Switching foods

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Bruce Blount

Bruce Blount

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My vet has suggested my switching Wicked from the dry kibble he has been eating - to a low carbohydrate wet food while keeping the amount of insulin the same as it is currently. I have big problems trying to get blood samples to home test. Isn't there a danger (when I switch) of his sugars running dangerously low?
 
Yes, food change can drop BG. Depending on what the dry food is that he has now, it could be significant.

I know I’ve seen you here before but can’t remember - do you have a spreadsheet?
 
So I went to his Vet this morning asking if it might be dangerous changing his food to one that has less carbs. Here is his reply:

In response to your questions today, decreasing the carbs doesn’t usually lower the blood sugar levels, just helps them not to go higher. Cats can sometimes have transient diabetes, meaning that diabetes actually goes away after a while of treatment so we do need to monitor sugars closely. If it’s a low carb dry food, you’ll just have to compare labels and get the lowest carbs. If Wicked eats canned, we have a list of low carb canned foods that you can get at the grocery/pet store if you would like us to email that over.

So - we have to trust, right? I suppose I will change his food tomorrow.

 
How much insulin is he on?

here are my suggestions fwiw: keep trying to test occasionally. Consider getting a Libre (continuous glucose monitor) so you get the info without a stick. Ask your vet about monitoring using urine glucose and ketone strips. Back in the day, before meters, that’s how they were monitored. It meant they ran to the high end for safety sake since blood tests weren’t available for home use.
 
I'm not sure how much experience your vet has at treating feline diabetes, but I would beg to differ. Decreasing carbs will drop your cat's blood glucose levels. If it's a matter of a few percent (e.g., changing from 15% carb to 12%) there may not be much of an impact. However, there are dry foods that are 30% carb and if you change to one of the two low carb foods, they are truly low carb (e.g., around 5%), there can be a dramatic change in blood glucose levels. Frankly, what the vet said makes no sense whatsoever. If a diabetic is eating cookies, cake, candy, bread, and pasta and then changes to a high protein diet, blood glucose will drop. This is pretty basic biochemistry.

Bruce - you either need to get a Libre or you need to test your cat. It is the only way to keep Wicked safe.
 
This:
Cats can sometimes have transient diabetes, meaning that diabetes actually goes away after a while of treatment so we do need to monitor sugars closely.

Sounds like he wants the BG monitored so I’m confused
 
Another day that I cannot get a sufficient amount of blood to test. Am VERY frustrated, and want to just give up with the whole thing. I lost my wife a few months ago, and the last thing I need is more stress. Might be shelter time?
 
Bruce

I’m sorry about your loss—and I realize how stressful diabetes can be. But you’re already good with giving injections so you’re halfway there.

there are some alternatives:
1. Get a Libre—the vet can place it and teach you to place future ones. Then you don’t need to stick him

2. get an alpha Trak—it requires a tiny drop less than a pin head of blood.

3. ask your vet to put him on a dose you can monitor by just checking his urine—it is how this was managed before we had home blood glucose monitors and cats did just fine. It’s not perfect but it can work for you.

it is extremely unlikely an overweight diabetic older cat will be adopted from a shelter. It is likely he will be euthanized. If you decide this is your only option consider asking the shelter if this will be the case and if so, please consider instead having him euthanized with you present to comfort him
 
Bruce seriously ask about a dose that you can monitor with urine checks. Managing diabetes was 1000 times less stressful 30 years ago when I —oblivious to his BG—just gave my cat a shot every 12 hours and periodically put Saran Wrap over his litter to collect urine (there are easier ways these days with No Sorb pellets). It doesn’t have to be as stressful as it seems right now
 
SmallestSparrow said:
Bruce

I’m sorry about your loss—and I realize how stressful diabetes can be. But you’re already good with giving injections so you’re halfway there.

there are some alternatives:
1. Get a Libre—the vet can place it and teach you to place future ones. Then you don’t need to stick him

2. get an alpha Trak—it requires a tiny drop less than a pin head of blood.

