New Member 11/10/23

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Kat & Elsie

Kat & Elsie

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Hello! I've been lurking and learning for a couple of months. Finally had the chance to make my first post! This might be a bit of an info dump, my apologies in advance.

My kitty, Elsie, was diagnosed in September. Vet prescribed 1 unit glargine (I haven't posted in the Lantus forum yet but I plan to get over there). At first I was using the pen needles, just to get used to giving the shots, and to overcome one learning curve at a time, since I was pretty overwhelmed (I know you all recommend the syringes). I got the Relion home meter everyone here uses. I have not been consistent with home testing, but I did some when I remembered, even have a sparsely-filled spreadsheet setup.

After about a month of seeing no change in symptoms or numbers on the single unit, I did take her in to the vet to have them run a curve, as they had requested (was supposed to be after 7-10 days, but I was busy researching since the vet was not as helpful as I'd have liked, no surprise there I'm sure, and her numbers didn't seem to be dropping into dangerous territory).

The numbers were still at the same elevated levels she had upon DX (upper 300s on the vet's pet meter, always mid-upper 200s on my human meter), so the vet upped her dose to 2 units. It was about a week before Halloween that her dose was raised. I went ahead and finished off the box of pen needles I had, and, feeling more comfortable with the routine by this point, decided to switch to the syringes. I didn't ever feel sure the pen needle shots were accurate, either due to pen or user error.

After 2 weeks of 2 unit doses, and possibly also due to the more properly accurate dosage after switching to syringes, I remembered that I should be testing more consistently. Of course the vet wanted another curve, but I decided I should run one myself today. For the first time since starting insulin, Elsie's numbers are not only under 200 (human meter), they dropped under 100! This is good news, but of course I now know I absolutely must be more diligent and informed, so as to avoid hypo. I honestly was not expecting such a dramatic change in such a short time. And so I have come to you all, finally.

Before she was officially DX'd, I had started to suspect diabetes as a possible cause of her sypmtoms (insatiable appetite, litter box troubles, back leg neuropathy), although I wasn't sure. She's a bit overweight as it is (12-13 pounds she carries all in her middle), and has always been very food-motivated. So just in an effort to try and get her to shed some weight for her general health, I had switched her over to all wet/low carb meals. She gets approximately 3 small (avg. 3 oz) cans of food per day, either Fancy Feast Classic pate or Tiki Cat After Dark, usually she gets some of each in a day. 1 can for breakfast, 1 for dinner, and 1 can split into 2 mid-day snacks. She does occasionally get a bite of our other cat's kibble, but we try to watch and put his food up after he's done. We no longer intentionally feed her anything dry. She also gets freeze-dried treats after every test & shot (just one little treat).

I don't know if I covered, or over-covered, everything, but I look forward to receiving more guidance from everyone here. The site has been very helpful in educating me so far; I've read everything I could, but I'm definitely still new to this whole thing. Let me know if you need more information, and thank you!

Edit: I forgot to ask if I should change the dose now that I have some green numbers? Or should I stick with 2 units?
 
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Welcome to FDMB!

You really have done your homework!

As for dosing, there's not a straightforward answer to your question. Rather, it depends on which dosing method you choose. With glargine, there are two options -- Start Low Go Slow (SLGS) and Tight Regulation (TR). They differ as to at what point you reduce the dose (numbers lower than 90 with SLGS; numbers lower than 50 with TR). The methods also differ with respect to how long a dose is held. I've linked the information on dosing. If Elsie is eating any dry food, your only option is SLGS. We also change doses in 0.25u increments.

With both dosing methods you need to be testing a minimum of 4 times per day. You always need to test before you give a shot. It's important to know if it's safe to give insulin. You also want to get at least one test during both the AM and PM cycle. We strongly advise getting a "before bed" test every night. That way, you're able to go to sleep not worrying if your cat's numbers are crashing.

