? 9/4 Vick AMPS ? PMPS 408 newly diagnosed kitty acting starved all day. Is it ok to feed all day? Are BG numbers high because he is eating all day?

S

soreto

Member
13 yr old cat lost 5 lbs in the past year (from 15 to 10lbs). took to vet 3 weeks ago & got diagnosed with diabetes.

put on 1u of lantus twice daily, but blood glucose (taken 1 hr after food at noon; at the same time as giving insulin) has been between 400-600 (22-33) every single day since diagnosis, averaging 500. i called vet to see if i should up the dose, but they insisted i do new glucose curve. i did it at home- it was mostly successful. i am missing first reading of the day- he wont cooperate when he is hungry. tried again today, but no luck. lowest number on curve was 408 (22.7), with most numbers in the 400s & 2 in the 500s.

Questions-
1) he acts starved all day, can i just feed him all day (every 2-3 hours)? is being fed all day why his BG #s are so high? (he eats 14oz of wet food a day plus 2-4oz of cooked chicken)

2) does it take a while for the body to get adjusted to insulin for it to work? is that why they told me to hold at 1u despite his BG numbers being so high? should i up the dose?

3) he has soft stools/diarrhea regularly. is this connected to the diabetes, or at least the high BG? i've been giving him pumpkin daily, but it doesnt always seem to work. (full panel of tests were done, there's no parasites, etc)

4) he has peed in his sleep a few times lately. not large amounts, but enough for me to put paper towels for him to sleep on. Is this related to the diabetes?

(thanks in advance. my vet is out for the month & since i've already spent so much money on initial testing/diagnosis, i'm not able to pay for advice from a new vet. also sorry if i did not follow terminology- i don't quite understand all of the +/- stuff yet)
 
glucose curve
 

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Welcome to FDMB, you are in the right place to get the answers you need, it is great that you a\are home testing, , we are very numbers oriented, I see that you are feeding wet can food, but it is important that a diabetic cat has a diet between 0-10% carbs, yes whit that high BG cats get very hungry, but at the same time to keep the insulin depot in check you should feed 2 main meals and 2-3 small snack or meals during the day, and testing before giving insulin is very important you do not want to feed on an empty stomach, we would like you to create your signature and create a Spreadsheet, as I said we are very numbers oriented, below, are several links to start you off with, also a Dr. food list and a carb calculator, you know the carbs in the food you are feeding you need the nutrient %s in the food, the calculator will give the Dry Matter carbs, I am tagging a very knowledgeable member that can help you with Lantus and dosing, in the meantime use the Links below, keep asking question, remember Feline Diabetes is manageable using the tools that are given by the members and trusting, I for instance this Forum saved my Corky's life :cat: 🐱:bighug:


https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
Sticky - New? How You Can Help Us Help You!
Info - Dr. Pierson - new Food Chart
Cat Food Nutrition Calculator | Elizabeth C Scheyder

@Sienne and Gabby (GA)
 
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CORKY said:
testing before giving insulin is very important you do not want to feed on an empty stomach,
Click to expand...
Hi! first off, thanks so much for the info. i was overwhelmed when i first got to the site. so much to read/sort through & i still posted to the wrong thread!

i was told to feed, wait an hour, test, and if BG is not low, to give insulin. so are you saying to test first thing in the morning, then feed & give insulin at same time?
 
soreto said:
Hi! first off, thanks so much for the info. i was overwhelmed when i first got to the site. so much to read/sort through & i still posted to the wrong thread!

i was told to feed, wait an hour, test, and if BG is not low, to give insulin. so are you saying to test first thing in the morning, then feed & give insulin at same time?
Click to expand...
Ok!? Let me tag several members , I use ProZinc I still don’t know what insulin you are using,.and who is they? You test after eating of course you will get a much higher BG, and do you know the carbs in the food you are feeding? Tell me what insulin you use so I can tag the correct member
 
The protocol for ProZinc is TEST FEED DOSE, tge Lantus is different, but I’m pretty sure that if you feed then test of course the BG will be highe for Corky (ProZinc) I test feed and 1/2way thru his meal I go behind him and shoot, then test again after 2 hours this insulin takes 2 hours to get to the system, but I need to know what insulin you are dosing with
 
