? Insulin dosing & Feeding kitty with IBD/daily Prednisalone

[Teya and Tweety]

Hi there, my Tweety is about 18 yrs old and type II as of August 2023.

In March 2021 was diagnosed with "Suspected smal cell lymphoma" but 3 years later we now think just IBD. Has been on Prednisalone ever since. Alternating 1 MG and 2 MG every other day.

We Started 1 unit glargine Lantus pen twice daily in August. She ran high 300s and rarely sat in the 100s but would hit and then go right back up.

She is being treated for a nasty UTI now, and up to 2 units twice daily as of 9 days ago as her glucose was well over 500 at times. I ALSO just learned you are supposed to "prime the pen" and wonder if all these months she was not getting enough insulin as I did not prime. I did always look for the drop at the end of the needle. If there was no drop - I did not give the shot. I got a new needle. Anyway, started priming the needle today.

Her fur looks greasy and separated, she is not super playful anymore and her rear legs have lost mass. She is still walking on pads of her toes though. the whole situation breaks my heart. I was hoping for remission so to get smacked with numbers over 500 was shocking.

She is wearing a Freestyle Libre right now - freshly on today. Last week she was swinging from 200s to 450s then one day out of the blue she was 138 in the morning. Normally she reads 300-500 every morning and night. Hopefully with the 2 units now she will not.

What do you feed your kitty? She is very bored with the Fancy Feast Pate Beef and Turkey.

Due to IBD chicken is not an option. Nor is fish.

I just feel just nutty and stressed trying to help her.

 

[kujo]

My cat who is 17 had very bad matted fur which came good once insulin was started even though you wouldn’t say he is regulated by looking at his numbers. He has also put on all weight lost (plus some more). He isn’t playful any more but I think that also has a bit to do with age. Although he does still jump up onto the bath and bed. I’m hoping somebody can help you with the food issue as all mine eats is fancy feast pate and Tiki which is chicken and fish.
My vet always told me to shoot 1 unit into the sink to test the pen is working. Seems a bit of a waste of insulin but I get why you do it now.

 

[Basic's Mom]

You aren't feeling something all of us hasn't. I promise it gets better.

Welcome to the forum. I'm happy for you and Tweety that you have found it.

We don't use the pen for injecting. We use syringes with half unit marks and draw up the insulin. We increase and decrease in .25 u increments, but the pen doesn't allow this. Therefore, we use the syringes with half unit marks. Let me know if you'd like a link.

The food you are feeding is fine and under 10% carbs. Fancy feast classic pate is all under 10% carbs. As long as she is happy with the food and that is all she is given, you are good on the food aspect. We have a food chart for all canned food in the US. It breaks down the caloric analysis. Let me know if you want that. I'm not sure where you are located.

We are very outspoken about the importance and need to home test and monitoring the blood glucose levels throughout the cycles. It is really the only way to keep a cat safe. Let me know if you'd like links on tips and tricks on hometesting. I am glad she was fitting for a libre. I was thankful to have one with this journey started. It is good to know how to home test. Libres fail often. Being stuck with a failed libre and no hand held meter isn't a fun place to be. I've been there.

We do ask that you put general information in your signature. You can see it at the bottom of everyone's information. This helps others that are helping you out. The same questions will keep getting asked if not and it is counterproductive. Scroll down for signature info. You'll also be asked to set up a spreadsheet. This information is here too. If you need help, just ask.
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

My cat's coat wasn't very pretty while he was so sick. As he started feeling better, his grooming returned and so did his nice coat.

Hope this helps you. Again, let us know if we can help you in any way.

 

[Teya and Tweety]

You aren't feeling something all of us hasn't. I promise it gets better.

Welcome to the forum. I'm happy for you and Tweety that you have found it.

We don't use the pen for injecting. We use syringes with half unit marks and draw up the insulin. We increase and decrease in .25 u increments, but the pen doesn't allow this. Therefore, we use the syringes with half unit marks. Let me know if you'd like a link.

The food you are feeding is fine and under 10% carbs. Fancy feast classic pate is all under 10% carbs. As long as she is happy with the food and that is all she is given, you are good on the food aspect. We have a food chart for all canned food in the US. It breaks down the caloric analysis. Let me know if you want that. I'm not sure where you are located.

