? Help with newly diagnosed cat

Q

QuinnA

Member Since 2026
Very new to this and it’s been a wild ride. Forgive me, I do not know the lingo/ correct terminology so I’ll do my best!

My 9 year old cat, alfalfa was diagnosed with diabetes October 14 after weight loss and increased thirst brought him to the vet. They started him on Bexacat but that didn’t start until Monday (Oct 19 ) in the evening as they had to order it. He also had a Libre 3 placed that morning. He went back to the vet Wednesday (Oct 21) for a ketone check and the vet called us to return that afternoon because ketones were concerningly high( I don’t know the number, sorry). Went that afternoon and she said that alfalfa looked good minus some mild dehydration and ketones were lower than the first test indicated, but after rechecking the bexacat guidelines she thought that insulin was a better option for him.

She started him on 2 units twice a day of insulin (lantus) which we started Wednesday (October 21)afternoon. He got 2units Wednesday, Thursday morning and Thursday afternoon and Friday morning. Friday morning I called the vet because I had questions for the weekend. His numbers didn’t seem to be coming up and we had some low alerts on the Libre. He was only at a 60 Friday morning before we fed him and gave him his 2 units which seemed much too low from everything I read online.
She said as long as he’s not showing physical signs of hypoglycemia to continue with the 2 units ever 12 hours, and that the blood sugar reading before the shot wasn’t super critical right now because looking at his trends he was still spending more time in the high zones. She said if we were really worried we could wait if it was below 80. Friday we were getting low alarms all day and he was significantly less active. He would not eat Friday when it was time for a dose so the on call vet told us not to give him his evening dose of insulin and just try to get him to eat overnight, giving the morning dose if his blood sugar came up and coming in if he got worse.
He finally ate which then caused a steady rise overnight to 310 before this mornings dose.
Gave him 1.5 units this morning as I was reading to reduce by .5 after a low reading and his numbers steadily lowered throughout the day spending some time in 69s this afternoon. He is currently 84 and due for another dose of insulin and I don’t know what to do!
Can someone give me advice on how much to give or how to continue? We have a consult at a cats only vet with 30 years of experience but that’s not until Friday.
I mostly need to know if 84 pre meal is too low to give insulin and how much you would give or what you would do tonight.
I feel so lost with this!

Attached are the Libre graphs from the last few days
 

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Welcome, to answer your immediate question, the information on this forum says not to shoot under 150 mg/dL on a human meter when you’re just starting out. Does he have any history of ketones or DKA? If yes, I’ll try to talk you through some other options to get some insulin in tonight but otherwise my vote is skip.

Edit: reread your post, can you stall without feeding and verify the pre-shot number with a handheld meter?
 
We’ve seen the Libre be unreliable in lower numbers. So ideally you could verify with a handheld meter, but I’m guessing that hasn’t come across your desk yet. See if he comes up without food in 30 minutes or so. It sounds like he’s seeing pretty low numbers on 1.5u. With the ketones in the recent history you don’t want him going too high with a skip.
 
Tim & Pookey said:
Welcome, to answer your immediate question, the information on this forum says not to shoot under 150 mg/dL on a human meter when you’re just starting out. Does he have any history of ketones or DKA? If yes, I’ll try to talk you through some other options to get some insulin in tonight but otherwise my vote is skip.

Edit: reread your post, can you stall without feeding and verify the pre-shot number with a handheld meter?
Click to expand...
We can run to Walmart and buy a handheld, our vet told us the Libre was all we needed right now and I’m learning that may not be true! He did have a higher ketone reading Wednesday but she never gave me a number. She said it was a little higher than she would like but not concerning at that point upon retest
 
If you’re going to make a run, it would be worthwhile to pick up some Ketostix to test ketones at home via urine, or a blood ketone meter. Also make sure you have hypo supplies for managing low numbers at home, see this post.
 
You’ll probably need this for when you get home.

Info - TESTING AND SHOOTING TIPS

One thing to consider is how off schedule you can get since the next shot will need to be 12 hours from this one. If we have to make a decision on some kind of dose soon we can try to talk it through with the information we have.
 
My husband is running to Walmart now, it looks like they have a meter in stock. We have some flexibility with the schedule this week but in the next week or 2 will need to get back to times that work with our life. I guess we will cross that bridge when we come to it, we’re just trying to triage and get him on track right now!
 
