New Diagnose, need advice!

Threecats

Member Since 2026
Hello all. Im going to try to keep this as short as I can to save you all!

My cat has been acting strange for a couple weeks. Assumed it was because it’s 100+ outside for weeks now. It was not. Took him in Saturday, he was diagnosed with diabetes and they kept him overnight Sunday for fluids for dehydration.

I picked him up Sunday. The vet was short staffed and chaotic that day. I didn’t get much instruction. I immediately ordered the pet glucose monitor the vet had from Amazon and it got here Monday evening.

When tested at the vet on day one on Saturday he came back over 500. We started insulin. The first time I tested at home was Monday night (30 mins after food. Didn’t know that’s not a great time to test.) and it came back 458.

Food and insulin (1 unit of lantus) 6:30AM and PM. The next day (Tuesday) was 413 waking up and 197(yay!) before dinner.

Wednesday, 228 waking up and 304 in the evening but he had a snack a couple hours before.

This morning he was 200 even.


He seems to be trending well but here are my questions.

1. He is a hungry boy. I’m feeding fancy feast pate. He is traditionally around 12 lbs, but after this event he lost nearly one pound. He’s just above 11 now. How much should I be feeding him? I give one can in the morning and have been splitting another into two portions for two snacks during the day, then one can for dinner.

2. He is a hungry DIVA boy, lol. This IS MY MAIN PROBLEM. He wakes up at 3:30 scratching my neck and nibbling my fingers. Knocking things off the nightstand. And just quietly rioting for food. What do I do? Can I give him something at night? If I lock him out of the room he scratches the bottom of the door until his paws bleed. Any advice here?

3. He is a hungry boy. In these night fits of rage, when he’s finally exhausted of annoying us, he goes and drinks soooo much water that he comes back and lays on my pillow next to me, and proceeds to throw up water on my head. Two nights in a row.


I know that hunger and thirst are the enemy and means he isn’t doing great. I think the vomitting is just from over drinking but I’m not positive. He doesn’t do the over drinking or vomitting during the day. His drinking is actually back to completely normal when I’m awake. His energy levels are great.

Im sure he’s still adjusting because he’s been a free eater his entire life before this (he’s 12) but PLEASE I need sleep and sanity! Lol. It’s only been four days for me!


Thank you so much for any advice and thank you so much for reading!


Ps- the vet has given me permission to increase to 1.5 units if his numbers didn’t go down after the first 400+ reading I took but they seem to be going down so I kept it at 1 for now. Anything else I’m doing wrong?
 
Welcome to the forum!!

What kind of insulin are you using?

I use a wet food feeder that gives them food at +.5, + 4.5 and +8.5, both morning and night. It has three trays, and the +.5 & +8.5 tray have one pate and the +4.5 tray has two, same morning and night. I have two cats. My civvie cat is a Big Boy but the less hungry cat atm.

Crowley was also drinking/peeing a lot, but as his blood sugar has gotten more and more under control, he definitely pees a lot less now, so I hope that thirst dies down soon for you, especially if the switch to wet food is new.
 
Welcome to the forum!!

What kind of insulin are you using?

I use a wet food feeder that gives them food at +.5, + 4.5 and +8.5, both morning and night. It has three trays, and the +.5 & +8.5 tray have one pate and the +4.5 tray has two, same morning and night. I have two cats. My civvie cat is a Big Boy but the less hungry cat atm.

Crowley was also drinking/peeing a lot, but as his blood sugar has gotten more and more under control, he definitely pees a lot less now, so I hope that thirst dies down soon for you, especially if the switch to wet food is new.
He is on Lantus. Thank you for your feeding schedule, this is helpful. I was told the snacking is okay but he’s just been so hungry with “snack” amounts. And the overnight is brutal.
 
Right now his body isn't processing his food well, so it's making him super hungry.

One thing we recommend is to include information about your cat in your signature so it's easily accessible to members. You can see what's in mine for an example or read more info here. We also recommend having a spreadsheet, which you can find info on here. The spreadsheet makes it easy to track/see patterns and easy for members to review your info and provide advice.
 
Welcome! Did I miss what his name is?

Liz sent you some great links in post #4 about the signature and spreadsheet. Especially the spreadsheet. Not only is it easier for you to have everything in one place, but it being a universal platform here makes it simpler for folks trying to help.

I think the hunger will improve once he starts getting into some better numbers. One of the symptoms of FD is eating a ton and losing weight, so that makes sense. As far as how much to feed, the 3oz Fancy Feast classic pate cans are roughly 90 calories per can. Did the vet give you a target weight? You can get a ballpark for how many cans to feed using a calculator like this one. And then of course let the scale be your guide.