We are very outspoken about the importance and need to home test and monitoring the blood glucose levels throughout the cycles. It is really the only way to keep a cat safe. Let me know if you'd like links on tips and tricks on hometesting. I am glad she was fitting for a libre. I was thankful to have one with this journey started. It is good to know how to home test. Libres fail often. Being stuck with a failed libre and no hand held meter isn't a fun place to be. I've been there.

We do ask that you put general information in your signature. You can see it at the bottom of everyone's information. This helps others that are helping you out. The same questions will keep getting asked if not and it is counterproductive. Scroll down for signature info. You'll also be asked to set up a spreadsheet. This information is here too. If you need help, just ask.
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

My cat's coat wasn't very pretty while he was so sick. As he started feeling better, his grooming returned and so did his nice coat.

Hope this helps you. Again, let us know if we can help you in any way.

Hi there, I see the spreadsheet info and will get that done as soon as I can.

Some days she just gets bored with the Fancy Feast two flavors... since she cant have fish or chicken it makes it kind of hard. She is hungry, but just does not want that type/flavor. To boot she has supplements/powders in each meal. I think maybe because it is "tainted" sometimes she would just like fresh stuff. So, I was hoping to find another brand to alternate with. I will wait and see if there are others who use another type of food. Glad to hear your baby's coat and grooming returned. She was always so floofy and pretty and not at all now. She just looks uncomfortable. I am rambling.

I have a Glucometer, but since we just had to go up we felt more comfortable adding another Libre just to be sure the bladder infection was not causing a temporary increase. Which can happen in humans I know.

I will look for the food chart and if I have any issues I will reach back out. Thanks so much. ~ Teya and Tweety

 

[Teya and Tweety]

My cat who is 17 had very bad matted fur which came good once insulin was started even though you wouldn’t say he is regulated by looking at his numbers. He has also put on all weight lost (plus some more). He isn’t playful any more but I think that also has a bit to do with age. Although he does still jump up onto the bath and bed. I’m hoping somebody can help you with the food issue as all mine eats is fancy feast pate and Tiki which is chicken and fish.
My vet always told me to shoot 1 unit into the sink to test the pen is working. Seems a bit of a waste of insulin but I get why you do it now.

Thank you -- helps to hear you are priming the pen as well. Seems wasteful, but we do have to throw them out. By the way... do you keep your pen in the fridge? I do and just saw we should not. Since cats can keep insulin for up to 3 months though... I think the fridge makes sense.

 

[Basic's Mom]

Here is the food chart
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

I feed my cats the friskies on the list that is under 10% and fancy feast. My cats get bored quickly too. Since I've gotten his bg more stabilized, I've been adding some 12 or 14% carb food. He is loving life again. My female is too. I'm sure she was wondering why all of her food changed. I can't have high carb food around or even bowls of med carb. He will eat everything. She is a grazer. It's been challenging, but I'm seeing results.

Yes, any infection or inflammation can increase blood glucose levels. I used to watch as my cat's skyrocketing at the vet.

As Tweety starts feeling better, you will see her beautiful coat return.

You are welcome.

 

[Teya and Tweety]

Here is the food chart
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

I feed my cats the friskies on the list that is under 10% and fancy feast. My cats get bored quickly too. Since I've gotten his bg more stabilized, I've been adding some 12 or 14% carb food. He is loving life again. My female is too. I'm sure she was wondering why all of her food changed. I can't have high carb food around or even bowls of med carb. He will eat everything. She is a grazer. It's been challenging, but I'm seeing results.

Yes, any infection or inflammation can increase blood glucose levels. I used to watch as my cat's skyrocketing at the vet.

As Tweety starts feeling better, you will see her beautiful coat return.

You are welcome.

Awwww it helps so much to hear yours are doing well! How long did it take you to get things handled? Tweety has been diabetic that I know of, since August. I do wonder if it will come down after this infection is gone, but she only has one day left of meds. Maybe she was always too low on insulin. My primary vet thinks the other vet let it stay too high. She was rarely ever in the 100s - mostly read 300-400 at breakfast and dinner (insulin times) and her primary thinks it is best if she was at 250 max or even 300 max at her peaks. Anyway, I am about to put her in the carrier to go get a Libre. The tech said I can record her doing it so I wont have to bring Tweety in anymore and can do it on my own! I LOVE THAT IDEA! Once less trip. She has to have Gabbapentin in order to go to the vet. Anyway, I will lookup the Friskies! I am excited to have an option.