3. ask your vet to put him on a dose you can monitor by just checking his urine—it is how this was managed before we had home blood glucose monitors and cats did just fine. It’s not perfect but it can work for you.

it is extremely unlikely an overweight diabetic older cat will be adopted from a shelter. It is likely he will be euthanized. If you decide this is your only option consider asking the shelter if this will be the case and if so, please consider instead having him euthanized with you present to comfort him
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I was just frustrated - I would never get rid of Wicky. He is my best friend. Since he does tolerate shots well, do you think I could use a needle in his scruff area to get a sample?
 
I was just ranting - I would never get rid of Wicky - he is my best friend. Since he tolerates incisions well, cant I just use a needle to draw a sample - from his "scruff (shoulder blade) area?
 
SmallestSparrow said:
Bruce seriously ask about a dose that you can monitor with urine checks. Managing diabetes was 1000 times less stressful 30 years ago when I —oblivious to his BG—just gave my cat a shot every 12 hours and periodically put Saran Wrap over his litter to collect urine (there are easier ways these days with No Sorb pellets). It doesn’t have to be as stressful as it seems right now
Click to expand...
Hi Bruce, I’m so sorry for your loss.
I’m sure you are feeling quite overwhelmed at this point, which is very, very understandable.

Colleen has given you some wonderful suggestions on managing your current situation with Wicked.

The Libre is a very good tool to use in managing feline diabetes. I’ve been using a Libre 3 on Ivy for about 1.5 years now. I am able to poke Ivy’s ear when she goes very low on the Libre just to make sure she’s safe but generally, I rely upon the Libre (she is very fractious).
I install them myself approximately every 13 or 14 days, unless one stops working and I have to apply one earlier.

I always keep several on hand because they can stop working at any given time (for various reasons) and I don’t want to be without one.
The first one I had applied by my internal medicine vet, and then I made it my mission to figure out how to do it myself which I have done ever since.

As mentioned previously there is a discrepancy between when you see LO readings and what the glucometer reads. I use a Contour Next, but it could be any handheld human meter.

It’s truly not that hard to put on. You just have to follow the directions very carefully. Once you’ve done it one or two times you will be very comfortable doing it.
I started out with the Libre 2 and moved to a Libre 3 about a year and a half ago. (I got her her own phone that stays with her at home and I can monitor her 24/7, the data is sent directly to my own phone through the Libre Linkup App)

***I strongly recommend learning about how to use a Libre from the Facebook group Freestyle Libre for Dogs and Cats.***
They have so much valuable information, guide guides, tutorials videos, and everything you will need to learn about using a Libre sensor.
Plus a vet office tends to use glue to install them and it is highly recommended not to use any glue.
The glue can kill the sensor and it’s terrible on their fragile skin.

I hope this helps. Please ask questions if you have them.

We are all here to help you and are rooting for you and Wicked to have success and good health.

Please don’t give up on him if at all possible. This is a manageable situation.

Wishing you and Wicked all the best!!:bighug::bighug:
 
Bruce Blount said:
I was just ranting - I would never get rid of Wicky - he is my best friend. Since he tolerates incisions well, cant I just use a needle to draw a sample - from his "scruff (shoulder blade) area?
Click to expand...
Bruce Blount said:
I was just frustrated - I would never get rid of Wicky. He is my best friend. Since he does tolerate shots well, do you think I could use a needle in his scruff area to get a sample?
Click to expand...

whew, I’m so glad to hear that and venting is always welcome here :)

sadly no you can’t use the scruff. You can use an ear or a toe pad (use a nonweight bearing toe or pad location).

