A Newbies Experience

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Sage13

Member Since 2013
One week ago my Tortie, Sage, of 10 years was DX'd with Diabetes with elevated liver enzymes. Her Glu was 458 and the rest of the blood was normal and urine was normal except for 2+ Glu.
Three months ago I started her on dry weight management food and she went from 16 pounds to 11 in three months. I knew it couldn't be the food and her water intake was endless. Both her and her sister were on dry food their whole lives because my previous Coon had multiple urinary crystal surgeries while he was on wet his whole life so with my new cats I thought I'd try dry. Little did I know until this week I've been feeding them crap their whole lives. During the last week I was completely overwhelmed with the whole DX, treatment, and food restrictions to come. I contemplated euthanasia. The experience of this wreaked havoc on me.
I've been reading endlessly for the whole weekend and knew I had to go to wet food with dry food cats. Sage's sister went right to wet without hesitation. Sage on the other hand had no plans to comply. The vet had me start her on augmentin as a precaution because of the liver enzymes. He wanted me to feed her Purina DM. Sage also had no plans to comply with that as well. There was no way DM was going in her gut let alone her mouth. I even thought the smell was repulsive. She stopped eating 2 days after I started her on the antibiotic. After 3 days of nothing but a nibble I decide to stop the antibiotic because she couldn't afford to lose anymore weight or nutrition and there was no clear evidence of any infections based on her blood work. I believe the antibiotic was too much on her gut. A dead cat with no infection isn't my priority right now.
Now the real test of my patience began yesterday. I tossed all her previous Pro Plan, Purina Naturals, and Bounce/Temptation treats right in the garbage a few days ago. I had to find a suitable dry food that she'd eat so I went with Solid Gold Indigo Blue. Nope, not gonna happen, back to DM, nope not gonna happen. At this point I'm thinking euthanasia again. I told her you need to eat or your gonna die. I went online and researched ingredients again and my conclusion was Wellness Salmon Kibble. Finally she started nibbling. Not much but seemed to like it. The other cat was eating Fancy Feast wet. Sage wasn't going for it. This was day 4 and shes on the insulin and I have to get food in her. I went back to the store and bought Wellness Core Wet Food, salmon and fish. I opened it up, I'm a guy so, Sage your eating this and there will not be a discussion or trial period because this is it. I clumped up little cat sized bites and stuck it up on the roof of her mouth. I did this several times through the day yesterday. Sure she was pissed but at least some food was going in, then she also ate a bit more kibble. Last night I was convinced this was not gonna work and with her weight there was nothing else I could do.
5:15 AM today I wake up clump up the wet food and got ready to jam it up in her mouth again. Instead she came over and started eating it off my fingers. I put some in the bowl and she ate it. I put some on the kibble she ate the wet but left the kibble. I don't know how the rest of the day will go but it is true, Tortoiseshell cats will work your last nerve even when they are sick.
Thank you Wellness Core Wet Food.

PS glucose is going down little by little from 458 to 340 in 4 days. 2U prozinc twice a day.
 
Good for you - persistence paid off. Sometimes it is the texture of the food, so adding a little warm water and making a gravy helps. The other thing that works great for some cats is a probiotic called FortiFlora. It has the enzyme that makes dry food irrestible? You can get it on line.

It sounds like you are testing at home? That is great if you are - you can be sure the amount you are planning to give is safe at each preshot and test at midcycle to see how low it is taking her.

Here is some info on ProZinc that could be helpful:

There is no established protocol for ProZinc. Dose is determined by looking at the history of the kitty – his doses and how he has responded including preshot numbers and midcycle numbers.

Starting Doses
The recommended starting dose for ProZinc or BCPPZI is .5 units or one unit twice daily. It is suggested that if the initial numbers are high, doses can be changed every three cycles, increasing by .5 at a time. If the initial numbers are in the 200-300 range at preshot and midcycle (nadir) numbers are not too low (not 50 and under), increases can be made .25 units at a time. During this early period, especially if wet low carb food is replacing higher carb dry, monitoring is very important. Insulin plus a diet change can result in sudden low numbers or in a gradual lowering of numbers overall, depending on the cat.