Red & Rover (GA) said:
What food has Alfalfa been eating? and when?
What are your normal shot times?
Click to expand...
He had been on a purina dry food, urinary formula. We had another cat that was eating that per vets orders and after we lost the cat we never switched. Vet recommended switching to wet food twice a day so we transitioned over about a week to fancy feast pate
We’ve only been doing shots a few days, we started 4am/4pm (weird work schedules) but skipping one threw us off and we’re so new and his numbers are so low I don’t know what time to do anything
 
He is currently 74 on a handheld meter. How in the world do we proceed? He still needs dinner but that’s too low for insulin from what I’m seeing everywhere.
 
Tim & Pookey said:
If you’re going to make a run, it would be worthwhile to pick up some Ketostix to test ketones at home via urine, or a blood ketone meter. Also make sure you have hypo supplies for managing low numbers at home, see this post.
Click to expand...
No ketone testing supplies at our Walmart tonight, we will have to order some!
 
QuinnA said:
74 on a handheld meter
Click to expand...
Ok… great number but too low for 1.5u right now. What are you thinking? The options are some reduced dose or a skip. There’s risk with giving insulin tonight and without a bigger picture on how he’s responding to insulin it feels irresponsible to tell you to do that. There’s risk with the skip that he develops ketones in higher numbers.

What would I do? I’d probably shoot a reduced dose (assuming he’s eating good) and if I could monitor all night and had the hypo supplies like Karo and high carb food. Ketones are scary. What should you do? Just being so new still, learning home testing, etc. schedule way off… you skipped earlier this week and it was okay… I don’t mind the skip.

I’m sorry I’m not giving you a clean answer. It will get easier once we know more about how his cycles go. Good job getting that manual test!
 
He is eating very well. I do have Karo and high carb food if needed. I can skip or give a VERY reduced dose (.5?)
We do not have a way to test ketones at home right now.
I know yesterday after he ate without insulin his numbers went quite high overnight, which is a concern. Ugh, I don’t love this
 
Tim & Pookey said:
How about another handheld test in 15-20 minutes and then we decide? That’ll at least give us a small trend.
Click to expand...
We are going to retest in a minute, but I gave him 2 small hard cat treats immediately before the last test to get him out froM under the couch without thinking about it. His Libre is now showing 107. It didn’t occur to me that it would mess up readings, I just needed him out!
 
Basically flat. Whatcha thinking? I think I’m leaning more towards skip because he does have a little depot built up from the bigger doses the last few days that might impact this cycle coming up. And he’s got a lower start so maybe he won’t zoom up as high.
 
we’re so late at this point I think that’s fine. So I feed him (the normal amount?) tonight, and then give what tomorrow? I still feel 1.5 has been too high for him.
 
See what @Wendy&Neko or @Marje and Gracie or @Bandit's Mom think about tomorrow’s dose.

If you’re going to stick around here there’s a whole community of folks using Lantus and supporting each other. It’s really a nice environment. There are two dosing methods for Lantus that you can look at for adjusting the dose. One reduces under 90 mg/dL and the other is a little more.. aggressive? and reduces under 50 mg/dL. The tight regulation dosing method is based on a research paper.

Last thing for now and sorry for loading you up, but there are folks all around the world here so we do use a standard platform for sharing glucose numbers. It’s just a Google spreadsheet. For situations like you saw tonight it makes it easier for everyone and for you to get better help.
 
Tim & Pookey said:
See what @Wendy&Neko or @Marje and Gracie or @Bandit's Mom think about tomorrow’s dose.

If you’re going to stick around here there’s a whole community of folks using Lantus and supporting each other. It’s really a nice environment. There are two dosing methods for Lantus that you can look at for adjusting the dose. One reduces under 90 mg/dL and the other is a little more.. aggressive? and reduces under 50 mg/dL. The tight regulation dosing method is based on a research paper.

Last thing for now and sorry for loading you up, but there are folks all around the world here so we do use a standard platform for sharing glucose numbers. It’s just a Google spreadsheet. For situations like you saw tonight it makes it easier for everyone and for you to get better help.
Click to expand...
Thank you so much, I appreciate all of your help tonight!!
 
