Hello Friends! I have a 13 year old diabetic kitty who was diagnosed when she went DKA in 2021 (June). Since then she has gone DKA about once a year since then, with the most recent being September 19 2023. I am doing my best to do all I can to prevent this in the future, so I've started testing her at home and doing BG curves myself now. Since she's gotten home, I've tested her dozens of times, multiple a day, and she has not been stable at all. She'll go really high one day and really low the next (for context, she gets wet food in the morning with her antibiotics, and previously dry food at night). This bewildered me for a while, but I realized yesterday the dry food I started feeding her (Crave, roughly 20%-30% carbs [YIKES!!! Wish I knew that before I bought it]) caused her DKA and incredibly spikes her BG. Because of this, I did a Glucose Curve yesterday where I gave her her normal dose (2.5 units of ProZinc) with some Purina DM Wet can of Cat food. I researched the caloric content from carbs and realized it's much lower, and this was reflected in the fact that her bg dropped to 40. I gave her some carb-y treats to get her back up to 429. Then, for her night dose, she got 2 units and the same food. For 4 hours, her BG dropped steadily (to 240) and I felt so relieved to maybe find something that works for her, but this morning I woke up and checked her BG before feeding and giving her insulin, and it was up to 500! She also threw up a little bit last night. I gave her some cans and 2.5 units instead of 2 because 500 was so incredibly high. I monitored her for about an hour before having to leave for class, and her BG dropped at a moderately quick rate (8:30am-516 | Insulin admin. at 8:50am | 9:30am-555 | 9:39am-509 | 9:49am-429 | 10:00am-414). I'm about to go check on her, since my classes are almost over, so I'll update after, but I'm just not sure what to do with her dosage and food. I plan to keep her on a strict wet-food-only diet from now on, but what is going on her with dosage! I've considered doing 2.25 units, but there's no line on her syringes, so I don't know if that's too varying to do. Any help or advice would be much much MUCH appreciated! Thank y'all in advance!! update!! At 12:53pm her BG is 329, she also finished her breakfast. I’m much happier with this, since previously 2.5 units tanked her BG very far. Still, any recommendations would be amazing! update 2: 2:39pm her BG is 303. Much happier that it’s stabilized, even if it’s a lil high. Still confused why it happened though, advice appreciated!
I am currently struggling with similar situation. I was advised to give my cat 2.25 insulin but I'm finding sometimes she needs 2.5. We tried that for a while but glucose getting too high in the daytime. I wonder if anyone has ever done different doses. I find her quite high in the morning. I was wondering if I could do 2.5 at night and 2.25 during the day? I don't know if any one has mixed doses like that. And you're correct it is very hard to see since there is no line. You also mentioned your cat is on antibiotics I presume they have an infection which could also drive those numbers up. Good luck - I'm having trouble regulating my kitty as well.
Thank you for the kind words! Yes, she had pancreatitis and a mild UTI which triggered her dka plus the high carb dry food diet. She only has 3 days left of 1 pill each day, so hopefully it’s not affecting her BG too much. Changing her diet to wet food has dropped her BG a lot, I now see why so many diabetic-pet owners really suggest it! I was also thinking your exact idea a few min ago! Giving her 2 different doses for breakfast v dinner, since I’m wary of doing 2.25 since there’s no marker for it but it seems 2 is too little and 2.5 is too much. Hopefully someone else who might’ve tried it can comment and give us some insight!
Good point you have about the dry food because I do leave some at night so she doesn't wake me up and that could be why her number is higher than when she gets canned. My cat is on Royal canin diabetic not sure the carb number count. We've only been at this a month but we started off with 2 Units then 2.5. Her BG was quite low. So now 2.25 very hard to read on the syringe so I do my best. I've been doing A BG test before I administer. If her numbers are high at bedtime I give her 2.5. And then I'm thinking 2.25 in day and then she won't get so low in the afternoon. I'm seeing my vet next week so hopefully we figure out something soon!
Great ideas! I found this amazing resource on this forum from a DVM that compares % carb for wet foods (https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf). From my understanding, The Royal Canin Glycobalance food is actually relatively high in carbs, (14%, diabetic cats should aim to stay under 10%). i've seen posts on here upset at how expensive DM foods are when normal cat food is much lower in carbs. I feed my kitty Friskies Pate because its actually only 5% carbs and my kitty will actually eat it. No pressure to change your kitties diet or anything, but that might help change her BG! Be prepared to change the dosage though, as seen in my original post where she went below 50BG because I gave her her normal dose + wet food.
