Just wanted to say hello and see if I can get any pointers

[Marina]

Hi all,

My name is Marina and my cat's name is Norton
We live in Australia

I've been lurking here for sometime and I'm still not really sure how to go about utilising this forum but I'll try my best

I've created a profile and attached a spreadsheet and some more information about my wonderful diabetic cat Norton. The spreadsheet only contains data since I started him on his current diet because he was EXTREMELY unregulated prior to the change with hypers and severe hypos due to issues with food. Thankfully his ketones have remained stable throughout all of this and thankfully any hypos he had were picked up and corrected instantly

Norton is a 9 year old adopted Ragdoll with a history of digestive sensitivities who is the most fussy eater I've ever known. He has issues with digesting just about every food I've ever tried to get him on, and he will flat out refuse to eat. After much trial and error I have accepted defeat about him being on a low-carb diet and he is eating Royal Canin Diabetic dry food and Tiki treats

He was diagnosed with diabetes April 24th this year and the first two months were absolute hell on earth with the largest issue absolutely being the many attempts at getting him onto the best food to help his diabetes but as I said, I have had to accept defeat about the food as it was becoming detrimental to my mental health, my finances and Norton's wellbeing

I guess I'm writing in because I'm frustrated with where we are at. As you can probably see from the spreadsheet in my signature we are far from regulated and I understand the food he consumes plays a large role

We are using the SLGS method. I just wonder if I should be doing anything else differently? (minus the food he consumes, I just can't go through the absolute horror those two months were)

I think I will keep persisting and continue to increase his insulin dose as per the protocol if needed unless there is anything else you think I should be doing? Please also let me know if I'm missing any relevant information I need to be adding to my posts and profile

Just wanted to say hello and thank you all for the contributions you all make here. I have learned so much and feel a lot less alone going through all of this

 

[Marina]

Just wanted to add that Norton started off on Toujeo 2U BD but has been switched over to Lantus. Started him on 1U BD but slowly increased his dose to 3U BD

 

[CORKY]

Hi all,

My name is Marina and my cat's name is Norton
We live in Australia

I've been lurking here for sometime and I'm still not really sure how to go about utilising this forum but I'll try my best

I've created a profile and attached a spreadsheet and some more information about my wonderful diabetic cat Norton. The spreadsheet only contains data since I started him on his current diet because he was EXTREMELY unregulated prior to the change with hypers and severe hypos due to issues with food. Thankfully his ketones have remained stable throughout all of this and thankfully any hypos he had were picked up and corrected instantly

Norton is a 9 year old adopted Ragdoll with a history of digestive sensitivities who is the most fussy eater I've ever known. He has issues with digesting just about every food I've ever tried to get him on, and he will flat out refuse to eat. After much trial and error I have accepted defeat about him being on a low-carb diet and he is eating Royal Canin Diabetic dry food and Tiki treats

He was diagnosed with diabetes April 24th this year and the first two months were absolute hell on earth with the largest issue absolutely being the many attempts at getting him onto the best food to help his diabetes but as I said, I have had to accept defeat about the food as it was becoming detrimental to my mental health, my finances and Norton's wellbeing

I guess I'm writing in because I'm frustrated with where we are at. As you can probably see from the spreadsheet in my signature we are far from regulated and I understand the food he consumes plays a large role

We are using the SLGS method. I just wonder if I should be doing anything else differently? (minus the food he consumes, I just can't go through the absolute horror those two months were)

I think I will keep persisting and continue to increase his insulin dose as per the protocol if needed unless there is anything else you think I should be doing? Please also let me know if I'm missing any relevant information I need to be adding to my posts and profile

Just wanted to say hello and thank you all for the contributions you all make here. I have learned so much and feel a lot less alone going through all of this

Welcome, you are in the right place if you follow the link helping us to help you
we can know a bit more of what's is happening with you fur baby, we are here to help you in your concerns, no concern is small, there will always be someone to assist you it's great you already made the spreadsheet, are you home testing? it is important you test before every insulin dose, and what type of food you are feeding, it is important you feed a diabetic cat with wet can food between 0-10% carbs, dry food contains too many carbs, and carbs do not digest below is Drs food list to choose from we a lot of the members like Fancy Feast it is very regulated, I do not know if in your area are available but you can choose from the many brands, in the third column you will find the amount of carbs in each food flavor, stay away from the gravies since they are high in carbs, you should also have available what is called a HYPO KIT, this contains, KARO SYRUP or Honey some Medium and High Carbs foods, you are in the right place we will be here for you
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

 

[Bron and Sheba (GA)]

Hi Marina and Norton and welcome to the forum. I live in Sydney Aust., so am happy to answer any questions you might have.
It’s great you are hometesting and have a spreadsheet set up. If you could set up Nortons signature that would be helpful. Info to do that is in the link Corky sent you above.
Looking at the SS it looks as if you are using a blood ketone meter. Is that correct? Thanks for putting the ketone results into the SS. Very helpful.

