9/25 Leo 336 / +8 360 +12 380 +6pm 347

[Susan Shropshire]

I had increased Leo's dose to 4.5 units. This has been day 4. His #s are still over 300. We had a PS at 290 but that was the best we got. I did get some pm #s and they seem to match up with the daytime #s. Should I go ahead and increase to 5 units starting in the morning?

It's weird, but I swear the more insulin he gets, the higher his #s go???? Has anyone else had that issue?

 

[Bandit's Mom]

Hi Susan,

Have you had a chance to read our dosing protocols and decide which one you'd like to follow? If you are feeding Leo only canned food, TR may be the way to go. It will help you get to Leo's good dose faster. However that you require at least one more test per cycle in addition to the PS tests. Would that be possible?

It's possible that Leo needs more insulin, but it would be good to get more tests to confirm that. Sometimes, too much insulin can look like not enough insulin. This happens if you don't get enough tests to see how low a dose is taking the cat. The cat could be bouncing from lower numbers in cycles where there are no tests to see how low it is going.

Are you using the AT or ReliOn? The ReliOn reads lower, the strips are cheaper and our protocols are written with a human meter in mind. It's better not to switch between meters. So best to pick one and stick with it!

I would suggest that you increase to 5U tomorrow morning but get at least one test per cycle in addition to the preshots so can catch any lower numbers.

 

[Susan Shropshire]

Hi Susan,

Have you had a chance to read our dosing protocols and decide which one you'd like to follow? If you are feeding Leo only canned food, TR may be the way to go. It will help you get to Leo's good dose faster. However that you require at least one more test per cycle in addition to the PS tests. Would that be possible?

It's possible that Leo needs more insulin, but it would be good to get more tests to confirm that. Sometimes, too much insulin can look like not enough insulin. This happens if you don't get enough tests to see how low a dose is taking the cat. The cat could be bouncing from lower numbers in cycles where there are no tests to see how low it is going.

Are you using the AT or ReliOn? The ReliOn reads lower, the strips are cheaper and our protocols are written with a human meter in mind. It's better not to switch between meters. So best to pick one and stick with it!

I would suggest that you increase to 5U tomorrow morning but get at least one test per cycle in addition to the preshots so can catch any lower numbers.

Thanks! He is on wet food and dry food with 10% carbs.
I prefer the TR and I use an Alphatrak 2 meter. I tried the reliOn 2x but prefer the alphatrak.
It says during the first couple of days with a new dose to test at +3 +6 & +9. Is that correct? Is that during the day and then should I also do that at night?
With our schedule he gets injections at 8:45. So +3 would be 11:45 +6 would be 2:45 and +9 would be 5:45. Not ideal during the night, but if I need to set an alarm to do it I will.

When you say “per cycle” to be sure I’m understanding, you mean the 12 hours between injections? So do I only do the 3,6,9 for the first 3 days and then days 4-5 only do one per cycle? Is there a best time to do the 1x check?

I’ve been doing multiple checks through the day to see where he might get lower but haven’t really seen a trend downward at any of the times. I’ve just recently started checking at night.

Also I tested his ketones with the precision blood meter and they were only .3 so that’s good.

 

[Susan Shropshire]

Hi Susan,

Have you had a chance to read our dosing protocols and decide which one you'd like to follow? If you are feeding Leo only canned food, TR may be the way to go. It will help you get to Leo's good dose faster. However that you require at least one more test per cycle in addition to the PS tests. Would that be possible?

It's possible that Leo needs more insulin, but it would be good to get more tests to confirm that. Sometimes, too much insulin can look like not enough insulin. This happens if you don't get enough tests to see how low a dose is taking the cat. The cat could be bouncing from lower numbers in cycles where there are no tests to see how low it is going.

Are you using the AT or ReliOn? The ReliOn reads lower, the strips are cheaper and our protocols are written with a human meter in mind. It's better not to switch between meters. So best to pick one and stick with it!

I would suggest that you increase to 5U tomorrow morning but get at least one test per cycle in addition to the preshots so can catch any lower numbers.

I actually just did his +3 pm test and it was 295. I’ve been doing +4 and +6. Interesting.
I’ll do a +6 & +9 tonight to see what they end up being but still seems we need the change to 5 units tomorrow (that’s .5 more than we did today). Even though 295 is lower (thank goodness it decreasing) but still too high.

