3/20/24 New Member! Rudy's Intro

Hello Community!

My sweet guy Rudy was diagnosed with Diabetes about 2 weeks ago and we have learned SO much from this forum since then, so firstly, thank you all who contribute. Rudy is a neutered male, 10 years old and about 16 lbs although he is now on a diet and should be closer to 14lbs. A bit about our journey so far:

-He tested ~460 at the vet when he was diagnosed on 3/9
-Vet started him on 1U of Glargine that day and gave us the AlphaTrak3 for home testing
-Numbers weren't moving much (still high300s - mid400s) so we upped him to 2U Glargine on 3/15
-Numbers are fluctuating between low200s to high300s now

I am really frustrated with our vet experiences so far and also getting really inconsistent readings from the AlphaTrak3 so I've decided to switch to a human glucose meter and the tight regulation method. Our current plan is to do 2 feedings (tiki cat wet food) per day with an injection at each feed, glucose testing throughout the day, and a ketone test a couple of times a week. We will adjust dosing based on the readings and according to this page that I found in one of the threads http://www.tillydiabetes.net/en_6_protocol2.htm

Wondering if this is giving anyone red flags and if there are thoughts about how we can be most successful with this change.

Thank you again, we are really happy to have found you all <3

 

Hello and welcome. Sounds like you are off to a good start; home testing, got him on a good insulin, a low carb wet food diet and thinking about following Tight Regulation (TR) for dosing. This post in our Lantus, Levemir, Biosimilars forum has more detail on TR and is what people here are used to.
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

You will note that we don't increase by 1.0 units at a time. Do you have the U-100 syringes with half unit markings?

As far as food goes, it's better if kitty gets more smaller meals per day. Same as human diabetics, smaller more frequent meals are easier on the pancreas.

We can help you even more if you can put those blood sugar numbers in a spreadsheet. We are all very numbers driven here. And I think you'll find it helpful too. Details on the spreadsheet as some basic information that can go in the signature (so we don't keep asking) are in this post:
New? How You Can Help Us Help You!

 

Thank you for the response! I just update our signature with the spreadsheet and other information, as you can see his numbers are really all over the place :/

Also, I'll be sure to start spreading his meals throughout the day. If you think of anything else after reviewing the sheet please let us know.

 

Love those green eyes!

Most common phrase used, especially by caregivers of newly diagnosed cats. You are in good company there. What you likely seeing quite a bit is what we call a bounce here:
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).

Thanks for getting things set up so quickly. Comments on spreadsheet. First, we always test before giving insulin - to make sure it safe to shoot. The sequence is typically, test then feed then shoot. Some people shoot while the cat's head is in the bowl. Typically all done in 10-15 minutes. With TR, you'll need to get both preshot tests per day plus at least one per cycle (time between the shots). So a total of at least 4. Note, many cats go lower at night, so try to get a test just before you go to bed, if it's at least 2-3 hours after the PM shot. That'll help us know if he's dropping at night.

 

The only thing I don't think you mentioned is what you're feeding Rudy. Hopefully, you are feeding him a low carbohydrate, canned or raw food diet. If not, in order to use TR, your cat needs to be on a low carb, canned food diet.

The link to the dosing methods that Wendy provided includes TR. It's based on what you read on the Tilly website. FWIW, I find our text easier to follow than the Tilly instructions.

 

Thank you both! I agree that the text in the link you shared is a bit easier on the eyes haha.

And yes, we are feeding Rudy TikiCat wet food exclusively now, checked for the ones with no carbs and highest protein. So far so good! We have been having trouble with his meter lately (just posted a thread on this hoping to get some help) but will continue with his spreadsheet updating once that is sorted.

 

Looking at the SS, it looks as if you are only giving the insulin once a day.
Is that correct?

 

Hey there- No we are giving him insulin 2x per day. I just learned what AMPS/PMPS means so we weren't really populating the right side of the spreadsheet. We just got a new monitor and figured out testing regimen so thinking things will be consistent moving forward.