Advice on switching to wet food

[GraceAndAngie]

Hi everyone,

My cat Angie has been diabetic since August last year. She has been quite stable this year on one unit of Lentas twice a day. I have only recently educated myself on feline diabetes and would like to change the way we're doing things. Angie has been visiting the vet for blood glucose curves (which she is very angry about). We started off weekly, then fortnightly, monthly, two monthly and now every 6 weeks. She is also eating Hills M/D.

I have just bought home blood glucose monitoring supplies and would like to start monitoring her blood glucose and switch her to wet food. I know that her need for insulin might drop quickly if she switches food. Has a protocol been developed for this situation? All the advice I can find is based on a newly diagnosed cat who is not yet on insulin.

I was wondering about doing a full curve tomorrow on her normal food to get an idea of what she is like. She's not a fussy eater so she won't mind the switch. If I switch her on Sunday morning, should I skip her insulin injection to see where her levels go and adjust the evening dose? Or should I give her half a unit with breakfast? Or should I give her half wet food and half dry food so that the change isn't so dramatic?

I'm a bit scared of changing her food because I don't want to hurt her. On the other hand, I haven't been happy with her "wellness level" with the vet's method. Some days she seems sicker than others and I keep wondering if her dose is right.

Has anyone switched an already stable cat?

Thanks,
Grace



PS - I've figured out the spreadsheet but haven't yet done any blood glucose testing so it's still empty.

 

[Blue]

Great news to hear you will be home testing now; you will be able to know exactly how well this insulin and the dose are working for your cat.

I would guess that the best thing to do is may no changes at all to how you dose, when you dose, and leave the diet exactly as it is. That way, you will be able to see later on how much of a difference it makes.

The curves at the vet really don't give you the true numbers for your cat, and you did say she was angry about the curves at the vet.... her numbers were likely higher than at home if she were upset about being there.

Until you are comfortable with testing and can see how she is doing with the 1u dose, leave things the same.... you mentioned she seems sicker on some days and that does not sound like a 'stable' diabetic cat. There could be times she is going very low, or it could be that her numbers are very high still; cats are notorious for hiding how they are feeling.

What times are your shots? Try to remove all food 2 hours before the shot time because you want to get a number that is not food influenced.

Test her just before her shot, then every 2 hours after that time until the next shot time 12 hours later... you can record the numbers you get from the testing in this thread and others can give you some feedback.

As soon as you know how this 1u dose of Lantus is working, you can then plan how to go about changing her diet.... if she is already eating wet food, you should have no problem just removing all the dry, but most times, it's best to lower the dose to avoid any possible hypo incidents.

Good luck with your curve and if you have any problems with the testing or concerns about the numbers from your tests, just post here and someone will help you along.

 

[GraceAndAngie]

Hi Blue,

Thanks for your advice - I will do as you suggest. I've just stuck myself with a lancet 4 times before I could get it working well enough on myself. At least I know that I'm in the normal range!

The sad thing is that she used to eat some wet and some dry food and the vet switched her entirely to dry Hills M/D when she was diagnosed.

I give her insulin at 8.30 am and 8.30 pm. I feed her then too and she has food out for about 1/2 the day (before Jetzin, the other cat, finishes off what she has left). She grazes for the first 6 hours-ish after I feed her and then fasts until I feed her again. Jetzin grazes all day as he has a food source that she can't get to but he likes eating out of her bowl better than his. He even gets jealous of her insulin injections! What's she getting that I'm not?

Do people test every two hours over night too? I'm not well enough to do that without a setback. Will it matter if I only test during the day?

 

[Wendy&Neko]

Hi Grace,

Good luck on your first curve done by yourself. That's an important milestone. In addition to seeing how Angie is doing on this dose, you want to get an idea of when her nadir is. The curve will help you do that. It's typically at +6, but can vary, both from cat to cat and from cycle to cycle. Once you have a better idea of when her nadir typically is, it'll help you plan what you do at night. Doing a curve just during the day should be fine. You don't need to do a test every 2 hours for every curve. After the first one, spot checks during the day can help fill in the spreadsheet to see how Angie responds to the insulin.

Here is a what the typical Lantus curve looks like but remember that ECID (every cat is different, you'll hear that a lot here).

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

I don't test all night. One test that many people find useful is the +2 (2 hours after the shot). If it's the same as or below your preshot, then you'll likely have a normal Lantus cycle. We also recommend getting a test before you go to bed. If she seems to be heading lower at that time, then you can set an alarm and wake up around nadir to test. If her numbers are on the way up, you're good to go to sleep.

 

[GraceAndAngie]

Thanks so much Wendy. People on this forum have been amazing! I would have been too confused and terrified to go though it alone.