Newbie, glucose extremely low after sub q normsol injection

[Ray_williams]

Hello everyone, today is November 16th of 2023.

My name is Ray, my Cody is newly diagnosed. He also has kidney failure, we have installed a libre on him.

With that out of the way, here is our problem: every time we give the normosol (normally within 2 hours of the insulin shot, Cody’s glucose will drop to extreme levels within few hours, i.e from 300s to 40s and 20s one time. He did not show any symptoms of hypoglycemia, but we do not know what happened. As you could imagine this is very scary. Anyone faced similar challenges please help. Thank you so much for any assistance and advice.

 

[Diane Tyler's Mom GA]

Hello everyone, today is November 16th of 2023.

My name is Ray, my Cody is newly diagnosed. He also has kidney failure, we have installed a libre on him.

With that out of the way, here is our problem: every time we give the normosol (normally within 2 hours of the insulin shot, Cody’s glucose will drop to extreme levels within few hours, i.e from 300s to 40s and 20s one time. He did not show any symptoms of hypoglycemia, but we do not know what happened. As you could imagine this is very scary. Anyone faced similar challenges please help. Thank you so much for any assistance and advice.

I can tag a few members for you,
@Suzanne & Darcy
@Wendy&Neko
@tiffmaxee
@Bandit's Mom
@Sienne and Gabby (GA)

 

[Ray_williams]

I can tag a few members for you,
@Suzanne & Darcy
@Wendy&Neko
@tiffmaxee

Thank you so so much!

 

[Red & Rover (GA)]

Two hours after an insulin injection is when most insulins start to kick in.

What insulin and how much are you giving?

A number of people on the forum balance the combination of diabetes and kidneys. We can help.

Tagging someone who uses Normosol
@Dyana

Also, some very important reading for you. An asymptomatic hypo can become symptomatic one in a split second.

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

 

[Ray_williams]

Two hours after an insulin injection is when most insulins start to kick in.

What insulin and how much are you giving?

A number of people on the forum balance the combination of diabetes and kidneys. We can help.

Tagging someone who uses Normosol
@Dyana

Also, some very important reading for you. An asymptomatic hypo can become symptomatic one in a split second.

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

Thank you for the information.
We have the Lantis, doctor said to give him 7 units per injection, so 14 units per day. We will start the purina DM diet for him today, for about 2 years now, he was on KD.

 

[Diane Tyler's Mom GA]

Thank you for the information.
We have the Lantis, doctor said to give him 7 units per injection, so 14 units per day. We will start the purina DM diet for him today, for about 2 years now, he was on KD.

That seems like a lot of insulin to give, how many units was Cody started on?
If Cody has kidney disease it's best to feed low carb and low phosphorus wet food such as
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

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 GA]

It would be helpful if you can do what we call our signature and our spreadsheet
Tap on the blue link
Hereis the link so you can set up your signature and spreadsheet or you can just tap on your name up top, then tap on signature add the information below and tap Save
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

The signature is at the end of everyone's post in gray ,information about our cats

• 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.

Also almost all of us use human meters that's what our numbers are based on


Just to show you about the Spreadsheet
Don't be nervous about the 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



You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it

If you need setting up the spreadsheet just ask we have a member who will be happy to do it for you

 

[Red & Rover (GA)]

Thank you for the information.
We have the Lantis, doctor said to give him 7 units per injection, so 14 units per day. We will start the purina DM diet for him today, for about 2 years now, he was on KD.

Seven units is an awful lot. No wonder you are seeing very low numbers. The dose is too high.

Can you hold off on the diet change until after you get a spreadsheet set up?
A change food has to be made very gradually. Just switching to low carb food can drop numbers overall by up to 100. And the KD, if I remember correctly, runs about 37% carbs. Low carb is under 10%.

Tagging @Wendy&Neko @tiffmaxee

 

[Wendy&Neko]

What dose did Cody start on? As others have said, 7 units is a large dose, we usually start around 1 unit here - depending somewhat on cat weight. Typically it takes a few months to get up to 7 units. If a cat gets to the 20's or 40's on a dose, that shows you the dose is way too high and needs to be reduced.