Re the food. Would Norton eat the canned RC diabetic?
I know how hard it can be having a cat with tummy issues so I don’t want to mess you around, but have you thought about a raw food diet you make yourself. Or a cooked homemade diet?

Looking at the SS you are doing lots of tests which is great. I think you are holding onto the doses too long. Do you have the SLGS dosing method printed out? I think that is the best way to follow it. I would also encourage you to post over on the Lantus forum once we get you sorted out and they will be able to guide you about dosing.
You can increase the dose after 7 days if needed. I don’t think you have reached the best dose yet. And having to feed the dry food, which is high carb, means you are going to need more insulin.
Keep asking questions and keep posting. We will be able to help get Norton into a better place with the BGs.

 

[Marina]

Hi Marina and Norton and welcome to the forum. I live in Sydney Aust., so am happy to answer any questions you might have.
It’s great you are hometesting and have a spreadsheet set up. If you could set up Nortons signature that would be helpful. Info to do that is in the link Corky sent you above.
Looking at the SS it looks as if you are using a blood ketone meter. Is that correct? Thanks for putting the ketone results into the SS. Very helpful.

Re the food. Would Norton eat the canned RC diabetic?
I know how hard it can be having a cat with tummy issues so I don’t want to mess you around, but have you thought about a raw food diet you make yourself. Or a cooked homemade diet?

Looking at the SS you are doing lots of tests which is great. I think you are holding onto the doses too long. Do you have the SLGS dosing method printed out? I think that is the best way to follow it. I would also encourage you to post over on the Lantus forum once we get you sorted out and they will be able to guide you about dosing.
You can increase the dose after 7 days if needed. I don’t think you have reached the best dose yet. And having to feed the dry food, which is high carb, means you are going to need more insulin.
Keep asking questions and keep posting. We will be able to help get Norton into a better place with the BGs.

Hello! Thank you so so so much for your response

I'll set his signature up shortly

Correct, I am testing with blood to check for ketones. I was advised by the vet to check his urine for ketones but he never had any show up in the urine when I did test that way, and I feel more comfortable having instant and accurate numbers from taking blood samples. Fortunately for me he is an extremely beautiful patient and will allow me to prick his paw pads to check whenever I need to (ears are an absolute no for him)

I've tried all sorts of wet food, he will take a bite then leave it. I've attempted to transition him to raw, and home-made food with no success. I tried to transition him to Ziwi Peak vension air-dried as a novel protein which did agree with his digestive issues, but he enjoyed it for all of a week before he started eating less and less of it and started having hypos again. He also peaked with his ketones during this time (0.9 at his worst) I believe because he was essentially starving. Unfortunately I'm not sure what he was fed before I adopted him but the rescue centre did say he is extremely fussy and only eats kibble.

He does love the Royal Canin diabetic dry and eats it with enthusiasm and has for a month now which is a huge relief as he was losing too much weight before the diagnosis of diabetes, then the digestive issues of trying various low-carb foods that involved complete indigestion and vomiting everyday, then just flat out refusing any food he doesn't like - so I'm just trying to base his diabetes management around the food he will tolerate which I know isn't ideal given that it is higher carb and dry, but believe me when I say I have exhausted all options

Though he will happily eat Tiki Baby Thrive mousse. I could possibly try blending wet food until it becomes a paste - and see if he may tolerate that

I agree with you about holding onto doses for too long, I think I'm dealing with a lot of anxiety about increasing his dose then having to leave him alone for some of the day but I will print off the SLGS method and follow it more accurately. I've also put a CGM on him just to check for any sudden decreases in BGL and I'm fortunate enough to work 10 minutes away from home and can come and attend to him if necessary. I also think you're correct about not reaching the right dose yet, but I will keep persisting until we find what works best for him

Thank you so much again for replying

 

[SmallestSparrow]