I will say that having a community to help definitely makes things much easier to manage! There is a wealth of knowledge and experience here (as you've already seen) and it's a really great community over on the lantus board.
 
Red & Rover (GA) said:
@QuinnA
How are Alfalfa's numbers this morning?

If your vet is open today, call and ask what the ketone numbers were.
Click to expand...
I’m working on a spreadsheet in the groups format to share. Vet is not open until tomorrow. He went up overnight so I gave 1u this morning with food and it still seems like it’s too much. He dropped from 263 to 60 in about 3 hours.we’ve given him some ff gravy lovers and it comes up for a short period of time then starts decreasing again.
 
QuinnA said:
some ff gravy lovers and it comes up for a short period of time then starts decreasing again
Click to expand...
Carbs only last so long.
If ketones are present, it is more important that he gets insulin and eats.
I'd like to tag @Bron and Sheba (GA) about this. She lives in Australia so may not respond right away.
Waving from Canada.

QuinnA said:
He dropped from 263 to 60
Click to expand...
Are these numbers from the Libre? or the handheld?
A number of people here have found that the Libre reads lower at low numbers than the handheld.

Some links.
Just to make sure, can you tell us what insulin needle you are using? And does it have an orange cap?
 
Red & Rover (GA) said:
Carbs only last so long.
If ketones are present, it is more important that he gets insulin and eats.
I'd like to tag @Bron and Sheba (GA) about this. She lives in Australia so may not respond right away.
Waving from Canada.


Are these numbers from the Libre? or the handheld?
A number of people here have found that the Libre reads lower at low numbers than the handheld.

Some links.
Just to make sure, can you tell us what insulin needle you are using? And does it have an orange cap?
Click to expand...
Sorry I’ve been at work so my husband has been on cat duty! The low was verified on a handheld. Yes the needles have an orange cap, they are a u100. I can verify brand when I get home but I’m positive they are correct. We also brought them by the vet to verify.
We talked to an emergency vet on the phone and she agreed, food and insulin at a lower dose were important right now so she had us do dinner and then give .5 units which seems to be a better dose for him, we didn’t see super high numbers and he hasn’t gone low since that. I think he was just started at too high of a dose for him! When I’m off I’ll finish the spreadsheet and get that loaded but I’m feeling much better with everyone’s help here! Thank you for the additional resources today!
 
Hello and welcome. Good to hear your vet was on the ball about stopping Bexacat with ketones present.

Changing from dry food to wet food that is typically much lower in carbs, can make a huge difference in the amount of insulin needed.

Got any idea how long until you get some way to test ketones? Almost all human pharmacies have Ketostix or the equivalent. Presence or not of ketones plays a large part in what we suggest for dosing. As does the spreadsheet history. And some items in your signature, details here: New? How You Can Help Us Help You! You should be able to ask the vet clinic for copies of any blood work or urinalysis tests. Getting copies of the ketones data would be very helpful.
 
Wendy&Neko said:
Hello and welcome. Good to hear your vet was on the ball about stopping Bexacat with ketones present.

Changing from dry food to wet food that is typically much lower in carbs, can make a huge difference in the amount of insulin needed.

Got any idea how long until you get some way to test ketones? Almost all human pharmacies have Ketostix or the equivalent. Presence or not of ketones plays a large part in what we suggest for dosing. As does the spreadsheet history. And some items in your signature, details here: New? How You Can Help Us Help You! You should be able to ask the vet clinic for copies of any blood work or urinalysis tests. Getting copies of the ketones data would be very helpful.
Click to expand...
We live in a small town and there was nothing available for ketone testing here today but they should be coming tomorrow morning via Amazon. Our vet opens in the morning and I’ll get all of our numbers and records! I’m working on the spreadsheet, I’ve been at work and had limited phone access. I’ll look through that links and get it all updated by morning. I really appreciate your help!
 
Wendy&Neko said:
OK, let's circle back tomorrow.

How has his appetite been?
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He’s been eating well, no issues with that. No vomiting or diarrhea or anything weird. He was displaying excessive thirst which is what caused us to take him to the vet initially but that has stopped and his water consumption seems to be back to normal, he’s not fighting us for water at the sink anymore 😅
 
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