3/22 Fitzy +4 404 +6 452

Sophie & Fitzy

Sophie & Fitzy

Member Since 2021
Hi there!

My poor guy feels crummy from swinging all over the place. His daytime numbers are always so high and his evening numbers swing into the blues regularly. Just got him on an all wet diet(Glycobalance wet) with a little Dr.Elsey's as a snack. I have a call with the vet this week to discuss and they are pretty open to suggestions. Any advice?

Thank you!
 
Hi Sophie!

Here's your last post from 3/5 for continuity: https://www.felinediabetes.com/FDMB...consistently-in-the-400s.244174/#post-2754767

It's great that you've got Fitzy mostly on wet food now, but you should definitely take him off Glycobalance as it's 14% carb and too high for a diabetic cat. I also fed my Ruby Glycobalance on the advice of her vet when she was first diagnosed and her numbers stayed really high until I put her on Fancy Feast and took away all kibble. The idea is to feed him wet foods with less than 10% carbs. Most people here are able to find foods that are less than 5% carbs even, and those are ideal so they don't influence BG levels as much.

One thing I noticed about your SS is you're not testing before giving shots (or at least a lot of those fields are blank). It is SUPER important that you get those tests before you give insulin, especially if you are going to transition to lower carb food as that can often lead to a dramatic drop in numbers. If you look at my spreadsheet for Ruby, you'll see I always test before shots and then do 3-4 tests in her AM cycle and at least 2 in the PM before I go to bed. You don't have to test as much as I do but you need a minimum of 4 tests: 1 before each shot and one mid-cycle shot, 4-6 hours after her shot to get the nadir or lowest point to which the insulin will bring your cat's BG levels. We dose based on nadirs, not the higher numbers you get before a shot.

I see you're also decreasing by one unit doses. On the FDMB, we increase and decrease by .25 units. Can you get syringes with half unit markings? Here's a link to dosing: Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

I know this is all a lot to take in but this is just a start to all of the things you can do to help your kitty get back to the way he was before the diabetes set in. My Ruby is regulated now thanks to the wonderful people here in this group and she is playful and frisky like a kitten. You'll get there with some work and patience. :bighug:
 
PerfumedCatMom said:
Hi Sophie!

Here's your last post from 3/5 for continuity: https://www.felinediabetes.com/FDMB...consistently-in-the-400s.244174/#post-2754767

It's great that you've got Fitzy mostly on wet food now, but you should definitely take him off Glycobalance as it's 14% carb and too high for a diabetic cat. I also fed my Ruby Glycobalance on the advice of her vet when she was first diagnosed and her numbers stayed really high until I put her on Fancy Feast and took away all kibble. The idea is to feed him wet foods with less than 10% carbs. Most people here are able to find foods that are less than 5% carbs even, and those are ideal so they don't influence BG levels as much.

One thing I noticed about your SS is you're not testing before giving shots (or at least a lot of those fields are blank). It is SUPER important that you get those tests before you give insulin, especially if you are going to transition to lower carb food as that can often lead to a dramatic drop in numbers. If you look at my spreadsheet for Ruby, you'll see I always test before shots and then do 3-4 tests in her AM cycle and at least 2 in the PM before I go to bed. You don't have to test as much as I do but you need a minimum of 4 tests: 1 before each shot and one mid-cycle shot, 4-6 hours after her shot to get the nadir or lowest point to which the insulin will bring your cat's BG levels. We dose based on nadirs, not the higher numbers you get before a shot.

I see you're also decreasing by one unit doses. On the FDMB, we increase and decrease by .25 units. Can you get syringes with half unit markings? Here's a link to dosing: Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

I know this is all a lot to take in but this is just a start to all of the things you can do to help your kitty get back to the way he was before the diabetes set in. My Ruby is regulated now thanks to the wonderful people here in this group and she is playful and frisky like a kitten. You'll get there with some work and patience. :bighug:
Click to expand...

Thank you for the information. We are going to stay with the Glycobalance wet for now, as it was pretty traumatic to even get here. I appreciate you sharing the information about the low carb food. I am very impressed with everyone's ability to ride the razor's edge with zero carb food and giving insulin! It makes sense why testing is so important. I can see where Fitzy's lowest points are, especially at night. For some reason he stays high all day, which really could be bounces from his little dips in the evening. But not sure how to address that in regard to his insulin dose.

I was instructed to lower the dose in a previous conversation from 5u to 4u after a scary night (https://www.felinediabetes.com/FDMB/threads/intro-and-first-blue-5-107.244017/), and then our new vet recommended 2u which we have been much more comfortable with and have stuck with for almost two weeks. That link is helpful in understand our insulin better, thank you for sharing that as well.

I really am doing the best I can and would love to hear any thoughts on our data so far.
 
I'm a little too new to provide dosing advice so hopefully a more senior member of the board will be by shortly.

