed dry food. You need to test before each dose and it is a good idea to test during the cycle if you are able to..
You need to do a curve after 7 days and if it is indicated you can increase the dose. You reduce the dose if BG drops under 90.

You can read more about the dosing methods HERE

 

[Diane Tyler's Mom GA]

So helpful. Thank you!

You're welcome

 

[Sienne and Gabby (GA)]

This is a link to information on ketones. There are two attached articles that discuss levels that are of concern for ketones being present -- you need to be concerned if levels are above 2.4 on a ketone meter.

If you really want to do a lot of homework, we have an information page with tons of links to information. Our Health Links/FAQ page is a great resource but you can spend days/weeks reading!

 

[Meredith Bear’s Mom]

This is not necessarily correct. With the blood ketone meter it often reads with ketones from 0 to 0.9 or sometimes higher and there is no concern. One also needs to be looking at the cat and seeing how the cat is….is he dehydrated, vomiting, lethargic, drinking a lot, weak, breathing fast. These are all red flags.
The latest information says that once the blood ketones meters read 2.4 to 2.55 then you need to take action
More information HERE

The Ketostix that most people use have a negative, trace, small, moderate, large and larger ketone colour. Like this

View attachment 65852

View attachment 65851
So we don’t want to see any ketones at all when we test. If we do that we have to be alert and tell the vet if they are more than a trace. Also monitoring the cat to see if he is unwell as listed above is also part of monitoring for ketones/DKA.

Just did my first test with the Ketone meter. I tried it twice and got .3 both times. I’ll try it again later too. Hoping that’s accurate. He didnt produce a lot of blood so hoping that didn’t affect it at all.

 

[Bron and Sheba (GA)]

Just did my first test with the Ketone meter. I tried it twice and got .3 both times. I’ll try it again later too. Hoping that’s accurate. He didnt produce a lot of blood so hoping that didn’t affect it at all.

Well done.
0.3 ketones on a blood meter is OK. No need to worry.

 

[Meredith Bear’s Mom]

Well done.
0.3 ketones on a blood meter is OK. No need to worry.

Thank you! I don’t know what I’d do without your help. I’ve actually been under the weather this weekend which is why I’ve been so slow to respond. I’m planning on opening up my laptop today to set up my signature and do some more digging. I hope you know how much we appreciate you!

 

[Bron and Sheba (GA)]

Thank you! I don’t know what I’d do without your help. I’ve actually been under the weather this weekend which is why I’ve been so slow to respond. I’m planning on opening up my laptop today to set up my signature and do some more digging. I hope you know how much we appreciate you!

I’m sorry you have been unwell. Hope you feel better soon.
I’m glad we can help you. Ask as many questions as you like.
He has had a lovely cycle this morning. Those black BGs were probably from a bounce. Very common in newly diagnosed cats.
Great to see you are putting information into the remarks column. Very helpful.
Such a beautiful boy.

 

[Meredith Bear’s Mom]

I’m sorry you have been unwell. Hope you feel better soon.
I’m glad we can help you. Ask as many questions as you like.
He has had a lovely cycle this morning. Those black BGs were probably from a bounce. Very common in newly diagnosed cats.
Great to see you are putting information into the remarks column. Very helpful.
Such a beautiful boy.

Thank you for your good wishes, feeling better And I think Bear is too! Tomorrow is our consult with our vet, will keep you posted!

 

[Meredith Bear’s Mom]

Welcome Bear is soooo adorable
weruva has low carb and low phospherous wet food
With weruva foods
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts.
https://weruva.com


For diabetic cats and cats that have elevated kidney values
You want to feed low phosphorous wet food

When you go to the weruva site and click on one of the pics of the food , click on Detailed Nutrition information that is under guaranteed analysis to the left
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS

Here is a list that one of our members posted ,if Bear likes pates

I don't know if the BFF play weruva pate is on the list your looking at or not. I wrote down the protein carbs & phosphorus #s in a notebook.
BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 129%
BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5%
Phosphorus 129%
BFF play chicken cherish
Protein 31%
Carbs 5%
Phosphorus 135%
BFF chicken & turkey tiptoe
Protein 31%
Carbs 5%
Phosphorus 136%
BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5%
Phosphorus 149%
BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 154%
BFF play chicken & duck destiny
Protein 32%
Carbs 5%
Phosphorus 165%
BFF play chicken & beef best buds
Protein 33%
Carbs 5%
Phosphorus 171%
Don't know if your kitty likes pate but here is the list of the BFF line.

Hi again! Looking at Weruva's website. They have new Rx food that is low phosphorous and 0% carb. Would this be something that would be good to try for him? @Bron and Sheba (GA) question for you too

 

[Bron and Sheba (GA)]

Hi again! Looking at Weruva's website. They have new Rx food that is low phosphorous and 0% carb. Would this be something that would be good to try for him? @Bron and Sheba (GA) question for you too

Can you post the link so we can see?

 

[Meredith Bear’s Mom]

Can you post the link so we can see?[/QUOTE

Yep! https://weruva.com/brand-summary/wx-phos-focused-foods/

 

[Bron and Sheba (GA)]

They look great! I’ve bookmarked that link for myself.
Much better than the prescription foods that are too low in protein.
Definitely try them and let us know how they go.