On this forum, dose changes in these smaller doses are usually made in 0.25 unit increments. If you've got some time, take a look at this post that talks about when to increase and decrease the dose.
Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
 
He wakes up at 3:30 scratching my neck and nibbling my fingers. Knocking things off the nightstand. And just quietly rioting for food. What do I do? Can I give him something at night?
Have you ever tested his blood sugars when he does this? Just wondering if he's going lower at night - many cats do. Food is how they bring up their low blood sugars.
 
Welcome! Did I miss what his name is?

Liz sent you some great links in post #4 about the signature and spreadsheet. Especially the spreadsheet. Not only is it easier for you to have everything in one place, but it being a universal platform here makes it simpler for folks trying to help.

I think the hunger will improve once he starts getting into some better numbers. One of the symptoms of FD is eating a ton and losing weight, so that makes sense. As far as how much to feed, the 3oz Fancy Feast classic pate cans are roughly 90 calories per can. Did the vet give you a target weight? You can get a ballpark for how many cans to feed using a calculator like this one. And then of course let the scale be your guide.

On this forum, dose changes in these smaller doses are usually made in 0.25 unit increments. If you've got some time, take a look at this post that talks about when to increase and decrease the dose.
Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
Thank you for the reply! I will update the signature etc here shortly. His name is Mouse. I will also read more of the stickies. I’m sorry, I’m on edge with him right now and very anxious so I wanted some quick answers to start with! The vet didn’t give much info at all. He even said he could just keep eating his normal diet in the beginning before telling me he could be on a Hills dry food diabetic diet two days later and writing me a script. Nothing concerning weight. Obviously I did not get that food and have decided to try the fancy feast instead for now as he has been doing good on it aside from the hunger
 
Have you ever tested his blood sugars when he does this? Just wondering if he's going lower at night - many cats do. Food is how they bring up their low blood sugars.
This is a really good point/idea. He associates the ear prick with his food now and I am worried he will not tolerate it as much if he’s not rewarded afterwards but I can do it once to see. If it is low do you think I should be portioning a part of his “snack” allotment to the nighttime? Or are they suggested to go through the night?
 
telling me he could be on a Hills dry food diabetic diet two days later and writing me a script.
Don't fill the script. Dry food is not suitable for a diabetic cat, and the Hills food is too high in carbs for a diabetic cat. Most people here feed commercially available low carb wet or raw food. What was he eating before his diabetes diagnosis?

He associates the ear prick with his food now and I am worried he will not tolerate it as much if he’s not rewarded afterwards
Invest in some low carb treats so it's a different food. There are all meat treats (Purebites is just one such brand) that are just freeze dried meat. And you can absolutely give him some food overnight. Especially if it's the time of night when his numbers might be lower. It's best on a diabetic cat to have several small meals a day.
 
Don't fill the script. Dry food is not suitable for a diabetic cat, and the Hills food is too high in carbs for a diabetic cat. Most people here feed commercially available low carb wet or raw food. What was he eating before his diabetes diagnosis?


Invest in some low carb treats so it's a different food. There are all meat treats (Purebites is just one such brand) that are just freeze dried meat. And you can absolutely give him some food overnight. Especially if it's the time of night when his numbers might be lower. It's best on a diabetic cat to have several small meals a day.
Thank you so much, I suspected this! He was eating Iams healthy adult dry food (orange bag). This is very helpful
 
Does he like the Fancy Feast? How long has he been eating it? Is it 100% wet food now? I'm just trying to figure out the timing of the change to wet food and his blood sugars. The spreadsheet will help with that. In the mean time, the fact that he got to 197 on the Tuesday means you should not be increasing his dose to 1.5 units yet. In fact, the most we'd increase would be to 1.25 units. But again, not yet. Lantus/glargine is a depot style insulin. Meaning it builds over several days, and can take 5-7 days in the beginning to build that depot. What day did he start insulin?
 
Does he like the Fancy Feast? How long has he been eating it? Is it 100% wet food now? I'm just trying to figure out the timing of the change to wet food and his blood sugars. The spreadsheet will help with that. In the mean time, the fact that he got to 197 on the Tuesday means you should not be increasing his dose to 1.5 units yet. In fact, the most we'd increase would be to 1.25 units. But again, not yet. Lantus/glargine is a depot style insulin. Meaning it builds over several days, and can take 5-7 days in the beginning to build that depot. What day did he start insulin?
He has been on fancy feast since Monday morning. It is 100% fancy feast now, it’s been about 3 cans a day divided into 2 main meals and two snacks of half a can in between. He adores it. He scarfs it down every time and gets extremely excited when I grab the cans. He’s like a little fancy feast fiend. I would occasionally treat him with it at random times before diagnoses and he’s loved it his entire life, so luckily the transition has been extremely easy aside from him not being able to free graze on dry food as he always has his entire life. I feed 6:30am and PM. 4-6:30 PM is brutal and he’s crying for food the entire time. I have been trying to adjust the time of the snack to hold him over properly but I was worried if I feed a snack too close to dinner it will mess with the blood sugar reading? Should I be giving 2 hours without food before testing?