As far as food, have you given any thought to feeding your cats the same diet? A low carb diet is completely appropriate for all cats given that they are obligate carnivores. Feeding your cats the same food means you don't have to keep hiding the kibble. (I drove myself nuts having my 2 cats on different foods. Gabby was very food motivated and would always try to eat my other cat's food. Someone here suggested I feed them the same thing. It make life much easier!)

There are several sticky notes at the top of the Lantus forum. I'd encourage you to read them over.
 
Sienne and Gabby (GA) said:
As far as food, have you given any thought to feeding your cats the same diet? A low carb diet is completely appropriate for all cats given that they are obligate carnivores. Feeding your cats the same food means you don't have to keep hiding the kibble. (I drove myself nuts having my 2 cats on different foods. Gabby was very food motivated and would always try to eat my other cat's food. Someone here suggested I feed them the same thing. It make life much easier!)
Click to expand...

Food-wise, for now, we are doing what we can. Our other cat, Alex, is 17 with kidney disease. And, unlike Elsie, who will eat anything even slightly resembling food, he is a very finicky eater. I've read over some food charts, and I'm on a continuous mission to find a wet food that is low enough in carbs for her, AND low enough in phosphorus for him, AND that he will actually eat. It's a struggle, and with Alex we've decided that eating *something* is better than him eating nothing. His dry food is prescription Royal Canin Renal Care, which has been helping to stabilize his kidney levels. He won't touch the Rx wet anymore, and it's too high carb for Elsie anyway. I tried some different suitable-for-both wet cans, but it's a crap shoot whether or not he'll eat them on any given day; he turns his nose up at most. He loves the Fancy Feast beef flavor, but it's got too much phosphorus for him to eat it on a regular basis. He does get some wet food at night, even if it's bad for him, because at least he's eating. But I don't want to stress his kidneys too much.

We really don't feed Elsie dry food on purpose, she doesn't usually get many nibbles in, if we fail to pick up the bowl in time. But it does happen. I'm hoping that once she is better regulated, her appetite will calm down and she won't be as much of a food-stealing bully. It was getting really out of hand there for a while, I felt so bad for her.

I will definitely read through more of the Lantus board info, I plan to do that tonight.

Thank you! I'm about to check BG again to update the spreadsheet & continue with today's curve.
 
Red & Rover (GA) said:
0Have you looked into aluminum hydroxide powder for phosphorous control in CKD cats? - though Elsie should not take it. Are they fed separately?

https://felinecrf.org/phosphorus_binders.htm
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I've read about phosphorus binders, but we haven't tried that yet. It might be a step we take soon, although that doesn't make it any easier to just feed both cats the same thing.

Yes, they are fed separately now. Alex in particular prefers to free-feed, so our compromise has been to put out small quantities of food at a time when he wakes up hungry. That way, if Elsie somehow manages to get into the bowl, she doesn't get more than a few pieces of kibble, rather than finishing off the entire thing.
 
Kat & Elsie said:
Food-wise, for now, we are doing what we can. Our other cat, Alex, is 17 with kidney disease. And, unlike Elsie, who will eat anything even slightly resembling food, he is a very finicky eater. I've read over some food charts, and I'm on a continuous mission to find a wet food that is low enough in carbs for her, AND low enough in phosphorus for him, AND that he will actually eat. It's a struggle, and with Alex we've decided that eating *something* is better than him eating nothing. His dry food is prescription Royal Canin Renal Care, which has been helping to stabilize his kidney levels. He won't touch the Rx wet anymore, and it's too high carb for Elsie anyway. I tried some different suitable-for-both wet cans, but it's a crap shoot whether or not he'll eat them on any given day; he turns his nose up at most. He loves the Fancy Feast beef flavor, but it's got too much phosphorus for him to eat it on a regular basis. He does get some wet food at night, even if it's bad for him, because at least he's eating. But I don't want to stress his kidneys too much.
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What stage CKD is Alex at? Look at Weruva. They have a large variety of flavours and textures that are both low carb and low phosphorus and they put their nutritional information on their website for every single one! In kibble, both Young Again and Dr. Elsey's kibble are low carb and low phos (under 1% on a dry matter basis).
 
