? 22 Feb New Member - Day 6 - BG 59 +3, 69 +4, 98 +5, 132 +6, 165+

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Crisp

Crisp

Member Since 2022
(The following is cut and paste of post 9 of this thread - Pasting to the top so my question is easy to see. Original question is still at the bottom of post 1)

Day 6

AMPS - 122
1.0u caninsulin
+3.5 - 59
+4.5 - 69
+5.5 - 98
+6.5 - 132
+7.5 - 165
+9 - 222
+11 - 238
PMPS - 236@+12

According to the beginner's guide to caninsulin, I should hold the starting dose of 1.0u for at least one week before making changes UNLESS
"your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."

For perfect clarity, I should reduce tonight's shot to .75u?

-----------------------------
Original post:

16 February - I took Crisp to the vet because he was walking with a weird gait. Blood sample taken.

17 February - Blood results in and Crisp was diagnosed with FD (six days ago). Started on 1 unit of Caninsulin every 12 hours.

18 February - Ultrasound - results show no complicating factors though there is some sand in the kidneys and some fat in the liver.

I'm Canadian but we're currently in Eastern Europe. There is a bit of a language barrier.

I bought the Optium Xido Neo glucometer and am struggling to master ear pricks and blood drops. If I can't get a reading after two attempts, I let him go to avoid the stress.

Crisp went on wet Royal Canin Diabetes as soon as he was diagnosed.

He's a big cat naturally. But he is obese at 9 kg.

Aside from those three visits, we haven't been back to the clinic yet. We're supposed to return two weeks in. The first vet told me not to give insulin if Crisp's BG is 100 or less. Another vet at the same practice said 90 or less.

This morning, Crisp's AMPS was 122. I waited 20 minutes but couldn't get a successful second reading. I gave him his food and then gave him his shot half hour later. He didn't eat all his food so I was watching him closely.

+3.15 his BG is 59.

I gave him soft Butcher's food because I wanted him to eat more. He's playful. I filled out the spreadsheet and read here that I should not have given him a shot under 200 until I got some guidance from the community.

I see BG of 59 is in the green zone.

But I don't know so much. And need some help from you while I'm trying to figure things out.

Should I take him to vet?

I'm going to take another reading.

Thanks much!
 
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+4.15 his BG is 69

Edited later:
Okay, I'm reading the hypo thread. I think we're good so I'll remove the 911 from the title and continue to observe and test.

Can you still advise on what is going on? And how we should proceed based on his numbers? Any future pre-shot readings under 200, I'll be sure to reach out for guidance.

Edit to add:
+5.15 his BG is 98
 
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Hi and welcome. I am new here and cannot offer much assistance. However, because you have so little data to go on, I would give more food immediately if it were my cat. Also, I would be testing again. Because there isn't enough data to know how long the insulin will keep working to drive down the glucose in the cat's blood, I would continue to try to counter the insulin with food because there is still a danger of going too low.

I'm sorry, I do not see an experienced member's name logged in that I know. Otherwise, I would alert them of your situation.


Here is a link to the hypo page on the forum https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

I will find someone to tag.
 
Thanks, I think I'm good with regards to hypo. BG is now at 98 +5 and I'll test every hour since both Crisp and I need the practice.
I did find that page while I was waiting for a response but the link is appreciated.
 
Day 6

AMPS - 122
1.0u caninsulin
+3.5 - 59
+4.5 - 69
+5.5 - 98
+6.5 - 132
+7.5 - 165

According to the beginner's guide to caninsulin, I should hold the starting dose of 1.0u for at least one week before making changes UNLESS
"your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."

For perfect clarity, I should reduce tonight's shot to .75u?
 
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Please keep a look out for a response from the people I have tagged. They are not online right now, but will respond as soon as they can.

Hopefully, that will happen before your next dose is due. They have the experience to help you that I do not.

I would update this post beginning with a ? mark in the title ("help" would also work). You can alter the title of this thread to add a ? at the beginning by clicking on the drop down "thread tools" at the top right of your thread. Click on "edit title" and make changes in the text box. That will let any experienced members I haven't tagged know that you are looking for help when they come online. Also, you can update the thread title with new BG readings.
 