I’d seriously consider a Libre —in the long run I’d bet the cost evens out vs strips and lancets. I wish I could use one but with Methos’ skin I can’t. But how great to know the BG whenever you want?

idk how much blood your meter requires —cats ears begin to bleed more after testing for a while. Now Methos almost bleeds too much.

is it that wicked ear doesn’t bleed or he shakes it off?

also I freehand poke with the lancet, I don’t use the lancing device —I think those make it more difficult actually

finally i saw something on chewy I will post in a bit when I find it again —it has a slight suction to increase blood

hang in there Bruce. And please consider the alternatives I mentioned—even if I’m no longer worried about Wicked I’m still worried about you. A few weeks of just checking urine and occasionally trying an ear poke (meaning poke once, not poke until you’re both upset) and I really think the world will be easier
 
So this is the lancing device that has a gentle suction
https://shoppettest.com/genteel/

I’ve not used it but when I first started sticking methos i considered it.
I thought I’d never get blood from his ear.
I didn’t test several times a day. Some days I didn’t test at all—I had the advantage that he was on Bexacat so I wasn’t checking glucose, just ketones for the most part but even after switching to insulin I didn’t test very much for the first week or two because I knew he was going to need more than one unit.
I tried to avoid making it so stressful on either of us that bad feelings would be associated.
He got a high value treat after an attempt—even if unsuccessful
We tried just once
I listened to what he didn’t like (so touch his ear only when absolutely necessary which actually isn’t much, and never hold him down)

now that he understands it’s something we do he gets treats sometimes (esp if he’s not getting fed right after) but not every time…intermittent reinforcement

You will find a rhythm/system that works for you and Wicked. Believe me, EVERYONE was where you are now (but without the loss you’ve had, again my condolences). You will get this.
 
Hi Bruce,

I am sorry this is all so stressful. I can totally relate testing is difficult. Testing Binie was a nightmare at the beginning. And not testing her too, because I was scared of missing a potential hypo. I can also recommend using a libre, it puts some stress from your shoulders and gives you and Wicky time to learn.

Today testing Binie works pretty good. Still learning though. I never imagined it would because she hated me messing with her ears. Today we got a rule - blood for churus. While I test her, she is licking churus from a plate. Like that I don't have to hold her head, which would be impossible. I always make sure her ears are warm enough, otherwise I don't get enough blood. You could also experiment with different gauge sizes. And the ear "learns" to bleed. It will get better over time. Keep on trying. Binie and I needed a LONG time before we managed. And I am still not a PRO because I used the libre for such a long time.

All paws and fingers are crossed for you and Wicky! :cat::cat::cat:
 
Heike & BInie said:
You could also experiment with different gauge sizes.
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This is an excellent tip! When I started I only had the lancets I got from my vet—28 gauge (28g) and I bought a box of them from the pharmacy. I don’t know if they make larger gauge like 26 but if they do buy those. I’ll look online.

the lower the number the bigger the needle. In this case, size does matter. A bigger needle will make a bigger hole and get more blood. Or if your needles are smaller do like i suggested earlier and when you poke make two quick pokes next to each other (this is possible if you poke freehand with the lancet, not sure if a cat would tolerate it with a lancing device)

once he was bleeding more (which they do as you poke more) I got smaller 3o-36 gauge but i keep some of the larger lancets in the testing bag in case I must test on his “saved” ear (I leave his right for two topical meds he gets but in an emergency would use it and I know since it doesn’t get poked it will be harder to get blood
 
SmallestSparrow said:
whew, I’m so glad to hear that and venting is always welcome here :)

sadly no you can’t use the scruff. You can use an ear or a toe pad (use a nonweight bearing toe or pad location).

I’d seriously consider a Libre —in the long run I’d bet the cost evens out vs strips and lancets. I wish I could use one but with Methos’ skin I can’t. But how great to know the BG whenever you want?

idk how much blood your meter requires —cats ears begin to bleed more after testing for a while. Now Methos almost bleeds too much.

is it that wicked ear doesn’t bleed or he shakes it off?

also I freehand poke with the lancet, I don’t use the lancing device —I think those make it more difficult actually

finally i saw something on chewy I will post in a bit when I find it again —it has a slight suction to increase blood

hang in there Bruce. And please consider the alternatives I mentioned—even if I’m no longer worried about Wicked I’m still worried about you. A few weeks of just checking urine and occasionally trying an ear poke (meaning poke once, not poke until you’re both upset) and I really think the world will be easier
Click to expand...
I think it is a combination of him disliking me messing with his ear, and my missing his vein, meaning I have to poke again and again. Before I try, he sees the lancet, etc. and runs away and tries to hide.
I am now giving him 1/2 dry food, and 1/2 wet food, his #s before insulin are around 270. I am reluctant to switch to all wet food, then insulin - fearing he might go low. Think I will contact the vet.
 