Ale & Bobo & Minnie (GA) said:
@Diane Tyler's Mom has a list of diabetic friendly low phosphorus wet foods she can give you to try
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I look forward to seeing the list. Most of the food charts I've seen here, while I'm following them as closely as I can, seem like they might need to be updated. Brands changing flavor names, etc. But they are still amazing to have! So far I've checked some local pet stores, and have found some available. He only likes 2 of the flavors I've tried, and only sometimes. Checking online will be my next plan I think.
 
Bandit's Mom said:
What stage CKD is Alex at? Look at Weruva. They have a large variety of flavours and textures that are both low carb and low phosphorus and they put their nutritional information on their website for every single one! In kibble, both Young Again and Dr. Elsey's kibble are low carb and low phos (under 1% on a dry matter basis).
Click to expand...
That is a good question. I don't recall the vet giving us a stage, although it seemed like it was not too advanced the last time his levels were checked. Although I think he may be due to have those numbers reevaluated soon.

I've tried a few different flavors of Weruva, including some specifically labeled as low phosphorus, and he wants nothing to do with them. But I will keep trying.
 
Ale & Bobo & Minnie (GA) said:
@Diane Tyler's Mom has a list of diabetic friendly low phosphorus wet foods she can give you to try
Click to expand...
Weruva Pates
They are low carb and low phosphorus which is good for kitties
You can probably pick up some of these in Pet smart ,or Petco so you can try them out to see if your kitty likes them

BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 133%

BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5.20%
Phosphorus 134%

BFF play chicken cherish
Protein 31%
Carbs 4.90%
Phosphorus 132%

BFF chicken & turkey tiptoe
Protein 31%
Carbs 5.10%
Phosphorus 133%

BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5.20%
Phosphorus 152%

BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 152%

BFF play chicken & duck destiny
Protein 32%
Carbs 5.10%
Phosphorus 163%

BFF play chicken & beef best buds
Protein 33%
Carbs 5.30%
Phosphorus 175%

Don't know if your kitty likes pate but here is the list of the BFF line.
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS

Also

https://www.amazon.com/Weruva-Focus...cphy=9003521&hvtargid=pla-1796056536677&psc=1

I know you can buy single cans of the BFF I listed at Petco, Petco, to see which ones your kitty likes , the Focused one not to sure
71WqJPQiM2L.__AC_SX300_SY300_QL70_FMwebp_.jpg




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.


You can even check out the soulistic pates
https://www.soulisticpet.com/pate
When you click on one of the flavors then click on
COMPLETE NUTRITIONAL INFORMATION (link to page)
and look at the same two places like on the weruva site
 
Diane Tyler's Mom said:
Weruva Pates
They are low carb and low phosphorus which is good for kitties
You can probably pick up some of these in Pet smart ,or Petco so you can try them out to see if your kitty likes them

BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 133%

BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5.20%
Phosphorus 134%

BFF play chicken cherish
Protein 31%
Carbs 4.90%
Phosphorus 132%

BFF chicken & turkey tiptoe
Protein 31%
Carbs 5.10%
Phosphorus 133%

BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5.20%
Phosphorus 152%

BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 152%

BFF play chicken & duck destiny
Protein 32%
Carbs 5.10%
Phosphorus 163%

BFF play chicken & beef best buds
Protein 33%
Carbs 5.30%
Phosphorus 175%

Don't know if your kitty likes pate but here is the list of the BFF line.
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS

Also

https://www.amazon.com/Weruva-Focus...cphy=9003521&hvtargid=pla-1796056536677&psc=1

I know you can buy single cans of the BFF I listed at Petco, Petco, to see which ones your kitty likes , the Focused one not to sure
71WqJPQiM2L.__AC_SX300_SY300_QL70_FMwebp_.jpg




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.