Hello there and welcome. I'm sorry you've been having such trouble ... and multiple DKAs! That's totally scary, dangerous and expensive. First of all, you should be testing for ketones. You can buy ketostix at a pharmacy and put it in the urine stream when she uses the litter box. Any time the reading is more than a trace for ketones, you need to take action. I actually bought a blood ketone meter for my boy after his DKA; it was just easier to test him in the same way as I already did the ear pricks. It was a Nova Max Plus meter from ADW Diabetes Supply. The strips are somewhat expensive, but it's far less expensive than another DKA.
We need you to get set up with a spreadsheet so we can help with dosing. I'm very concerned about the lows. The high is probably just a bounce, which happens when the glucose drops too low (or what the cat's body perceives to be too low, which can be whatever she's not used to) or drops too rapidly. The cat's body will release a form of stored sugar and hormones that will cause the BG to spike up high for a time. It's a protective mechanism. I would like to see some data though. Let me send you a link to get a spreadsheet set up. Where are you located (what country and time zone?)
GOOGLE SPREADSHEET: TRACKING KITTY’S PROGRESS It is important to track your kitty’s progress over time. FDMB has a process for this, using a Google spreadsheet (SS). Other FDMB users can provide you better help if you keep your cat’s spreadsheet up to date. Once you type in the numbers, the SS will automatically update. Make sure when setting up your spreadsheet that you choose the correct type: We have one sheet for human meters and another for pet meters. If you are not from the United States: Make sure you choose the World version so that your numbers will automatically convert to what most members are used to seeing. How to Create the Spreadsheet: If you have difficulty creating your spreadsheet, ask for help. Post the spreadsheet in your FMDB signature. Once you create the spreadsheet, put it in your FDMB signature block. See the link above, which includes easy instructions on how to update your signature block. How to Use the Spreadsheet: detailed information on how to fill in the spreadsheet.
I would not shoot a higher dose just because of a higher preshot number. We need to gather data and take a look at the big picture. I'm assuming that you have your test numbers recorded and will be able to fill them in on the spreadsheet to get us started. We need to know what she does during the cycle -- how fast and how much does she drop, what is her nadir, etc. Only then will we be able to make decisions on dosing. By all means, if her BG drops below 90, please reduce her dose by .25 units. Jockeying the dose around all the time can be detrimental (although sometimes it is necessary to REDUCE the dose based on a low preshot test, especially when we do not have data to tell us how she handles the insulin at that particular preshot number. What kind of meter are you using? Human or pet meter? We need you to get your signature set up as well. Take a look at mine above for an idea. Cat name and your name if you like, Dx date, type of insulin, history of DKA with dates, type of meter being used, type of food being fed, etc. Are you using U-40 syringes with half unit markings?
Yes, whenever switching a cat from high carb food to low/lower carb food, caution is warranted. We always recommend making the switch SLOWLY because (as you already discovered) low carb food can radically lower a cat's blood glucose. When switching diets, it's best to do it gradually and to do extra tests to make sure you catch any lows (drop below 50) -- and be prepared to take action with karo syrup or high carb food as necessary (which you should already have in your Hypo kit, and I'm sure you probably already do.)
What is your feeding schedule like? Are you giving snacks in the early part of the cycle. By snack, I mean a teaspoon or two of wet food.
Hello! Thank you so much for your response! I'm in the USA (GA) and I followed the spreadsheet instructions, so it should be in my signature! She uses a human monitor (Just cvs brand, since that's what is cheapest and I'm a college student). I also have ketone strips, but I've never used them because I feel like I can never catch her while she's peeing. Yes, I do use u-40 with 1/2 unit markings! I actually got a call from her vet since posting this to check on her, and we discussed her dosage. She agreed to give less insulin for wet food, but said essentially what you said about pre-shot values; don't increase dose just because BG is higher, let her get acclimated to 2 units + wet food, and if she stays high after a few days, then change dosage. I will be reading about the spreadsheet info and doing my best to fill out what I can now! I appreciate your response very much! She seems to be fine physically, and my vet said that was the most important thing. As long as she's eating consistently, urinating the normal amount, and temperament is stable and normal, I should worry less about the numbers. She greeted me when I got home today with meows, purrs, and normal temperament. She's currently sitting next to me and has a good amount of energy, so I'm much less worried!!
Also, sorry forgot to answer this, feeding schedule is 12 hours apart, minimal treats (except when she goes low), but she is more of a grazer than a single-meal kitty. What I mean by that is that she will eat about half her food, walk away and do something else, and then come back and finish more, if not all, of her breakfast. I try to get her to not do this, but I can't force it down her throat :/
Interesting thank you for giving me that information. The vet gave me that cat food and also proplan DM wet food. She prefers wet food but has gotten tired of this one pretty quickly. I know she would eat frisky's for sure. I have another cat and she is always dying to eat his cat food. I wasn't sure if it was good to give if she's diabetic but I appreciate the information you gave me definitely going to look into things.
agreed! In any case, don't make the mistake I did, and do a gradual transfer with monitoring, good luck friend!