 

[Red & Rover (GA)]

Thank you -- helps to hear you are priming the pen as well. Seems wasteful, but we do have to throw them out. By the way... do you keep your pen in the fridge? I do and just saw we should not. Since cats can keep insulin for up to 3 months though... I think the fridge makes sense.

The insulin lasts longer if you keep it in the fridge and a 5-pack of pens lasts a long time.
Most of us use a needle and syringe. Dose changes should be 0.25 units because you might go right past the ideal dose if you can only shoot straight units.
Ask your pharmacy for half unit syringes. Then you won't lose any by priming.

Tagging
@Wendy&Neko
@tiffmaxee
regarding IBD.
There are some limited ingredient foods in the Food List Sybil mentioned.
Have you tried a raw food diet?

The rear leg muscle mass is diabetic neuropathy. Methylcobalamin (a form of B12) can help with that over time.

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

And welcome to the best place you never thought you would be.

 

[Basic's Mom]

Those numbers are far too high. Starts stressing organs when numbers sit that high.

Also, your cat's body is used to those high numbers. When they do see lower numbers, it invariably causes a bounce. The body panicks and organs start producing more hormones because it views the "lower" numbers as a threat.

My cat was diagnosed on 9/2023. I have only somewhat recently seen improvements in his numbers. Remind yourself that your goal is to get the numbers under 300s, under 200s, etc. Some cats never get regulated. Don't put undo pressure on yourself. Once I got him a dose of insulin that was keeping his bg in check (no longer 500s, 400s, 300s), his coat improved. The raw diet was also really helping, but he isn't a fan. I only give him a teaspoon a day, but I believe even that small of an amount helps.

I'm not sure of Tweety's age, but you may want cosequin too. It really helped my cat. I didn't even know he was in pain. It is for joint and hip support.

 

[Teya and Tweety]

The insulin lasts longer if you keep it in the fridge and a 5-pack of pens lasts a long time.
Most of us use a needle and syringe. Dose changes should be 0.25 units because you might go right past the ideal dose if you can only shoot straight units.
Ask your pharmacy for half unit syringes. Then you won't lose any by priming.

Tagging
@Wendy&Neko
@tiffmaxee
regarding IBD.
There are some limited ingredient foods in the Food List Sybil mentioned.
Have you tried a raw food diet?

The rear leg muscle mass is diabetic neuropathy. Methylcobalamin (a form of B12) can help with that over time.

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

And welcome to the best place you never thought you would be.

I will ask about the B12... I just started putting some in her food from Jackson Galaxy and there are no sugars in it. https://www.jacksongalaxy.com/products/b12-for-cats-dietary-supplement?variant=39351808065571

I will also ask about switching to a 1/2 dose pen. For some reason they prefer this Glargine Lantus pen. So I will for sure ask. Sadly we didnt get great care with Blue Pearl so I am going local moving forward.

Fancy Feast has plenty of stuff in it that is not ideal for her including "fish" but it is not the primary meat. Friskies has a turkey pate I will pick up tomorrow. The list is AMAZING! It looks older but I will research to ensure nothing has changed. I hear they can change ingredients, etc. on you out of the blue. Koha is another brand I heard good things about but it is pricier. I will check that one too again. Last time it had sky high phosphorus.

Thank you SO MUCH for the warm welcome. Tweety is baked on Gabbapentin right now, but the new device is on and calibrating as we speak.

 

[Teya and Tweety]

Here is the food chart
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

I feed my cats the friskies on the list that is under 10% and fancy feast. My cats get bored quickly too. Since I've gotten his bg more stabilized, I've been adding some 12 or 14% carb food. He is loving life again. My female is too. I'm sure she was wondering why all of her food changed. I can't have high carb food around or even bowls of med carb. He will eat everything. She is a grazer. It's been challenging, but I'm seeing results.

Yes, any infection or inflammation can increase blood glucose levels. I used to watch as my cat's skyrocketing at the vet.

As Tweety starts feeling better, you will see her beautiful coat return.