Over time, as data is collected and nadir numbers are available, doses can be adjusted more confidently.
If the cat is in the 250+ range at preshot and does not drop 50% or more for nadir, a small adjustment could be considered, if monitoring is possible.
If the cat is in the 250+ range at preshot and drops below 50% at nadir, bouncing is a possibility (bouncing occurs when the cat’s body perceives a drop that is below what has been occurring and releases extra glucose, resulting in an “artificial” rise in numbers) Bouncing most often involves a lower midcycle number than the cat has experienced previously. If bouncing is suspected, any increases in doses should be tiny and monitored carefully.
If the cat is high and flat during the entire cycle, the dose could be raised .5 units, as long as monitoring is possible.

ProZinc and PZI are unique in that they can be dosed in two ways, depending on how the car responds. Some cats seem to do best if a specific dose is held for several cycles. It seems to take that long for their numbers to really change. Some cats respond to a sliding scale, getting a different dose for different preshot numbers. Collecting data will help you see which regiment works best for your cat. If you need help with a sliding scale, ask people on the PZI forum to guide you.

Low Preshot Numbers
The general recommendation for new diabetics is not to shoot a preshot under 200, but to wait 20 minutes (without feeding as food raises blood glucose levels) and retest. If the number is rising and above 200, then a shot can be given with perhaps a little less insulin given.

If midcycle (nadir) numbers are in the 40-50 range, the cat should be carefully monitored for the next couple of hours with tests given every 30 minutes as long as the cat stays low. First small amounts of low carb food can be given to raise the blood glucose levels. If that doesn’t raise the levels, higher carb food should be given. If the levels are dropping and below 40, then honey can be put directly on the cat’s gums. If the numbers still aren’t rising, a trip to an emergency vet is probably necessary.

If one preshot is above 200 and shootable, and one preshot is too low to shoot, it probably means the dose is a little too high and lasting more than the usual 12 hours. Try reducing by at least .25 to see if you get two shootable preshot numbers (ideal) rather than one that is too high and one that is too low to shoot (not ideal)

If you are using U40 syringes and find yourself trying to eyeball doses under .5, you may want to consider using U100 needles and the conversion chart. (Conversion chart) This will allow you to give mini doses.

It is important to test for ketones regularly, at least once weekly even if the cat is eating well and has no infection present. Test daily if any infection is present, the cat is not eating well and/or is in higher ranges. Testing for ketones can catch DKA early. Cats with DKA should be seen immediately by a vet.

Data Collection
Until the bean gets data on their cat’s responses to the insulin, advice on dose changes can be gotten on the forum or from the vet. Using a spreadsheet to record data is the best way to share this data with forum members and the vet.
 
Hello to you and Sage,
and welcome to FDMB!

Ask any and all the questions you want to. This is a great forum for advice and support. And we look forward to following Sage's progress. :smile:

Eliz
 
I'm not claiming success or anything I'm just glad she ate today. Based what I've read I know the starting dose is high and what the vet told me is after a week on that dose he'll make the adjustment until I get used to the numbers, curves, and testing. Right now I'm kind of ignorant being I just started with this process of home testing and nutrition. The cat has been a free eater her whole life and never had a real feeding time. Both just picked throughout the day and never finished when they had dry. The whole wet food thing is completely new to them.
I know when the numbers start coming down dosage has to change and I'm sure that will be a test of will as well.
Thanks!
PS Elizabeth, I see your from Surrey UK, most of my favorite musicians come from Surrey.
 
You might consider an automatic feeder for them during the day if they are used to grazing. (I love my PetSafe5). Some of us also freeze the food and leave it out to thaw. (a muffin tin works great for this.)
 
Welcome to the board!

I love your attitude and find it inspirational because you were firm with your cat and it paid off. Now if you can get her to eat it consistently, and maybe try some lower carb wellness flavours then you are laughing! the salmon is 13% carbs which is a bit high for a diabetic cat if your goal is remission or tight regulation, plus you really don't want to feed fish every day... but you can work on that later. For now just getting her to eat consistently is important. Many of us free feed wet, whether leaving it out and refreshing twice a day, using a timed feeder, or freezing the food and letting it defrost slowly.

Sue mentioned spreadsheet to track readings- this is useful to help with dosing and watch trends but also you can share it with your vet and us if you want more advice.. heres how : http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207. Let us know if you need help setting it up.



Wendy
 
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