I see you haven't chosen a protocol to follow yet, but since you're still feeding dry food, you would be obliged to choose the SLGS protocol, which advises lowering the dose by .25 units anytime the cat goes below 90, and holding the dose if the cat nadirs between 90 and 149 (which he did a few days ago). With SLGS, you hold doses for 7 days, do a curve (test every 2-3 hours for 12 hours) and make a decision regarding increasing doses then. Below is the sticky on the two dosing protocols, from which I've excerpted the following about SLGS dosing (highlighted in red the part that applies to Fitzy):

Starting Dose:
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • 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.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

Is there a reason why you aren't testing before shots? If you're trying to limit how much you are testing, I would personally skip all other tests and just do the ones before you give insulin. It's really that important.
 
PerfumedCatMom said:
I'm a little too new to provide dosing advice so hopefully a more senior member of the board will be by shortly.

I see you haven't chosen a protocol to follow yet, but since you're still feeding dry food, you would be obliged to choose the SLGS protocol, which advises lowering the dose by .25 units anytime the cat goes below 90, and holding the dose if the cat nadirs between 90 and 149 (which he did a few days ago). With SLGS, you hold doses for 7 days, do a curve (test every 2-3 hours for 12 hours) and make a decision regarding increasing doses then. Below is the sticky on the two dosing protocols, from which I've excerpted the following about SLGS dosing (highlighted in red the part that applies to Fitzy):

Starting Dose:
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • 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.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

Is there a reason why you aren't testing before shots? If you're trying to limit how much you are testing, I would personally skip all other tests and just do the ones before you give insulin. It's really that important.
Click to expand...

I’ve found it difficult to chose a method since I found this group after the diagnosis and the vet had me doing 3 then 4, before I protested. Sounds like SLGS makes sense for what we’re doing so I can add that to our sheet.

As for testing, it’s pretty chaotic to get any tests before food time, he is so hungry that he heards me into the kitchen 3 hours before food time. Can’t sit at all, let alone still, and for a while I was really holding him down to get a test before eating but then he started avoiding me. So I try to get more tests other times as close to shot time as I can in my best effort to keep him as safe as I can. When I get 400’s 2 hours before dinner. I feel okay going ahead with insulin, especially when his appetite remains this fierce. I know that eventually we will need preshot tests and every day I try to manage his hunger through the day so that he is hungry for shot time. Truly a work in progress here.
 
Sophie & Fitzy said:
I’ve found it difficult to chose a method since I found this group after the diagnosis and the vet had me doing 3 then 4, before I protested. Sounds like SLGS makes sense for what we’re doing so I can add that to our sheet.

As for testing, it’s pretty chaotic to get any tests before food time, he is so hungry that he heards me into the kitchen 3 hours before food time. Can’t sit at all, let alone still, and for a while I was really holding him down to get a test before eating but then he started avoiding me. So I try to get more tests other times as close to shot time as I can in my best effort to keep him as safe as I can. When I get 400’s 2 hours before dinner. I feel okay going ahead with insulin, especially when his appetite remains this fierce. I know that eventually we will need preshot tests and every day I try to manage his hunger through the day so that he is hungry for shot time. Truly a work in progress here.
Click to expand...
Understood. I had a HECK of a time testing Ruby when she was first diagnosed. It was literally :arghh::banghead::blackeye::(:mad::confused::eek:o_O:stop: every day. I get it. Keep in mind though that two hours is a huge amount of time in terms of feline diabetes, and things can change quickly in that short span. You can feed him UP TO 2 hours before shot time. You can also stave him off with some carb free treats like freeze dried chicken that will affect this BG levels less. I feed 6 times a day--three meals in the morning and three meals in the evening, with a test right before each one. Ruby now knows that when she gets a test, she gets a nice meal afterwards, so she is happy to sit still for me. You can train a cat! :cat:

Another thing I would ask you to seriously consider is transitioning him off the Glycobalance. I know, it's another battle, but you are working against the insulin by feeding him food with such high carbs. You might find that by transitioning him to low carb food, he might not need insulin at all.
 
@PerfumedCatMom I appreciate your support. I've read by some others on the board that 14% isn't the worst to feed and it is definitely an improvement from our previous dry food(33%). I am also unable to manage my cat on such a frequent basis but I do envy your process with Ruby! She sounds very loved! I've heard it is possible to train a cat, maybe Ruby can come tell Fitzy about it sometime! Fitzy doesn't care about treats which I would have loved to know about prior to buying every kind imaginable for diabetic cats. As I type this out, I think it is me who has been trained by him! haha

Thankfully, this switch to wet food did not come with any soft stool or vomit, which has been a win for us! Any time he pukes or has loose stool, Fitzy is somehow more miserable so we have been happy to avoid it so far. He doesn't have any other health problems at the moment though I know something could be lurking around the corner. Thanks again for chatting with me about this!
 
You must log in or register to reply here.
Back
Top