From what I read that is why I did not increase his dose, thank you for confirming that and explaining the depot style meaning. The vet gave him one shot of insulin supposedly the day we brought him in (Saturday) and I begun the lantus injections when I got him home on Sunday night.


08/25
413 level waking up 6:30am before food and insulin.
197 level 6pm. Gave food and insulin 6:30


08/26
228 waking up 6am. Food and insulin 6:30
Small amount of water vomit 6am
304 5pm (snack at 3) dinner/insulin 6:30



08/27
200 6am. Food and insulin 6:30



I will work on the spreadsheet!
 
If you are up for it, an alternate very low carb snack is some boiled or baked chicken breast cubes. You can give those late in the cycle without much impact on his blood sugars.

For Lantus, the "typical" low points or nadirs are around 6 hours after the shot. We determine how to change the dose based on how low the dose is taking the cat. If you can, try getting some tests in the 4-7 hours range after the shot. Note, not all cats like to be considered typical. 🤣
 
If you are up for it, an alternate very low carb snack is some boiled or baked chicken breast cubes. You can give those late in the cycle without much impact on his blood sugars.

For Lantus, the "typical" low points or nadirs are around 6 hours after the shot. We determine how to change the dose based on how low the dose is taking the cat. If you can, try getting some tests in the 4-7 hours range after the shot. Note, not all cats like to be considered typical. 🤣
Oh, he would give you a skippity pap on the head if he heard you refer to him as “typical.” 😂. Will do! Thank you, you’ve been very helpful
 
If you are up for it, an alternate very low carb snack is some boiled or baked chicken breast cubes. You can give those late in the cycle without much impact on his blood sugars.

For Lantus, the "typical" low points or nadirs are around 6 hours after the shot. We determine how to change the dose based on how low the dose is taking the cat. If you can, try getting some tests in the 4-7 hours range after the shot. Note, not all cats like to be considered typical. 🤣
Hi just a quick question! I’m only on day 4 of logging and I just checked his nighttime level and it’s 439 pre insulin. I went ahead and fed him and gave him the same dose. He’s been okay, this is the highest he’s been since I’ve brought him home but he did sit on the porch for an hour or so earlier so maybe he got excited? He’s now laying next to me very tired but seems okay. Anything I should look out for?
 
Did you get any tests between that morning 200 and tonight's 439? It's possible he went lower than 200 today and his body is not used to it, so he's bouncing. Here's the definition of that extremely common reaction:
  • 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).
 
I did not. I will try to do 3 tests a day now. It’s just hard to fit it all in! Thank you again for your help! It is very possible it went lower this afternoon. I will aim to test around 6-7 hours after the first shot as you recommended earlier. That’s his snack time anyway. This is all so nerve wrecking. I thought he was trending better! 😭
 
It is very early days yet. One of our many sayings here is that feline diabetes is a marathon, not a sprint. Our kitty's bodies have to get used to working with the insulin (a hormone). It takes time. The fact that he's already seen a number under 200 is a really good sign. Some cats (like mine) take months.
 
It is very early days yet. One of our many sayings here is that feline diabetes is a marathon, not a sprint. Our kitty's bodies have to get used to working with the insulin (a hormone). It takes time. The fact that he's already seen a number under 200 is a really good sign. Some cats (like mine) take months.
Thank you for your timely replies and support. You’re the best.
 
Have you ever tested his blood sugars when he does this? Just wondering if he's going lower at night - many cats do. Food is how they bring up their low blood sugars.
Hello again! I have time this weekend to finally set up the spreadsheet.


Quick question in the meantime. Mouse has been hanging out around 300 all day yesterday. This morning he came in at 126! Was I right to skip his insulin? I also divided his meals up as well so that he got a 4th of a can at 3am when he starts rioting and it worked like a charm and have been giving him pieces of plain cooked chicken breast I cooked for him for small treats.
 
Which Lantus protocol are you following? Start Low Go Slow or Tight Regulation?

Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Probably best to stick to SLGS to start. Here's the info on when to not give insulin:

How to handle a lower than normal preshot number:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.

  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
 
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