 

[Bandit's Mom]

Thanks! He is on wet food and dry food with 10% carbs.

Which dry food is he on? Is it possible to cut it out and switch him to 100% wet food?

When you say “per cycle” to be sure I’m understanding, you mean the 12 hours between injections? So do I only do the 3,6,9 for the first 3 days and then days 4-5 only do one per cycle? Is there a best time to do the 1x check?

Yes, a cycle is the 12 hours between insulin shots. There are 2 cycles in a day - the AM cycle and the PM cycle.

We usually suggest getting a +2 because it can act like a crystal ball for the rest of the cycle is going to look like. For some cats a +2.5 or a +3 is a better indicator of how active the cycle will be.

• If the +2 is about the same as the PS, it's usually going to be a pretty normal cycle....gradually down to nadir and then gradually back up to the next PS.
• If the +2 is higher than the PS, that usually means there's a bounce starting and it's usually OK to take a break on testing.
• If the +2 is lower than the PS, that's an indication that numbers might be going a lot lower later in the cycle and it's important to try to get some more tests keep the cat safe.

TR requires only 4 tests per day, but that doesn't mean you should only get 4....if it's possible, it's better to get tests at different points in the cycles so you can get a good idea of when Leo's onset and nadir are. If you can only get 4 per day, then you always get the 2 pre-shots and then get at least 1 somewhere mid-cycle in the AM cycle (like between +4 and +6) and at least a "before bed" in the PM cycle (usually at least 2-3 hours after the PM shot).

 

[Susan Shropshire]

Which dry food is he on? Is it possible to cut it out and switch him to 100% wet food?


Yes, a cycle is the 12 hours between insulin shots. There are 2 cycles in a day - the AM cycle and the PM cycle.

We usually suggest getting a +2 because it can act like a crystal ball for the rest of the cycle is going to look like. For some cats a +2.5 or a +3 is a better indicator of how active the cycle will be.

• If the +2 is about the same as the PS, it's usually going to be a pretty normal cycle....gradually down to nadir and then gradually back up to the next PS.
• If the +2 is higher than the PS, that usually means there's a bounce starting and it's usually OK to take a break on testing.
• If the +2 is lower than the PS, that's an indication that numbers might be going a lot lower later in the cycle and it's important to try to get some more tests keep the cat safe.

TR requires only 4 tests per day, but that doesn't mean you should only get 4....if it's possible, it's better to get tests at different points in the cycles so you can get a good idea of when Leo's onset and nadir are. If you can only get 4 per day, then you always get the 2 pre-shots and then get at least 1 somewhere mid-cycle in the AM cycle (like between +4 and +6) and at least a "before bed" in the PM cycle (usually at least 2-3 hours after the PM shot).

We have tried with 100% wet and didn’t see a big difference in the #s. He also has food allergies and finding a wet food option has been difficult.

I have been actually testing correctly then. I get the am and pm pre-test and at least 1x per cycle. I could get a +2 in the pm, that wouldn’t be a problem.

I just did his +6 pm and it was 345. So definitely need the adjustment in the dose tomorrow.

 

[Katherine&Ruby]

Getting Leo on 100% wet food is best for his diabetes and his general health. Here is Dr. Pierson's take on why wet food is the best diet for an older cat: https://catinfo.org/

Can you tell us what brands of foods Leo is currently eating? There are lots of limited ingredient wet foods out there that could possibly help with food allergies. Have you tried an elimination diet to see if there is a particular protein that might be causing the inflammation? Ziwipeak is a good brand that has lots of novel protein options like venison, lamb, and duck, basically proteins that are not prevalent in other commercial canned foods, and it doesn't have the additives that can cause allergies or aggravate pancreatitis.

Sometimes cats don't want to give up their dry food, so that's when we recommend only three brands of low carb dry for diabetic cats: Dr. Elsey's, Young Again, and Wysong. The optimal percentage of carbs is 5% of total calories in a food.

 

[Susan Shropshire]

Getting Leo on 100% wet food is best for his diabetes and his general health. Here is Dr. Pierson's take on why wet food is the best diet for an older cat: https://catinfo.org/

Can you tell us what brands of foods Leo is currently eating? There are lots of limited ingredient wet foods out there that could possibly help with food allergies. Have you tried an elimination diet to see if there is a particular protein that might be causing the inflammation? Ziwipeak is a good brand that has lots of novel protein options like venison, lamb, and duck, basically proteins that are not prevalent in other commercial canned foods, and it doesn't have the additives that can cause allergies or aggravate pancreatitis.