CORKY said:
The protocol for ProZinc is TEST FEED DOSE, tge Lantus is different, but I’m pretty sure that if you feed then test of course the BG will be highe for Corky (ProZinc) I test feed and 1/2way thru his meal I go behind him and shoot, then test again after 2 hours this insulin takes 2 hours to get to the system, but I need to know what insulin you are dosing with
Click to expand...
i am using lantus- 1u twice daily. thanks! I am updating my signature to reflect. 'they' was the vet tech
 
soreto said:
13 yr old cat lost 5 lbs in the past year (from 15 to 10lbs). took to vet 3 weeks ago & got diagnosed with diabetes.

put on 1u of lantus twice daily, but blood glucose (taken 1 hr after food at noon; at the same time as giving insulin) has been between 400-600 (22-33) every single day since diagnosis, averaging 500. i called vet to see if i should up the dose, but they insisted i do new glucose curve. i did it at home- it was mostly successful. i am missing first reading of the day- he wont cooperate when he is hungry. tried again today, but no luck. lowest number on curve was 408 (22.7), with most numbers in the 400s & 2 in the 500s.

Questions-
1) he acts starved all day, can i just feed him all day (every 2-3 hours)? is being fed all day why his BG #s are so high? (he eats 14oz of wet food a day plus 2-4oz of cooked chicken)
Click to expand...

Yes, small meals spread throughout the day is fine. Human diabetics often have snall snacks to keep their glucose levels stable. Diabetic cats are no different. Most people use a programmable timed feeder for this purpose.

Unregulated diabetics are literally starving because their bodies aren't able to process nutrients in food properly. When the glucose levels are more regulated the constant hunger will go away.

2) does it take a while for the body to get adjusted to insulin for it to work? is that why they told me to hold at 1u despite his BG numbers being so high? should i up the dose?
Click to expand...

Lantus is a depot insulin. You have to hold the dose for at least a week before doing a curve to see how the dose is working. The high bgs are scary to see but have patience and wait for the depot to fill.

There may be a few instances where one would increase more often.

Sticky - What is the Insulin Depot?

3) he has soft stools/diarrhea regularly. is this connected to the diabetes, or at least the high BG? i've been giving him pumpkin daily, but it doesnt always seem to work. (full panel of tests were done, there's no parasites, etc)
Click to expand...

Probably not. Has GI issues been ruled out?

A probiotic can be helpful. Pumpkin is more for constipation than diarrhea.

4) he has peed in his sleep a few times lately. not large amounts, but enough for me to put paper towels for him to sleep on. Is this related to the diabetes?
Click to expand...

Could be. You may want to get puppy pads or Human incontinence pads to contain pee. Some types of pads are washable.

Feed, test, insulin scheduling is kind of up to you. Lantus is somewhat flexible. It's probably easiest to test, feed immediately, and give insulin while the cat is busy eating. A cat doesn't necessarily need to eat right away so you could test and give insulin and just be sure that the cat eats within an hour or so.
 
@squeem3

thanks so much for the detailed reply! the sticky about depot insulin was really helpful.

kitty has been on 1u/twice daily for almost 3 weeks now, and the last glucose curve (done yesterday) still gave back all numbers above 400 all day.

my plan is to try going up by 0.5u/twice daily for a week & do another glucose curve. is that the usual protocol?
 
@CORKY

i forgot to thank you for mentioning carb content. one of the foods i feed is fine, but the sheba website doesnt even list the carbs! i will definitely be switching to another food.
 
Here's a carb calculator link use the nutrients, you can find the food you are looking for at Chewy.com, find the food, click on the can, scroll down and copy the nutrient %s onto the calculator, I use it all the time, the dry matter is correct % of carbs, normally the Fancy Feast pate 0-10% are excellent food for a diabetic cat, this food is US made it has no waste in them, stay away from the gravies, they are all high carbs, :cat: 🐱:bighug:

Cat Food Nutrition Calculator | Elizabeth C Scheyder
 
soreto said:
@squeem3

thanks so much for the detailed reply! the sticky about depot insulin was really helpful.

kitty has been on 1u/twice daily for almost 3 weeks now, and the last glucose curve (done yesterday) still gave back all numbers above 400 all day.

my plan is to try going up by 0.5u/twice daily for a week & do another glucose curve. is that the usual protocol?
Click to expand...


