Hi all! Here is my previous/first thread: Lily, newly diagnosed, lots of questions and in need of recommendations! Was wondering if anyone could look at our spreadsheet. Lily's numbers have been on quite the spectrum. Our vet's first plan was to stick with 1u over 250 mg/dL. Then he recommended .5u for 200-250, 1u for >250. Recently we've been seeing red numbers in the mornings, so she'd been getting 1u, but then for her PMPS, the numbers under 200, so no shots then. That did make me feel uneasy seeing as I knew she'd be high the next cycle. I updated our vet yesterday and he said >150 we can give the .5u and be consistent with that number even at >250. This morning she was at 80 so again, no shot. That number I do feel fine with not giving a shot, but I do wonder if we should change up our protocol going forward. Any guidance would be really appreciated!
Hi! I think you would be far better off giving a consistent dose every cycle when it is feasible to do so — and to gather data by testing as much as you can at various points in the cycle or to do a curve at home from time to time. As for this morning’s low AMPS, I agree that skipping was the correct thing to do. We don’t have enough data to know how Lily would do with even a token dose of .25 units yet. Gradually, as you gain more data on your spreadsheet, you will be able lower your “no shoot” number and to know when to shoot a token dose and how much. I wish that a few nights ago when she was in yellow (223, 224) at PMPS time and you shot .5 units that you had been able to get some tests so we could have seen how she did. It may not have been enough because the next morning she was in the pink, but that also could mean that she dropped lower than her body is used to during the night. So you see how we need more information. I definitely think that we can help you get into better and more consistent numbers if you will gather data and post here for help. I definitely do not think the skipped shots the last few evenings have been helpful. Look how she has climbed by +4 when you have tested. I totally do understand your anxiety about the lower numbers. It takes a few hours for the insulin to kick in and that gives time for the BG to climb before it starts to lower BG. One other thing I would like to know— is Lily eating low carb wet food consistently? I saw some food with oat in it on your spreadsheet and I don’t know the carb content of your other food, but the carbs will definitely elevate her BG. So it would be good for us to talk about her food and feeding schedule so that I can understand and get the whole picture.
Yes, I agree, I wish I had tested then too! At that point I had no idea her numbers were going to get into red again. I'll definitely be doing at least four a day but more when possible. And also agree about the skipped shots, at the very least I wish I did for the 198 and 152. I'm glad that for now our vet said it's okay to shoot >150, I'm thinking we may get there for tonight's test but I did just test her right now and she's at 108. As for food, no more grain! She hasn't had it since the beginning of her diagnosis. The Tuna/Oat from Purina is 53% protein and 10% carbs, so definitely on the higher end for diabetics. From now its been Fancy Feast Classic pates and Weruva BFF pates. She unfortunately does not recognize Tiki Luau as food I'll try and be more exact about her meals in the remarks section. As for timing, she's a grazer so she gets her biggest meals about 20-30 minutes before shot time, but doesn't finish it all in one sitting. I've also been letting her eat around 1pm and right before I go to sleep around 1am because she does get quite hungry. However, I'm pretty strict about no food 2 hours before testing. I'm not totally sure what the best feeding schedule is. I've seen some people recommend 2 strict meals per day around shot time but I think I've read here that multiple smaller meals throughout the day are fine too. Our vet said she could have access to food whenever she wants.
As for a good feeding schedule for a diabetic cat on insulin, feed at shot time and after that small snacks of 1-2 tsp pf low carb wet food around the +2 mark and then again at +4 or so. You can feed more or more frequently. Some people will give a little food each hour. Multiple small snacks throughout the early portion of the cycle before the cat’s typical nadir is very beneficial for stabilizing Blood Glucose and preventing steep drops. It’s just not normally recommended to feed very much after nadir because it can shorten the duration of the insulin and cause BG to rise prematurely.