Hey. I’m in Georgia, too. I’m in middle Georgia. Where are you in school? and we can also help you here on the FDMB. Just post any time on this ProZinc forum.
Ugh. I don’t think my reply got put in the correct place. @Hotmomma26 I was saying that you should make a post in this ProZinc forum any time you have questions pr would like help. We love helping people with their kitties.
I go to UGA! Lived in Sandy Springs before this, though. I live in the dorms with my baby as my Emotional Support Animal.
Okay. Well, I just wanted to point out that it is important to give snacks during the early portion of the cycle before nadir. Feeding a snack around +2 (two hours after shot time) is important. Feeding another one at +4 or +3 can also be very helpful. Feeding snacks in the early part of the cycle can really help prevent steep drops in blood glucose and will stabilize blood sugar in general (low carb wet snacks.). We just don’t recommend feeding after nadir (once you know when her nadir is.) So why is it important to prevent steep drops (other than the obvious wish to not let your kitty drop too low?): because steep, fast drops can trigger a bounce where BG goes too high in response to numbers that are perceived as “too low.” As for feeding after nadir, it’s not normally recommended because it can shorten the duration of the insulin (meaning the numbers will start to rise prematurely — too early in the cycle.). Sometimes with underweight or post-DKA cats it is necessary to allow them to eat after nadir, but carbs should be kept to a minimum.
GO DAWGS! That’s cool about having Ginger with you. Sandy Springs seems like a nice place. I’ve only been there about four times though— taking my cat Ginger (yes Ginger!) to the Blue Pearl specialty hospital there.)
What a small world! Her first two DKA's were at bluepearl, i lived like 5 minutes away from the sandy springs location! Go dawgs indeed! And yes, I'm up studying so I've been updating her chart with BG readings. Insulin was at 9:10, so about 30 min for her next reading. She's doing very consistently good today!!! 190 before food + insulin, +1 = 256 and +2 = 235. If you dont mind me asking though, what is nadir? Thanks!
Morning update! 186 before food and insulin. Much much happier with this!! Hopefully this keeps up this week
Oh, of course. I’m sorry. Nadir is the lowest point in the cycle. For a lot of cats it will be around +6 or so (6 hours after shot time. ). That is a very important number for us to know because dosing decisions are based largely upon the nadir, or how low the dose takes the cat. We also give some consideration to the preshot values, of course, but we need to know how low a cat goes on a given dose to decide upon dose changes.
I hope you were able to get a +2 test or at least a +3. It’s good to find out what’s going on that early in the cycle to see if you need to do anything to help steer her numbers.
I was not able to get a +2/+3 test today, but I will be around for a +6! I’ll check her soon. I’m almost back to my dorm. Thank you so much for your help and your explanations!
Actually, her +6 value dropped her to around 45. It's a lil frustrating, but a midday snack, like you were suggesting, should be an easy fix! She just got 1.5 spoonfuls of wet food, so she should be good.
Currently (+8) she's back up to 95. Thinking I'll just give her half a can instead of 1/3 for her food servings. Let me know your opinon!
Tonight I see she is bouncing from the low number. She has earned a reduction back down to 1.75 units. Ignore the fact that she's really high, that is a bounce brought on because of the protective mechanism in her body that is reacting to that low BG under 50. Ginger will come back down.
Oh, I almost forgot, but yes to snacks. It’s looking like a snack at +2 and +4 might help stabilize things.
Today she did pretty good. I changed her diet to 1/2 a can of wet food instead of 1/3 can and her BG has stayed stable so far. Started at 484 Pre insulin, ate all her food, at +7.25 she was 219, at +8 she was 182, and right before her 2nd dose she was 213. I’m running a fever so I couldn’t check the other times and I have yet to adjust her chart, but she was amazing today. Playing with some string, purring and sitting on my bed with me, enjoying plenty of pets and being super vocal. It’s the best I’ve seen her in honestly months. She’s 13 and hasn’t acted like a kitten in a long time, but she just moved from a 5-cat, large household to a dorm with only her in August and she’s LOVING it. The food change and dosage change seems to be working so far. I’ll continue updating her chart and posting, but I’m happy with the progress she’s making! Thank you so much for your help. I’ve learned so much from monitoring her.
Also, I’ve noticed waiting a few min after she starts eating might be helpful. I think I was giving her her insulin too early.
Something just occurred to me, are you making sure that she hasn’t had any food for the two hours prior to her morning and evening teats? This is important to make sure that the BG test you get at preshot time is an accurate “fasting glucose” number that hasn’t been influenced (inflated) by food. Just another of the many questions we always have to ask in the beginning.