You can even check out the soulistic pates
https://www.soulisticpet.com/pate
When you click on one of the flavors then click on
COMPLETE NUTRITIONAL INFORMATION (link to page)
and look at the same two places like on the weruva site
Click to expand...
Thank you so much!! I will definitely try some more of these. I hadn't tried the BFF yet, maybe he'll actually eat some of it. I have found a local small pet store that carries individual cans of the Focused. I bought 4 different flavors, so far we've tried two of them with mixed reviews from Alex. He's such a picky old man, set in his ways.

I appreciate the extra info about how to find the right nutrients on the charts, they definitely don't make it easy on us lol.
 
Kat & Elsie said:
Thank you so much!! I will definitely try some more of these. I hadn't tried the BFF yet, maybe he'll actually eat some of it. I have found a local small pet store that carries individual cans of the Focused. I bought 4 different flavors, so far we've tried two of them with mixed reviews from Alex. He's such a picky old man, set in his ways.

I appreciate the extra info about how to find the right nutrients on the charts, they definitely don't make it easy on us lol.
Click to expand...
Your welcome Kat , I hope they will both like one of the BFF :cat:
 
One other option is they now make a microchip activated feeder. They either work off of your cat's microchip (if your cat is chipped) or a microchip they provide that you can put on a collar. It keeps the "other" cat out of a kitty's food. My kitty who's afraid of her own shadow wouldn't use it, though.
 
Kat & Elsie said:
That is a good question. I don't recall the vet giving us a stage, although it seemed like it was not too advanced the last time his levels were checked. Although I think he may be due to have those numbers reevaluated soon.

I've tried a few different flavors of Weruva, including some specifically labeled as low phosphorus, and he wants nothing to do with them. But I will keep trying.
Click to expand...
Bobo is on stage 2 and his IM says it’s too early for a binder. I believe it’s something used for stage 3 and beyond.
 
Sienne and Gabby (GA) said:
One other option is they now make a microchip activated feeder. They either work off of your cat's microchip (if your cat is chipped) or a microchip they provide that you can put on a collar. It keeps the "other" cat out of a kitty's food. My kitty who's afraid of her own shadow wouldn't use it, though.
Click to expand...
I've seen those, however, neither cat is chipped and they refuse to wear collars. Especially Alex our CKD boy, he'll scratch his neck raw trying to get it off.
 
Every cat is different but CKD seems to be a very slow to progress disease. Bobo’s numbers were actually better at his last visit in august than the previous one in March. I didn’t even know that was possible. He’s been on his regular food because he refuses to eat anything but FF. I do add water to every one of his meals and some of the snacks too. I also started him on subq fluids once a week even thought it’s not really needed just yet. He’s also very good about drinking lots of water on his own. Someone already said that here but helping with the water intake seems to be super helpful. Anyway, to give you an idea, he’s been on stage 2 for over 2 years now.
 
Ale & Bobo & Minnie (GA) said:
Every cat is different but CKD seems to be a very slow to progress disease. Bobo’s numbers were actually better at his last visit in august than the previous one in March. I didn’t even know that was possible. He’s been on his regular food because he refuses to eat anything but FF. I do add water to every one of his meals and some of the snacks too. I also started him on subq fluids once a week even thought it’s not really needed just yet. He’s also very good about drinking lots of water on his own. Someone already said that here but helping with the water intake seems to be super helpful. Anyway, to give you an idea, he’s been on stage 2 for over 2 years now.
Click to expand...
 
Sorry to be off topic if I am, but I have a cat with kidney disease, and if I give her 50 or 100 ml once a week or twice a week, do you need to throw away the other 900 ml in the bag? I heard they only last 7 days once "opened". I would like to know, if I ever go there.
 
Nope. It lasts at least 30 days when kept in the fridge but you’ll need to warm it up in hot water before administering. Cold fluid doesn’t feel great going in.
 
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