Hello! Thank you so so so much for your response

I'll set his signature up shortly

Correct, I am testing with blood to check for ketones. I was advised by the vet to check his urine for ketones but he never had any show up in the urine when I did test that way, and I feel more comfortable having instant and accurate numbers from taking blood samples. Fortunately for me he is an extremely beautiful patient and will allow me to prick his paw pads to check whenever I need to (ears are an absolute no for him)

I've tried all sorts of wet food, he will take a bite then leave it. I've attempted to transition him to raw, and home-made food with no success. I tried to transition him to Ziwi Peak vension air-dried as a novel protein which did agree with his digestive issues, but he enjoyed it for all of a week before he started eating less and less of it and started having hypos again. He also peaked with his ketones during this time (0.9 at his worst) I believe because he was essentially starving. Unfortunately I'm not sure what he was fed before I adopted him but the rescue centre did say he is extremely fussy and only eats kibble.

He does love the Royal Canin diabetic dry and eats it with enthusiasm and has for a month now which is a huge relief as he was losing too much weight before the diagnosis of diabetes, then the digestive issues of trying various low-carb foods that involved complete indigestion and vomiting everyday, then just flat out refusing any food he doesn't like - so I'm just trying to base his diabetes management around the food he will tolerate which I know isn't ideal given that it is higher carb and dry, but believe me when I say I have exhausted all options

Though he will happily eat Tiki Baby Thrive mousse. I could possibly try blending wet food until it becomes a paste - and see if he may tolerate that

I agree with you about holding onto doses for too long, I think I'm dealing with a lot of anxiety about increasing his dose then having to leave him alone for some of the day but I will print off the SLGS method and follow it more accurately. I've also put a CGM on him just to check for any sudden decreases in BGL and I'm fortunate enough to work 10 minutes away from home and can come and attend to him if necessary. I also think you're correct about not reaching the right dose yet, but I will keep persisting until we find what works best for him

Thank you so much again for replying

I don’t know how this group feels about Tiki Cat food, and I’m NOT saying change diets bc it’s imho better to have a diabetic cat who eats less than perfect choices than a diabetic cat refusing to eat. But I do wonder, since Norton likes Tiki Cat baby mousse if any of the Tiki Adult mousses would appeal to him? At least it’s a wet food

 

[Marina]

I don’t know how this group feels about Tiki Cat food, and I’m NOT saying change diets bc it’s imho better to have a diabetic cat who eats less than perfect choices than a diabetic cat refusing to eat. But I do wonder, since Norton likes Tiki Cat baby mousse if any of the Tiki Adult mousses would appeal to him? At least it’s a wet food

I can certainly give them a try. I believe Tiki are all low carb food choices. I started with the Tiki Baby Thrive a couple of weeks ago just to help Norton gain some weight, I could definitely see how he tolerates their wet food options

 

[SmallestSparrow]

Well if he needs the calories and it’s low carb then maybe just stick with the Tiki baby. Good luck, I know how it can be convincing a cat that “no, I’m not trying to poison you, this new food is yummy!”

 

[Bron and Sheba (GA)]

The RC diabetic dry is 18.8% carbs so you can see how you are needing more insulin.
Is it the fact he won’t eat the food or the fact he gets tummy upsets from some foods?
Another brand you could try is Weruva. Their website shows the carb content of all their food which is rare in the cat food industry. In Australia I know we have ‘cats in the kitchen’ variety of Weruva but I’m not up to speed if they are now supplying other varieties.
But at the end of the day, the most important thing is that Norton eats. That trumps everything.
Just be aware that if you are trialling him on lower carb foods … he will most likely need less insulin. So I would do any trialling of lower carb food when you are around to monitor the effect on the BG

 

[Sienne and Gabby (GA)]

As Bron noted, the important thing is that Norton eats! It does sound like he has food sensitivities and my guess is that he may have developed some food aversions before he became your kitty. At least in the US, there are not many options for low carb, dry food. The only two that I can think of are Young Again Zero Carb and Dr. Elsey's Clean Protein. Stella & Chewy's has a freeze dried raw food if that's available in Australia. The ZiwiPeak sounded like a good option. Have you considered alternating Norton's foods so he doesn't get tired of a particular food?