We recommend dose changes of 0.25 units at a time. You have to eyeball in between the 1 unit line and the 1.5 unit line. There's some close up pictures here: Sticky - Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

Which Lantus protocol are you following, Tight Regulation or Start Low Go Slow? Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Sheba might be on the Catinfo.org chart. http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Do keep some gravy and high carb foods around. Those are useful if your cat has hypoglycemia. Honey, corn syrup, etc works in a pinch but the effect doesn't last very long.
 
A few additional thoughts/comments...

It will be very helpful if you can set up a spreadsheet. The instructions are in the helping us to help you link that Maria/Corky posted above. None of us will recommend a dose change without benefit of seeing your cat's spreadsheet. We value your cat's safety so seeing test data is important.

There are only a handful of pet foods that have information on carbohydrates on their website. They are not required to provide that information. Using a carb calculator is helpful but it is not entirely accurate. The nutritional information that the manufacturers provide is the guaranteed analysis. It's not the "as fed" values. You can get a decent idea of the carbs but you generally need to contact the manufacturer to get the actual value. We have food charts with nutritional information (Squeem3 linked a chart) if you need them. We consider low carb as under 10% although most members tend to feed their cat a food that's in the vicinity of 5% carb.

We use two dosing methods with Lantus. I'd encourage you to take a look at the sticky notes at the top of the Lantus board. They will familiarize you with the insulin as well as give you information about dosing. Lantus doesn't start to work (i.e., onset) until roughly 2 hours after you give a shot. Thus, there is no need to wait after feeding your cat. We recommend that you test, feed, and shoot all within a few minutes. I would give a shot while my cat's head was in her bowl. With shorter acting insulin you do want to wait between feeding and giving a shot but this is not the case w/ Lantus. Also, how much you raise the dose depends on which dosing method you're using.

I suspect that Soreto may be having some GI troubles if you switched from dry food to canned. If the switch wasn't done gradually, many cats experience GI issues. I'd suggest a particular probiotic -- S. boulardii -- to help with the diarrhea. You start with about 1/4 to 1/3 of a capsule mixed into food.
 
@CORKY @squeem3 @Sienne and Gabby (GA)

thank you guys for the great information! i will be doing the 'start low go slow' method.

i upped the dose by 0.5u last night for the first time & his reading today was the first time it was under 400... it was 398. haha! i will hold at this dose & do a glucose curve in a week. hopefully by then i will have the spreadsheet set up.

i'm feeling better about things already thanks to all of you. i have been so overwhelmed over the diagnosis. i'm so glad i found this forum. thank you for taking the time to respond to me so thoroughly.
 
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There are two ways to test for ketones - use urine dip sticks that test for ketones or use a blood glucose meter that also tests for ketones. The urine dip sticks are the cheapest method but can be frustrating to get a fresh sample of pee from the cat. You need a fresh puddle of pee, not wet litter. Catching and testing urine
 
You can pick up Ketostix (or a similar brand) at any pharmacy. The ketone meters use expensive strips -- abut $1.00 each. You're paying that with the AlphaTrack which is why most members here use the Relion meters from Walmart.

The version of SLGS that you first posted is older. The dose increments are based on Tight Regulation. If a cat's in high numbers it's likely OK to increase by 0.5u. You just need to make sure to test several times during each cycle so you don't miss a drop in numbers.
 
@Sienne and Gabby (GA)

thanks! how often should i be testing for ketones? is it an emergency visit to the vet if it comes up positive?

& yes, don't worry, i did go up to 1.5u b.i.d., but i have tested multiple times a day. BG is now high 300s-low 400s. still not normal range, but way better than before. i will hold at this dose for a week to see if the numbers shift even more over time.
 
With ketone testing, once or twice a day is fine. If you are using urine test strips, if the results are over "trace", it's a vet visit. We tend to err on the side of caution and the vet may not be as concerned as we are. The issue is that a small amount of ketones can turn to "large" very quickly and then it can be a life threatening emergency. If you get a trace level, I would test more frequently, add as much water to your cat's food as he'll tolerate, and make sure he eats. Ketones develop if there is an infection or inflammation + not enough insulin + not enough calories.

This is a link to our primer on ketones. It will give you background information as well as information on test results.
 
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