 

[Meredith Bear’s Mom]

@Bron and Sheba (GA) - he went in for his check-up yesterday. Vet said he is seeming to stabilize a bit and agrees with the food change to Wereuva. My partner is home sick so I left him with her today. She just called saying he had a BG of 67. Told her to give him some food and bit of honey and some dry treats. It's back to 90 after 15 minutes. Was his AMPS of 118 too low to give insulin?

 

[Chrispooky12]

@Bron and Sheba (GA) - he went in for his check-up yesterday. Vet said he is seeming to stabilize a bit and agrees with the food change to Wereuva. My partner is home sick so I left him with her today. She just called saying he had a BG of 67. Told her to give him some food and bit of honey and some dry treats. It's back to 90 after 15 minutes. Was his AMPS of 118 too low to give insulin?

@tiffmaxee

 

[Bron and Sheba (GA)]

@Bron and Sheba (GA) - he went in for his check-up yesterday. Vet said he is seeming to stabilize a bit and agrees with the food change to Wereuva. My partner is home sick so I left him with her today. She just called saying he had a BG of 67. Told her to give him some food and bit of honey and some dry treats. It's back to 90 after 15 minutes. Was his AMPS of 118 too low to give insulin?

Normally in the beginning we like you to get more data before shooting the lower numbers
BECOMING DATA READY TO SHOOT LOWER PRESHOT NUMBERS
When you start to shoot the lower numbers we suggest you get a +1 and / or a +2 so you can see how your kitty is handling the lower numbers.ie. Are they going to drop lower, or just stay flat or bounce. By testing early you can deal with any potential issues.
I’m glad someone was home to test. Bear is doing very well for a newly diagnosed FD kitty.
Because it was early in the cycle it is ok to give some higher carb food to bump the numbers up, but normally we don’t suggest feeding higher carb foods until the BG drops under 50 with TR.

 

[Meredith Bear’s Mom]

Normally in the beginning we like you to get more data before shooting the lower numbers
BECOMING DATA READY TO SHOOT LOWER PRESHOT NUMBERS
When you start to shoot the lower numbers we suggest you get a +1 and / or a +2 so you can see how your kitty is handling the lower numbers.ie. Are they going to drop lower, or just stay flat or bounce. By testing early you can deal with any potential issues.
I’m glad someone was home to test. Bear is doing very well for a newly diagnosed FD kitty.
Because it was early in the cycle it is ok to give some higher carb food to bump the numbers up, but normally we don’t suggest feeding higher carb foods until the BG drops under 50 with TR.

Hi! Thank you for this. This was a helpful read. He is holding steady around 164. If he continues to stay around that range for the evening (his shot time will be in 4 hours), would I shoot, or would I wait since I don't have a ton of data to help guide me either way?

 

[Bron and Sheba (GA)]

Hi! Thank you for this. This was a helpful read. He is holding steady around 164. If he continues to stay around that range for the evening (his shot time will be in 4 hours), would I shoot, or would I wait since I don't have a ton of data to help guide me either way?

Keep the SS updated and post the PMPS when you have it. If it is lower than you have shot before, stall, don’t feed and post and ask for help. And test again 20 minutes later. Change the subject line to indicate you need help for the preshot dose.
Indicate if you will be able to monitor the cycle if you shoot lower than normal, have higher carb food in the house if needed…these are the things we will want to know.
We don’t want you to skip the dose with DKA in the history.

 

[Meredith Bear’s Mom]

Keep the SS updated and post the PMPS when you have it. If it is lower than you have shot before, stall, don’t feed and post and ask for help. And test again 20 minutes later. Change the subject line to indicate you need help for the preshot dose.
Indicate if you will be able to monitor the cycle if you shoot lower than normal, have higher carb food in the house if needed…these are the things we will want to know.

Got it! Thanks!

 

[Bron and Sheba (GA)]

Looking at the SS there is no data or a dose given for last night or any monitoring of the cycle.
Did you give it but forget to add it in?

 

[Meredith Bear’s Mom]

Looking at the SS there is no data or a dose given for last night or any monitoring of the cycle.
Did you give it but forget to add it in?

You're correct. My partner still has the monitor. I had her send over pictures and added it in. It is there now.

 

[Bron and Sheba (GA)]

You're correct. My partner still has the monitor. I had her send over pictures and added it in. It is there now.

Thanks. Those black numbers are from bouncing as he is not used to the lower numbers again yet and his body thinks he needs to panic. I sent you information about bouncing in Post 5 above. Don’t be surprised if he bounces from the 67 today. All perfectly normal for a newly diagnosed FD kitty. You are doing a good job looking looking after Bear.

 

[Meredith Bear’s Mom]

Thanks. Those black numbers are from bouncing as he is not used to the lower numbers again yet and his body thinks he needs to panic. I sent you information about bouncing in Post 5 above. Don’t be surprised if he bounces from the 67 today. All perfectly normal for a newly diagnosed FD kitty. You are doing a good job looking looking after Bear.

Phew! Okay! Thank you so much