Wow. Ok, couple things to unpack:

What specifically has he been eating the last 3-4 days? You said Royal canin diabetic, I believe that is same is glycobalance. 14% carbs, so higher than we like (aim for about 5% from this list: https://catinfo.org/chart/index.php) @Bandit's Mom do you have the European/UK list?

You mentioned the butchers food - do you mean raw meat, or is that a brand?

Please do not give insulin below 200 right now, I about had a heart attack reading that advice from the vets. You are very lucky nothing more serious happened. Once we get more data we'll have a better idea what's safe to shoot.

Once I have answers about diet I'll have better idea about dose. If you can get him permanently switched to raw food or something near 5% I think you have a great shot at diet-induced remission, or maybe with a little bit of insulin support.

What blood test did they do, fructosamine or just a blood glucose? What was specific value?

Edit for clarification: do not change diet just yet. Very serious risk of hypo this way, I just need to know what he's eating recently in order to safely move forward
 
Thanks for your reply!

Royal Canin Diabetic was the only food since the day of diagnosis (six days now). It was purchased from the vet office on their recommendation. The outer box says it's 1.3% sugars and 1.2% starch. I did see a spreadsheet somewhere that recommended Fancy Feast Classics. I haven't found it here yet. Royal Canin Diabetic being 14% carbs is not good if that is the case.

I spent about 90 minutes yesterday reading all the tables of wet food available here (Poland). And did not have any luck figuring out which ones were actually low carb. Top Secret information I guess. I did see some Sheba varieties but no pate.

Butcher's is a soft pouch brand here. It was the only one I actually bought yesterday and it was only so I could research it better from home. No luck figuring out the carbs yet.

582.6 Fructosamine
286.2 Glucose

It was those two results plus Crisp's weird new gait that led to the diabetes diagnosis. There was a third number that the vet referred to as well. But looking at the blood results sheet, I cannot recall which one was notable.
 
So reading more, the unusual gait was likely Neuropathy. We saw an improvement the day after his first shot. And he is walking perfectly now. I suspect there is more to healing so I will try to find some methyl B12 supplements.

It is terribly frustrating that the vet is not suggesting this.
 
Let me run some numbers on the diabetic. I suspect today is a result of giving the Butcher's vs Diabetic.

Do you plan to keep giving the Butcher's or was it a one time thing?
 
Wendy&Neko said:
To answer the question in the first post, yes, reduce tonight to 0.75 units.
Click to expand...
I am thinking 0.5U...that was pretty low for Caninsulin plus the diet wobble. But if sticking with Diabetic formula for now, then 0.75U if above 200

Edit - advice has changed from this post, see later in thread
 
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The Butcher's was a one time thing. I was looking for a well-recommended replacement for the Royal Canin Diabetic.
I see on the UK food list that you guys provided the link for that there are a couple low carb types that were in the grocery store.
 
Understood on reducing based on how low. Thanks for your support.

If the Royal Canin Diabetic is reasonably okay, I'll finish the pouches I currently have and then switch to something available at the grocer instead. If that is reasonable?


582.6 Fructosamine
286.2 Glucose

Above is the results from blood drawn on 16 February.
Glucose of 286 doesn't seem nearly as high as what many others were reporting.
Are there any concerns with the diagnosis?
 
From what I can find, yes the Diabetic is about 14% carbs on a dry matter basis (it's like 2.7% on a wet matter basis, but we reduce everything to dry matter basis for equal comparisons).
 
FrostD said:
From what I can find, yes the Diabetic is about 14% carbs on a dry matter basis (it's like 2.7% on a wet matter basis, but we reduce everything to dry matter basis for equal comparisons).
Click to expand...
Okay,
I will switch to one of the low carb pouches tomorrow.
Will the Royal Canin at 14% be okay for my emergency kit then?
 
Crisp said:
Understood on reducing based on how low. Thanks for your support.