While it would be ideal to have Norton on a low carb, canned food diet, if he won't eat (and he drives you crazy because of his being picky) that's an issue. Potentially trying a very, very, very slow transition to a different buffet of food may help. If not, like with cats that need to be on a medication that has an effect on blood glucose levels, we work the insulin dose around what your cat needs. Functionally, that may mean looking to get Norton's diabetes solidly regulated but he may not go into remission. (But many cats never go into remission even if they can eat a low carb diet.)

Regarding Norton's spreadsheet, I honestly don't see any numbers that I would consider too low. Even the 94 is still in a safe range. It can take some time for a caregiver to get comfortable with seeing lower numbers in their cat. We also differentiate between low numbers and hypoglycemia. When we consider hypoglycemia, it means your cat is having symptoms of hypoglycemia.

 

[Marina]

Well if he needs the calories and it’s low carb then maybe just stick with the Tiki baby. Good luck, I know how it can be convincing a cat that “no, I’m not trying to poison you, this new food is yummy!”

Exactly, any food is better than what we went through previously. But I just gave him his morning treat of Tiki Baby and he inhaled it-Tiki also do puree wet food so I think when I get paid next I'm going to purchase a couple of sachets and see how he goes with that

 

[Marina]

The RC diabetic dry is 18.8% carbs so you can see how you are needing more insulin.
Is it the fact he won’t eat the food or the fact he gets tummy upsets from some foods?
Another brand you could try is Weruva. Their website shows the carb content of all their food which is rare in the cat food industry. In Australia I know we have ‘cats in the kitchen’ variety of Weruva but I’m not up to speed if they are now supplying other varieties.
But at the end of the day, the most important thing is that Norton eats. That trumps everything.
Just be aware that if you are trialling him on lower carb foods … he will most likely need less insulin. So I would do any trialling of lower carb food when you are around to monitor the effect on the BG

Some of the low-carb food options he genuinely enjoyed but within 12 hours (between feeds) he would vomit the entirety of what he ate back up as if it was just sitting in his stomach the whole time. He'd also have loose stools during that time. Some of the other options I offered him he would take a bite or two of and never go back to it again. The last low-carb option I offered him he would really like for a week or so before he just ate less and less of it every day. All of the above landed him with hypos. The RC is the only food I've given him over the last few months that he races to his auto feeder for, likely because kibble is cat crack lol.

 

[Marina]

As Bron noted, the important thing is that Norton eats! It does sound like he has food sensitivities and my guess is that he may have developed some food aversions before he became your kitty. At least in the US, there are not many options for low carb, dry food. The only two that I can think of are Young Again Zero Carb and Dr. Elsey's Clean Protein. Stella & Chewy's has a freeze dried raw food if that's available in Australia. The ZiwiPeak sounded like a good option. Have you considered alternating Norton's foods so he doesn't get tired of a particular food?

While it would be ideal to have Norton on a low carb, canned food diet, if he won't eat (and he drives you crazy because of his being picky) that's an issue. Potentially trying a very, very, very slow transition to a different buffet of food may help. If not, like with cats that need to be on a medication that has an effect on blood glucose levels, we work the insulin dose around what your cat needs. Functionally, that may mean looking to get Norton's diabetes solidly regulated but he may not go into remission. (But many cats never go into remission even if they can eat a low carb diet.)

Regarding Norton's spreadsheet, I honestly don't see any numbers that I would consider too low. Even the 94 is still in a safe range. It can take some time for a caregiver to get comfortable with seeing lower numbers in their cat. We also differentiate between low numbers and hypoglycemia. When we consider hypoglycemia, it means your cat is having symptoms of hypoglycemia.

Yep I think its a combination of extreme fussiness but also sensitivities
I've sort of accepted that he may never go into remission which I can live with, I just want to be sure that his quality of life is as great as it can be and that his diabetes is managed to avoid complications down the line

I do think I'll try give him some proper Tiki wet puree food as a "treat" and see if he will tolerate that. He likes pureed treats in small quantities, maybe we could work up to enjoying puree wet foods as a full meal

You're right about discomfort with seeing low numbers. The first two months with all his digestive/food issues he was having hypos every second day (correcting hypos, rebound hypers, ad nauseam) so I've gotten comfortable with seeing less than optimally regulated numbers if it means he isn't at a risk of dropping again so SLGL has been followed incorrectly over the last month and a half since starting from square one. His last hypo (when he began eating less and less of his low-carb food just before RC was introduced) was BGL of 20mg/dl, as far as I could tell he wasn't symptomatic. If he does reach levels like that again and he isn't symptomatic, should I be treating it or just allow it to correct itself while closely monitoring?