Good luck—I’d suggest practicing toward being able to test even if you get a Libre or switch to monitoring urine.

You both already have some bad feelings about testing but it can be overcome. If there is a place you generally test maybe try just giving him a treat there, no testing…and no treats elsewhere. until he know if he gets a treat it will be there, and if he goes there he may get a treat. If instead you test many places but he knows lancets mean testing, call him over for a treat to a spot. Next time call him for treat but have lancets nearby (no testing). Repeat until he knows lancets or lancets in the testing spot means treat. If he goes to the spot (or next to your lancets) give a treat. Once that’s an understanding then start testing.

if the vet can have him on a dose that doesn’t require several tests a day or even daily testing it will give you both a breather to reset and make testing hopefully less stressful. In the old days we didn’t stick, we tested urine to be sure there were no ketones and a trace of glucose. This meant the cat wasnt perfectly
Controlled but it was sort of controlled and unlikely to go hypo.

If so then I’d say start by trying to get him to let you set up and maneuver how you’d test but no poke at first—meaning he will come to you or let you bring him to the testing spot and get him into a position to test. Reward him. Do this a few days. You can mentally make sure you have what you need laid out and the order you’d do things. Reward yourself.

Next try testing. If no blood ok, don’t try again just reward him. Maybe try again 12 hr later. Be easy on yourself. If he cooperates praise him a lot. If he doesn’t don’t ever loose your cool and yell at him or yourself. Cats pick up on anger and avoid where it happens. Always praise him during testing.

some feed treats during testing. I can’t because Methos thinks he will lose his treat if I touch his head. But he knows treat follows test. In the beginning I’d put the treat bag next to my testing bag so he knew I would pay him.

when I test I position him so he can’t run but I don’t hold him down—cats really hate that. Before I called him over I got my 2x2 out, took the tip cover off the lancet (I free hand poke and recommend doing that), and put a strip in the meter but didn’t push all the way in yet. Your flexibility may vary but I kneel on the floor with his back to me so he can’t back up. I’d keep him from running away forward by looping my left arm around the front—not holding him but blocking an exit. With my arms making a circle around him I’d push the strip into meter, put it down and put 2x2 in left hand, pick up lancet in right hand. Quickly grab left ear with left hand/2x2 under ear and poke quickly. Let go of left ear and rotate hand like I showed before to hold head steady. Scratching under chin if needed to distract while at same time drop lancet, pick up meter and by now hopefully enough blood to test has formed. Collect blood and immediately put down meter, hold 2x2 for a second or three on poke spot , give treat.

it’s been a few months now with Methos so we don’t necessarily use “the testing spot” but he still goes over there when he wants a treat. I don’t have to kneel behind him anymore (I do if he’s sitting in The Spot) but he will let me test him if he’s laying on the sofa, etc. I no longer give him a treat each time but I do often. In the beginning always reward, even if unsuccessful, until he’s cool about it.

with repeated pokes their ears bleed more. It will get easier to get blood —but like I said in the beginning bigger is better so get some larger lancets if you can.you might need to order from a pet supply bc humans are wimps so pharmacies generally carry thinner 28g or higher lancets. Also he’s black so that makes it harder—choose a spot with good light so you can see the blood drop. If freehand poking be sure to have a cotton ball or 2x2 to place under ear so you don’t poke yourself. It is not the end of the world if you poke all the way through so be bold and confident in your poke just have something behind the ear so you don’t stick yourself (which would make Wicked laugh I’m sure)

you can do this.
 
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