Have you ever tried giving fluids a couple hours before the evening dose? The typical Lantus curve is a downwards curve to the middle of the cycle, then going back up. Some cats do respond with lower numbers when they get fluids. For that reason, I gave fluids in the afternoon, when the blood sugar numbers were going up on their own.

 

[Ray_williams]

What dose did Cody start on? As others have said, 7 units is a large dose, we usually start around 1 unit here - depending somewhat on cat weight. Typically it takes a few months to get up to 7 units. If a cat gets to the 20's or 40's on a dose, that shows you the dose is way too high and needs to be reduced.

Have you ever tried giving fluids a couple hours before the evening dose? The typical Lantus curve is a downwards curve to the middle of the cycle, then going back up. Some cats do respond with lower numbers when they get fluids. For that reason, I gave fluids in the afternoon, when the blood sugar numbers were going up on their own.

Thank you for the reply, I will get the spreadsheet done, to your questions: Cody started on 3, and doctor raised to 5after three days, then to 6and 7 after few days, cause his number is upper 400s or just “HI” in libre. Then she told us just keep to 7 if we give dry food. I would like to gradually decrease the dosage if the number is under control, but he has been having those crazy swings of the number during this past three weeks. Will definitely try to do the fluid in the afternoon and see what will happen.
Thank you again for the information.

 

[Ale & Bobo & Minnie (GA)]

Echoing what everyone said but also these were big increases and done way too fast. I’d keep everything the same till you have the spreadsheet set up and we can give you dosing advice. The dry food is likely what’s keeping him safe right now but ideally you’ll want to transition him off the dry food and to low carb foods only. But again, not until we can see the data you’ve gathered. We don’t dose here by the preshot values or the high values but by the lowest the dose is taking your cat. The high numbers could be from bouncing after going too low which is the body’s defense against a potential hypo. Lantus is a great insulin, but his dose is likely too high if you’ve seen numbers below 50.

I’d also recommend you read all the yellow sticky notes on the Lantus forum, especially the one about our dosing methods. With the dry in the mix, you’d have to follow the SLGS method:

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

you’ll also want to consider getting a back up meter since the libre can be glitchy on those low numbers.

Unfortunately most vets do not know a lot about feline diabetes….they have many animals to look after and they all have different diseases and treatments. A dry high carb diet is not good for any cat, especially a diabetic cat. That’s like feeding your diabetic child a diet of chips, ice cream and sweets. With a diabetic cat you need a low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs and Diane gave you some great options for CKD as well above.

Don’t worry, you’ve come to the right place and we can help!

 

[Wendy&Neko]

Cody started on 3, and doctor raised to 5after three days, then to 6and 7 after few days, cause his number is upper 400s or just “HI” in libre. Then she told us just keep to 7 if we give dry food. I would like to gradually decrease the dosage if the number is under control, but he has been having those crazy swings of the number during this past three weeks. Will definitely try to do the fluid in the afternoon and see what will happen.

Lantus is a depot style insulin, meaning it takes several days before you see the impact of a dose. Our dosing methods have you hold the initial dose 5-7 days (depending on the blood sugar results and dosing method being used), before you think about increasing. Your vet increased both too quickly and by too much. We also dose based on how low the dose takes the cat, and anything below 50 is too low. 20's means a hypo and it's too dangerous to keep him at a dose that might take him there.

What was likely happening with those high numbers was Cody's body working to protect himself from too much insulin. Here is our definition of what we call 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).

As you can see by the above, his body saw those 40's or worse, 20's, and dumped glucogen or counter regulatory hormones to protect himself, causing those high numbers. Too high a dose is what is causing those crazy swings in numbers. The concern is that next time, he will see a clinical hypo. A couple documents you might want to keep on hand:
Symptoms of & how to treat HYPOGLYCEMIA - what to do if your kitty experiences hypoglycemia
Jojo's Hypo Tool box - be prepared, what to have on hand in case of an emergency

 

[Diane Tyler's Mom GA]

I agree with Ale to get a back up meter since the numbers on the Libre can be glitchy on those low numbers such as
Most of us use the Relion human meter from Walmart
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

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 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar

Do you have the U-100 syringes with the half unit markings ?