If the Royal Canin Diabetic is reasonably okay, I'll finish the pouches I currently have and then switch to something available at the grocer instead. If that is reasonable?


582.6 Fructosamine
286.2 Glucose

Above is the results from blood drawn on 16 February.
Glucose of 286 doesn't seem nearly as high as what many others were reporting.
Are there any concerns with the diagnosis?
Click to expand...
No, not really with those numbers - unless he's been ill with infection for a long time or something. It's good that his numbers aren't all that high though
 
FrostD said:
Let me run some numbers on the diabetic. I suspect today is a result of giving the Butcher's vs Diabetic.

Do you plan to keep giving the Butcher's or was it a one time thing?
Click to expand...
To be clear, I gave him Butcher's after the alarmingly low reading. I just assumed the Canin I was feeding him as per the vet was actually low carb. And the 'junk' I was buying the grocer would be higher. And I wanted him to eat something immediately that would raise his glucose.
 
Crisp said:
Okay,
I will switch to one of the low carb pouches tomorrow.
Will the Royal Canin at 14% be okay for my emergency kit then?
Click to expand...
I would switch slowly over a few days, and do it when you can be home - if you can't be home you'll probably end up needing to skip most doses. Because you can see he had a pretty drastic response to getting half the carbs.

Do you have urine ketone strips? I suspect you'll have to skip a few doses while you transition and we always like to keep an eye on ketones.

Yes keep the diabetic for hypo kit.
 
Crisp said:
To be clear, I gave him Butcher's after the alarmingly low reading. I just assumed the Canin I was feeding him as per the vet was actually low carb. And the 'junk' I was buying the grocer would be higher. And I wanted him to eat something immediately that would raise his glucose.
Click to expand...
Ok so other than that low reading, he's been getting the Diabetic? If that's the case I think he's been overdosed leading to the higher numbers youve been seeing.

See what wendy thinks, but if it were me - while doing the transition I'd do 0.25U max if above 200, if anything. And watch ketones.
 
FrostD said:
... I think he's been overdosed leading to the higher numbers youve been seeing.
Click to expand...
For reasons too long to go into here, Crisp has likely had a stressful past two weeks. He was delivered to me at 0200 on the morning that I made the observations about his gait and took him to the vet. I don't know too much about his care for those two weeks but I know that it involved strangers (to him), a temporary new home, and lots of transportation which he despises on a good day. I know he was well looked after for the circumstances but he is a needy cat.

Is it possible that the high glucose was completely stress induced and he does not actually have diabetes? Maybe a dumb question, but I have to ask.
 
+11 238

FrostD, I understand about tonight (.25u or not at all). I'm leaning toward the .25u because Crisp started insulin at 286 and is now 238.

Given the time change, I'm really wondering about how to proceed in the morning. I don't think most will be awake to reply at that time.

Nothing below 200 until I can get assistance.
If it's above 200 but not alarming (whatever alarming is? - over 300?) continue with a .25u?

Many thanks!
 
I only meant no insulin or 0.25U once you've started to change the food, which sounds like sometime tomorrow or the day after. But you'll want to keep an eye on ketones when you reduce insulin like that.

If you can stay up to monitor tonight, have hypo kit with some higher carb food, and he's still getting the Diabetic food, you can try 0.5-0.75U. Your call on what you're comfortable with.

I would not change dose based on preshot because it's nadir that matters. You want to be consistent in dosing; just because he dropped X amount at Y preshot, does not mean that's what it will always do
 
Crisp said:
For reasons too long to go into here, Crisp has likely had a stressful past two weeks. He was delivered to me at 0200 on the morning that I made the observations about his gait and took him to the vet. I don't know too much about his care for those two weeks but I know that it involved strangers (to him), a temporary new home, and lots of transportation which he despises on a good day. I know he was well looked after for the circumstances but he is a needy cat.

Is it possible that the high glucose was completely stress induced and he does not actually have diabetes? Maybe a dumb question, but I have to ask.
Click to expand...
This is a better question for Wendy because I am honestly not sure. Today's numbers give me pause but I just really don't know. Let's see how food change goes
 
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