You are welcome.

AMAZING FOOD LIST thank you so much. I am bookmarking it!

 

[Teya and Tweety]

Those numbers are far too high. Starts stressing organs when numbers sit that high.

Also, your cat's body is used to those high numbers. When they do see lower numbers, it invariably causes a bounce. The body panicks and organs start producing more hormones because it views the "lower" numbers as a threat.

My cat was diagnosed on 9/2023. I have only somewhat recently seen improvements in his numbers. Remind yourself that your goal is to get the numbers under 300s, under 200s, etc. Some cats never get regulated. Don't put undo pressure on yourself. Once I got him a dose of insulin that was keeping his bg in check (no longer 500s, 400s, 300s), his coat improved. The raw diet was also really helping, but he isn't a fan. I only give him a teaspoon a day, but I believe even that small of an amount helps.

I'm not sure of Tweety's age, but you may want cosequin too. It really helped my cat. I didn't even know he was in pain. It is for joint and hip support.

Thanks so much! She is about 18 years old... give or take. I adopted her when they thought she was about 5 years old. I agree... those numbers are super high and Blue Pearl was not worried because they were more concerned about the curve. So our local vet upped her to 2 units of insulin about 9 days ago and the numbers are still all over. Hopefully once her infection clears she will level out.

I will look into raw but she has IBD... although 3 years ago they said it was suspected small cell lymphoma. Since 3 years have passed her primary and I think it is just IBD.

She is on daily Prednisalone which is not helping the diabetes either. Thank you again !!

 

[Basic's Mom]

I will let others weigh in on all of your concerns and questions. You may change the subject line from what it currently says to dosing info and feeding a car with IBD and the prednisalone use. I've seen both discussed in length here.

They will get to you when they can. I'll tag more people if you don't get a reply by tomorrow. Thank you for your patience.

 

[Teya and Tweety]

I will let others weigh in on all of your concerns and questions. You may change the subject line from what it currently says to dosing info and feeding a car with IBD and the prednisalone use. I've seen both discussed in length here.

They will get to you when they can. I'll tag more people if you don't get a reply by tomorrow. Thank you for your patience.

Thank you! I will do that.

 

[Teya and Tweety]

The insulin lasts longer if you keep it in the fridge and a 5-pack of pens lasts a long time.
Most of us use a needle and syringe. Dose changes should be 0.25 units because you might go right past the ideal dose if you can only shoot straight units.
Ask your pharmacy for half unit syringes. Then you won't lose any by priming.

Tagging
@Wendy&Neko
@tiffmaxee
regarding IBD.
There are some limited ingredient foods in the Food List Sybil mentioned.
Have you tried a raw food diet?

The rear leg muscle mass is diabetic neuropathy. Methylcobalamin (a form of B12) can help with that over time.

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

And welcome to the best place you never thought you would be.

OHH great news! The B12 I have started using is the Methylycobalamin! I drop it right into her breakfast. https://www.jacksongalaxy.com/products/b12-for-cats-dietary-supplement?variant=39351808065571

 

[Wendy&Neko]

I will look into raw but she has IBD

A couple good sites for you: https://www.rawfeedingforibdcats.org/ and https://www.ibdkitties.net/
I fed my Neko raw, but there are lots of canned options out there now that are low carb and have non fish/chicken proteins. Raws, Natures Variety, Hounds and Gatos, Natures Logic, Ziwipeak, and Identity are a few that come to mind. If kitty can eat turkey, there are more types with just that. But you've also got duck, rabbit, venison, lamb, kangaroo as options. You are right that so many vendors put chicken or fish in products that don't have them in the name. Current IBD kitty doesn't do fish, beef, and only occasional chicken.

You might want to talk to your vet about budesonide instead of prednisolone. In many kitties, including my Neko, budesonide did not increase blood sugar values. My girl couldn't have pred because of her heart condition. The SCL group I belong to suggests that kitties on pred go to budesonide if they become diabetic for that reason.