For your Hypo kit
Med and High Carb food and some honey/karo
If you can get these where you live


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

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

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

 

[Ale & Bobo & Minnie (GA)]

Lantus is a depot style insulin, meaning it takes several days before you see the impact of a dose. Our dosing methods have you hold the initial dose 5-7 days (depending on the blood sugar results and dosing method being used), before you think about increasing. Your vet increased both too quickly and by too much. We also dose based on how low the dose takes the cat, and anything below 50 is too low. 20's means a hypo and it's too dangerous to keep him at a dose that might take him there.

What was likely happening with those high numbers was Cody's body working to protect himself from too much insulin. Here is our definition of what we call 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).

As you can see by the above, his body saw those 40's or worse, 20's, and dumped glucogen or counter regulatory hormones to protect himself, causing those high numbers. Too high a dose is what is causing those crazy swings in numbers. The concern is that next time, he will see a clinical hypo. A couple documents you might want to keep on hand:
Symptoms of & how to treat HYPOGLYCEMIA - what to do if your kitty experiences hypoglycemia
Jojo's Hypo Tool box - be prepared, what to have on hand in case of an emergency

@Red & Rover (GA) shared these links on post #4

 

[Sienne and Gabby (GA)]

I absolutely agree with what Wendy posted.

In addition, giving fluids can further drop blood glucose. Essentially, your diluting the glucose that's in your cat's bloodstream.

 

[Ray_williams]

I absolutely agree with what Wendy posted.

In addition, giving fluids can further drop blood glucose. Essentially, your diluting the glucose that's in your cat's bloodstream.

That was what we suspecting, thank you for confirming this.

 

[Ray_williams]

To all, thank you for all the advices, I have filled out the Spreadsheet, hope this would give a somewhat completed picture.

 

[Ray_williams]

That seems like a lot of insulin to give, how many units was Cody started on?
If Cody has kidney disease it's best to feed low carb and low phosphorus wet food such as
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

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

Thank you for the list, I will look into these.

 

[Ray_williams]

I agree with Ale to get a back up meter since the numbers on the Libre can be glitchy on those low numbers such as
Most of us use the Relion human meter from Walmart
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

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 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar

Do you have the U-100 syringes with the half unit markings ?

For your Hypo kit
Med and High Carb food and some honey/karo
If you can get these where you live


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

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

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

Definitely helpful, Cody is sooo stressed these few days, don't even play with me anymore, just give me the stares...

 

[Diane Tyler's Mom GA]

@Ray_williams
Ray I was looking at your spreadsheet and noticed you have using meter calibrated for feline blood (eg Alpha Trak ) listed up top. But where it asks what type of meter you are using you have Libre Freestyle there.
The Libre is actually considered a human meter so the 2 color coding up top need to be changed so they reflect that . The Dark green should be 50-99
The lime green should be BG<50
I will tag Bhooma
@Bandit's Mom to get in touch with you so she can fix it
Can you set up your signature instructions are in my post #7 . Post numbers are to the right of each post.

@Bandit's Mom

 

[Diane Tyler's Mom GA]

Have you read the link for Lantus ?
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Since you are feeding some kibble you will have to follow SLGS method
The link will explain the dosing methods. Anytime Cody's BG drops under 50 you need to reduce by 0.25 units .I see he did drop to 47 on 11-12

Just keep in mind if you are going to transition to all low carb and low phosphorus wet since Cody has kidney disease you need to transition slowly and need to be testing like you have been and recording the BG numbers on your spreadsheet
@Ray_williams

 

[Diane Tyler's Mom GA]

@Ray_williams
Ray I gave you suggestions for med and high carb foods for your hypo kit
They are OK but the phosphorus is higher since Cody has kidney
Well I found 2 of the Weruva that are higher carbs but still low phosphorus in case you ever need to bring Cody's BG numbers up