Sometimes cats don't want to give up their dry food, so that's when we recommend only three brands of low carb dry for diabetic cats: Dr. Elsey's, Young Again, and Wysong. The optimal percentage of carbs is 5% of total calories in a food.

Here is a post I made about his allergies
https://felinediabetes.com/FDMB/threads/low-carb-dry-food.253333/#post-2857178
he was actually blood tested for allergies.

He loves fancy feast but there isn’t an option with his allergies. The foods that meet his allergies he doesn’t like.

 

[Katherine&Ruby]

Thanks for the previous post. You have options. A homemade diet using Alnutrin as a meal completer with proteins that he won't be allergic to is one. There are lots of raw pet meat purveyors like Raw Feeding Miami that sell bison, venison, and duck that all have low inflammation profiles that you can mix with Alnutrin and a liver of your choice. You can get a sample from the company and mix it with a small amount of raw food to see if he likes it. Many cats including mine took to raw feeding easily, even after being kibble junkies most of their lives.

You can also try a hydrolyzed protein dry food diet that you get as a prescription from your vet, but that means fighting the higher glucose levels these foods cause with more insulin. Sometimes you have to pick your battles. As the caregiver to two cats with GI issues, I empathize with you!

 

[Susan Shropshire]

Thanks for the previous post. You have options. A homemade diet using Alnutrin as a meal completer with proteins that he won't be allergic to is one. There are lots of raw pet meat purveyors like Raw Feeding Miami that sell bison, venison, and duck that all have low inflammation profiles that you can mix with Alnutrin and a liver of your choice. You can get a sample from the company and mix it with a small amount of raw food to see if he likes it. Many cats including mine took to raw feeding easily, even after being kibble junkies most of their lives.

You can also try a hydrolyzed protein dry food diet that you get as a prescription from your vet, but that means fighting the higher glucose levels these foods cause with more insulin. Sometimes you have to pick your battles. As the caregiver to two cats with GI issues, I empathize with you!

I actually tried the homemade food. I used one of the supplements. He wouldn’t touch it. I also have 6 other cats so it’s trying to work with that as well.
With testing I haven’t seen any significant differences in his #s when switching from 10% to zero carbs. Tiki cat is also a quality food. I’ve had several vets tell me it’s what they feed their cats.

 

[Katherine&Ruby]

I actually tried the homemade food. I used one of the supplements. He wouldn’t touch it. I also have 6 other cats so it’s trying to work with that as well.
With testing I haven’t seen any significant differences in his #s when switching from 10% to zero carbs. Tiki cat is also a quality food. I’ve had several vets tell me it’s what they feed their cats.

Tiki is great. Lots of people here feed Tiki wet food and it's good for older cats as well because some flavors are low phosphorus so it's easier on their kidneys. I just don't know that the dry food is 10%. It's 10% on an as fed basis and 11% on a dry matter basis but I'm not great on calculating percentage of calories or ME (metabolizable energy), which is what we use to gauge whether it's good for diabetic cats.

I don't mean to argue, just looking for ways to help.

 

[Susan Shropshire]

Tiki is great. Lots of people here feed Tiki wet food and it's good for older cats as well because some flavors are low phosphorus so it's easier on their kidneys. I just don't know that the dry food is 10%. It's 10% on an as fed basis and 11% on a dry matter basis but I'm not great on calculating percentage of calories or ME (metabolizable energy), which is what we use to gauge whether it's good for diabetic cats.

I don't mean to argue, just looking for ways to help.

Thank you! I don’t think you are arguing. I appreciate the help. It seems I’ve tried everything.
I have only recently starting mixing the Tiki cat dry food back in with his wet. So the #s up until the last couple of days were total wet food. We just got to a mix of 50/50 today. I had kept up with the #s on my own before joining the group. This spreadsheet are all on wet food.
He can have Tiki cat canned after dark rabbit and chicken liver. He just turns his nose up at it.
He will sort of eat Purina organic chicken and carrot. There is a merrick purrfect bistro that he can have. One is salmon and one is chicken but he doesn’t really eat those either.
I keep thinking that he will get hungry enough to eat it but I end up throwing away a lot of food. Plus I am worried about him getting pancreatitis again. I just don’t feel like he’s eating enough.