If you are using the pen needles, the current in use pen has to stay outside of the fridge or the pen mechanism can have problems. But it'll only last 28 days which on smaller doses means throwing out a lot of insulin. The not in use pens can stay in the fridge so they'll last longer. The only lasting 28 days with using pen needles is one of several reasons we use syringes to inject. Insulin isn't cheap. Other reasons are that we change doses by 0.25 units at a time - cats are sensitive to smaller dose changes. Plus there is some thought that the pen needles hurt more than the syringes. More information in this post:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

 

[Teya and Tweety]

A couple good sites for you: https://www.rawfeedingforibdcats.org/ and https://www.ibdkitties.net/
I fed my Neko raw, but there are lots of canned options out there now that are low carb and have non fish/chicken proteins. Raws, Natures Variety, Hounds and Gatos, Natures Logic, Ziwipeak, and Identity are a few that come to mind. If kitty can eat turkey, there are more types with just that. But you've also got duck, rabbit, venison, lamb, kangaroo as options. You are right that so many vendors put chicken or fish in products that don't have them in the name. Current IBD kitty doesn't do fish, beef, and only occasional chicken.

You might want to talk to your vet about budesonide instead of prednisolone. In many kitties, including my Neko, budesonide did not increase blood sugar values. My girl couldn't have pred because of her heart condition. The SCL group I belong to suggests that kitties on pred go to budesonide if they become diabetic for that reason.

If you are using the pen needles, the current in use pen has to stay outside of the fridge or the pen mechanism can have problems. But it'll only last 28 days which on smaller doses means throwing out a lot of insulin. The not in use pens can stay in the fridge so they'll last longer. The only lasting 28 days with using pen needles is one of several reasons we use syringes to inject. Insulin isn't cheap. Other reasons are that we change doses by 0.25 units at a time - cats are sensitive to smaller dose changes. Plus there is some thought that the pen needles hurt more than the syringes. More information in this post:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

Thank you so much! I am drafting an email to her vet as we speak.

 

[Diane Tyler's Mom GA]

@Tootsie778
Most vets don't have the U-100 syringes with the half unit markings when using lantus, You can get them at Amazon without a script from your vet
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

Or any of the other syringes that are on the link Wendy gave you in blue

 

[Teya and Tweety]

Hi there, I am struggling with the spreadsheet.

In addition we had a horrible episode with Tweety Friday night that I was reeling from until today. Out of nowhere her BS dropped to 45, then 30 and she was acting/looking weird. Not lethargic but I could see her face was weird. I called the ER vet and they said that if she did not rise soon to bring her in. She was eating the honey, kibble and wet food. Slowly it rose to 61 then 2 hours later was at 112.

NOW - the ER vet said to drop her and keep her at 1 unit instead of the 2 her primary just put her on 3 weeks ago. The primary is not happy and disagrees. I am playing it safe at 1 unit, but ultimately I am going to get them to show me how to use a syringe instead of the pen needles and go with 1.25 then 1.5. She seems to stay in the 250s then rocket up to 350s or even 450s. But then this 30 came from nowhere and we are afraid to give her 2 units. I feel so badly for her. To top it all off she will not eat her Fancy Feast Pate she always liked after this incident. Strange.

Anyway, help with the sheet would be great as well if anyone else experienced vets disagreeing? My gut says she is probably safest at 1.5 - but sitting in these 200s and 300s isnt good either.

I look forward to the days this is managed well. The UTI and her prednisolone probably plays a part in not being able to regulate her well.

The ER vet says keeping her 100s to 300 is ideal. Primary said no way - it should be 70-200 max. I am rambling. Thank you.

 

[squeem3]

Just seeing this thread My cat has had IBD for 4 years now and was on prednisolone until recently when the vet switched him to budesonide after diagnosing diabetes (likely a result of long term steroid use). He has eaten commercial raw food since weaning age. He's 13 now. Commercial raw is usually more acceptable to cats than homemade raw. Does your cat have any food sensitivities because of the IBD? Mine can't eat poultry, beef, pork, and some filler ingredients.

There's no special trick to using insulin syringes with an insulin pen. Uncap the pen, stick the needle end of the syringe into the rubber stopper, and draw up a dose just like you would with an insulin bottle. Pull up the skin around the back of the neck to create a tent and stick the insulin syringe needle into the tent.

https://www.felinediabetes.com/FDMB...info-proper-handling-drawing-fine-dosing.151/

Normal non diabetic range is roughly 60 to 150 mg/dl. A diabetic cat should stay in this range as much as possible with insulin.