They are Grandma's Chicken Soup carbs 20.70 carbs. Phosphorus is 193

Funky Chunky. Carbs 19.50
Phosphorus 201
But you can still stick with the Fancy Feast Gravy Lovers that I listed above because I'm sure you won't have to feed that much of it to bring his BG up if needed and you won't be feeding tons of it,

 

[Ray_williams]

@Ray_williams
Ray I was looking at your spreadsheet and noticed you have using meter calibrated for feline blood (eg Alpha Trak ) listed up top. But where it asks what type of meter you are using you have Libre Freestyle there.
The Libre is actually considered a human meter so the 2 color coding up top need to be changed so they reflect that . The Dark green should be 50-99
The lime green should be BG<50
I will tag Bhooma
@Bandit's Mom to get in touch with you so she can fix it
Can you set up your signature instructions are in my post #7 . Post numbers are to the right of each post.

@Bandit's Mom

Oops, I will fix it ASAP.

 

[Wendy&Neko]

I'm glad to see you reduced the dose to 6.5 units. When cats are on larger doses (over 5 units), we'll usually say that reductions should be by half a unit at a time. The smaller reductions (1/4 unit) are for smaller doses.

I see you have also started to switch the food. Besides the KD wet and dry, is the DM dry you are feeding the Purina one you get from the vet? It's dietetic management, not diabetic management, so not a great food for diabetics. The carb levels in DM are too high. It's OK to feed it to start if your cat likes the food, as it'll just slowly reduce the amount of carbs Cody is getting. Note, when you make food changes lowering the carbs, it can take several days before you start seeing changes in the blood sugar, so try to keep the same portions of food for at least 3 days before you make any more changes in the food.

 

[Ray_williams]

I'm glad to see you reduced the dose to 6.5 units. When cats are on larger doses (over 5 units), we'll usually say that reductions should be by half a unit at a time. The smaller reductions (1/4 unit) are for smaller doses.

I see you have also started to switch the food. Besides the KD wet and dry, is the DM dry you are feeding the Purina one you get from the vet? It's dietetic management, not diabetic management, so not a great food for diabetics. The carb levels in DM are too high. It's OK to feed it to start if your cat likes the food, as it'll just slowly reduce the amount of carbs Cody is getting. Note, when you make food changes lowering the carbs, it can take several days before you start seeing changes in the blood sugar, so try to keep the same portions of food for at least 3 days before you make any more changes in the food.

Yes, our vet suggested us to switch to the DM dry diet, so we have the prescription with one of the online stores. I will definitely careful for the portion control. Should I try to switch him to 100% can food?

 

[Ray_williams]

I agree with Ale to get a back up meter since the numbers on the Libre can be glitchy on those low numbers such as
Most of us use the Relion human meter from Walmart
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

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 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar

Do you have the U-100 syringes with the half unit markings ?

For your Hypo kit
Med and High Carb food and some honey/karo
If you can get these where you live


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

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

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

Thank you again for the information, we used to have a really hard time to conduct the blood test, I remember the first time we tried, it took us about 3 hours, not to mention the stress was imposed on Cody. This information is great!

 

[Wendy&Neko]

Should I try to switch him to 100% can food?

Eventually that would be a good goal, but not right away. K/D is still too high in carbs for a diabetic cat, but wet food is generally a better option for kidney cats. You want to make any food changes gradually, so you don't suddenly find yourself fighting low numbers that can come with switching from a high carb to low carb diet.

 

[Larry and Kitties]

Are the low BG value from the Libre ? The presphot BG value must be from the AlphoTrac since the libre does not read as high as some of the value in your SS. If the lows are Libre where is th Libre located in relation to you injecting the Norsol? If close the Norsol will dilute the interstitial fluid that the Libre is reading.

 

[Wendy&Neko]

Yikes on last night's numbers! Good catch. Looks like a reduction down to 5.5 units now. Have you switched all his food to the BFF chicken now? If so, I'd be tempted to go reduce the dose even more to 5 units.