14th Feb New Member Herman and Lisa

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Lisa AG

Lisa AG

Member Since 2023
Hi FDMB! Short term lurker, first time poster.

Herman is an 11yo domestic long-haired cat who I raised from 10 days old. Herman was displaying symptoms such as insatiable appetite, increased thirst and frequent, large quantity of urine in August 2021. Took him to the vet and he was diagnosed with FD. He was placed on insulin glargine at 1IU, slowly increasing with vet supervision using only fructosamine checks to 2.5IU until he had a hypo on 29/01/2022. He was taken off insulin until symptoms returned with a blood draw at the vets on 18/05/2022. He was put on 2IU and has been on this dose since. He had eaten the same diet for years, Science Diet Urinary Care C/D Stress (dry kibble). Vet wanted to keep him on this due to a history of crystals and being in a multi-cat household. He hasn't had urinary issues in years.

Recently (in the last month) my husband and I have noticed neuro signs (weakened hind legs, splayed walking) along with increased thirst/urination. I had been lurking on the FDMB Facebook page for quite a while but had not started home testing as per my vet’s instructions. I decided it was time to switch him over to a low carb wet food and to start home testing because I was unhappy with his decline and knew we could do better by him.

Herman's SS is in my signature. I am not quite sure where to go from here. Should we keep the 2IU for now? He seems to be bouncing all over the place and I have not been able to give him his regular 2IU dose for more than 3 cycles in a row. Just hoping for some guidance on what his numbers mean. I have seen him with a hypo and I never want to have that happen again if we can avoid it.

Currently waiting on delivery of the freestyle libre (on vet suggestion) to get some solid data to make choices with.
 
Hi and welcome to the forum Lisa and Herman!
Great you have the SS and signature set up…thank you.
I’m glad you swapped to a low carb diet. The C/D dry food you were feeding was very high carb.
A wet low carb diet would be much better for any urinary issues as it has a lot more moisture in it than dry.
Because of the change in diet, he will most likely be needing less insulin.
You look as if you are testing absolutely fine so I can’t see the necessity for a Libre.

A couple of comments about the SS:
Great you are putting information into the remarks column.
I would try and get at least one test in every pm cycle as they are just as important as the am cycle. A before bed test is a good habit to get into. If that test is lower than the Preshot test, you might need to get up and test later to see it hasn’t dropped too low.
I can see you are doing the SLGS method. With that method if the BG drops under 90, you need to reduce the dose by 0.25 units. So I would reduce the dose to 1.75 units and see if you can shoot both cycles with that dose. I can see you have skipped some cycles because of a lower preshot.
Lantus likes consistence so try not to chop and change the dose unless the BG drops under 90. Lantus dosing is based on the nadir or lowest point in the cycle not the preshot BG

If you find the pre shot is lower than normal, stall, don’t feed, and test again in 20 minutes. And post and ask

Read the yellow stickies at the top of the Lantus page. Once we get you set up properly and sorted I will get you to start losing over there. In the meantime you can read the stickies as they have lots of great information in them
LANTUS PAGE YELLOW STICKIES
 
The issue with his back legs is called neuropathy and it’s common in unregulated cats. Minnie had it and it was pretty severe but she recovered almost completely once she was regulated. It happens because all the excess sugar starts attacking the nerves and damaging them. Once the sugar in the bg is regulated, the nerves start to regenerate

Also just wanted to make sure you’re feeding him more than just twice a day. Some vets still advise that but cats are grazers and do much better with smaller meals throughout the day

welcome!!! :bighug::bighug::bighug:
 
Lisa AG said:
Recently (in the last month) my husband and I have noticed neuro signs (weakened hind legs, splayed walking) along with increased thirst/urination. I had been lurking on the FDMB Facebook page for quite a while but had not started home testing as per my vet’s instructions. I decided it was time to switch him over to a low carb wet food and to start home testing because I was unhappy with his decline and knew we could do better by him.
Click to expand...

While getting the blood glucose under control as soon as possible, many of us use Methyl B-12 which, along with getting the BG down, can help the nerves regenerate faster.

You can use any Methyl B-12 (only the Methyl form works on neuropathy) as long as it doesn't contain any sugars or xylitol. Some people use Zobaline for Cats, but it's gotten expensive. Zobaline contains 3000mcg of Methyl B-12. You can get 5000mcg of Methyl B-12 from Amazon. B-12 is a water-soluble vitamin so any the body doesn't use is just peed out.

The B-12 shots your vet might offer are a different form of B-12 that doesn't help with neuropathy. It's used more for helping with appetite and energy levels.
 
Thanks everyone!

This evening, PMPS was 167 mg/dL. I waited 20 mins and tested again and it was still 167. He has not yet been fed. What should I do?

Edit: tested at 8.50pm and it's at 164 so it's going down. I'm going to skip this shoot and start fresh tomorrow morning with 1.75iu if his numbers allow. It looks like my boy gets a late nadir as this is the third time this has happened. I'll check the thread before I go to bed in case anyone has a suggestion for tonight that differs from what I've decided to do.
 
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I'm sorry I didn't see this earlier. I must have just missed it when checking.
Its good you stalled. It isn't uncommon for the kitty's BG to drop because he needs to eat.
I'm future if no-one answers you you can look up the SLGS method. In fact it would be a good idea to print it off so you have it there in case you need it.
From the SLGS dosing method:

My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
So you can see you could have given a token dose. But skipping is OK too. The only time we would not like you to skip a dose is when your kitty has a history of ketones.
Once you reduce the dose you will hopefully find that you can shoot both am and PM doses. if you are consistently finding you are having to skip a dose because of a low preshot...then the dose may need to be reduced so you can shoot both doses. This happens sometimes to new kitties when the dose has been started too high or in your case where you have changed the food to a low carb diet..
 
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