 

[Bron and Sheba (GA)]

His last hypo (when he began eating less and less of his low-carb food just before RC was introduced) was BGL of 20mg/dl, as far as I could tell he wasn't symptomatic. If he does reach levels like that again and he isn't symptomatic, should I be treating it or just allow it to correct itself while closely monitoring?

If the BG drops under 50 you need to actively be giving some high carb food and/or honey to bring the BG up over 50 (2.7) again. With a BG of 20 (1.1) I would go straight to honey followed by high carb food. That is a very low and concerning BG. In all instances of BGs under 50 the routine is to give the high carb/honey then retest in 20 minutes and keep doing that routine until the BGs are up over 50. Then you can change to low carb food but you must keep testing to see Norton can stay up on his own without further intervention of high carb food for 2 more hours. You can keep giving low carb. If you have to intervene because the BG drops again, then the clock starts again.
In Saying all that, because you are doing SLGS, any drop under 90 requires you to feed Norton to bring back the BG over 90 and to reduce the dose.
Dies sll that make sense?

 

[Marina]

If the BG drops under 50 you need to actively be giving some high carb food and/or honey to bring the BG up over 50 (2.7) again. With a BG of 20 (1.1) I would go straight to honey followed by high carb food. That is a very low and concerning BG. In all instances of BGs under 50 the routine is to give the high carb/honey then retest in 20 minutes and keep doing that routine until the BGs are up over 50. Then you can change to low carb food but you must keep testing to see Norton can stay up on his own without further intervention of high carb food for 2 more hours. You can keep giving low carb. If you have to intervene because the BG drops again, then the clock starts again.
In Saying all that, because you are doing SLGS, any drop under 90 requires you to feed Norton to bring back the BG over 90 and to reduce the dose.
Dies sll that make sense?

Yep perfectly. Thats what I did at the time and have done so anytime he has a hypo. Though I've always treated hypos as anything less than 85. I use maple syrup and mix it with a treat and that will bring him back up again, then maybe some dry high-carb food (his old RC Sensitivity Control) and recheck in 15 minutes until he is stable, then recheck every hour until I can see he's climbing up and stable

 

[Marina]

Yep perfectly. Thats what I did at the time and have done so anytime he has a hypo. Though I've always treated hypos as anything less than 85. I use maple syrup and mix it with a treat and that will bring him back up again, then maybe some dry high-carb food (his old RC Sensitivity Control) and recheck in 15 minutes until he is stable, then recheck every hour until I can see he's climbing up and stable

***recheck every 15 minutes until he is stable

 

[Bron and Sheba (GA)]

Yep perfectly. Thats what I did at the time and have done so anytime he has a hypo. Though I've always treated hypos as anything less than 85. I use maple syrup and mix it with a treat and that will bring him back up again, then maybe some dry high-carb food (his old RC Sensitivity Control) and recheck in 15 minutes until he is stable, then recheck every hour until I can see he's climbing up and stable

Until it drops under 50 it is ok to feed low carb. And maple syrup can also be rubbed on his gums. The maple syrup/honey will only last an hour or hour and half and then the BG can drop again, so that is why it’s good to follow up with some food.
There is a company in Perth that sells raw food products, freeze dried products and meal completers if you are making your own food. They are called Raw Meow. Not cheap but excellent quality. They also have a Facebook page called Australian Raw Fed Cats. It is very well run by the lady who owns RawMeow and they are very knowledgeable and may be able to give you some ideas.

 

[Sienne and Gabby (GA)]

Marina --

I'm not sure what numbers you are calling "hypo." To be honest, at least on his spreadsheet, Norton hasn't really seen much in terms of even low numbers. We consider normal blood glucose as between 50 - 120. Unless you are seeing symptoms of hypoglycemia, Norton is in low numbers. If his numbers were to drop below 50, you would use high carb to get them back into a safer range. With SLGS, members will nudge numbers up, typically with lower carb food, if numbers are below 90. (There are a lot of considerations in terms of how you intervene but that's more detail than you need at this moment.) My kitty never experienced symptomatic hypoglycemia and her numbers on occasion dropped quite low. (You can scan Gabby's spreadsheet to see what I mean.)

Just so you have it handy, I'm linking a post from the Lantus board on handling low numbers. It is geared toward using the Tight Regulation protocol so when you look it over, keep that in mind.