Balancing Meals and Insulin?

[oreosmom]

Hello,

How do you schedule a cats meals and insulin? Our cat Oreo just started using insulin as of Thursday. He is on 1 unit twice daily. He is still very hungry and thirsty and not interesting in playing. He wakes us at 5:15 AM and wants to eat!!! Should I feed him exactly 1/2 hour after food? This morning, I accidentally fell back to sleep after his 5:15 breakfast. I woke up at 7:00 and gave him yet another "breakfast" since I was afraid to give him any insulin until he ate.

We are giving him Fancy Feast Classic of which I was told is carb. free. I also suppliment with Purina DM canned. Since he is still hungry all the time, how might I appease his hunger and balance the insulin? Can I give him all the food he wants if it is carbohydrate free?
And .....How soon might we see results with the insulin? PS: His glucose on an Alpha Trak meter this AM after breakfast was at 301. [/b][/i][/color]

I appreciate all of your help getting through this.

Sincerely,

Carol...Oreo's Mom

 

[MommaOfMuse]

All mine are fed 4 times a day they get fed at 7am (shot time), 1pm (+6), 7pm (shot time) and again at 11pm right before I go to bed normally for the night The last meal of the day I put down frozen so the can nibble on it all night as it thaws.

Fancy Feast Classics are not carb free, they are low carb, but many of them are grain free.

My newly adopted diabetic Autumn is the only exception to the feeding schedule, mostly because she went untreated for 10+ months before I adopted her, so she is free fed canned food. She is grossly underweight right now so I'm letting her eat all she wants to try to put some of her weight back on.

Mel, Maxwell, Musette, Autumn & The Fur Gang

 

[Larry and Kitties]

You said: "Should I feed him exactly 1/2 hour after food". That does not make sense. Unless you are using N insulin, you can feed when he finished eating. You can also feed more than before each shot. The key is to do everything consistently day to day otherwise it is hard to determine the right insulin dose.

 

[BJM]

Test
Feed
Shoot

Never shoot if the cat hasn't eaten; its a fast way to a hypo!

multiple small meals tend to work better for diabetics, with the majority of the food in the first 6 hours of a 12 hour interval between shots.

 

[Sue and Oliver (GA)]

You said: "Should I feed him exactly 1/2 hour after food". That does not make sense. Unless you are using N insulin, you can feed when he finished eating.

:lol: you didn't make much sense either, Larry.

It's test, feed and shoot. You want a number not influenced by food, so you withhold food 2 hours before the test. Lots of us shoot while the cat is busy eating. Some people feed twice daily, some three times (adding a nadir feeding), some give small frequent meals. What works for you and your cat. With ProZinc, people seem to have the most success with smaller, frequent meals.

Unregulated cats are more hungry; their bodies aren't metabolizing the food well. So, yes, you can feed more. The smaller meals, with some warm water added to make it gravy-like, may also help satisfy him.

 

[Carl & Polly & Bob (GA)]

Hi
can you tell us what type of insulin you are using? They all work a bit differently, and the food timing can be tweaked to best suit the insulin.

Carl

 

[Larry and Kitties]

Why does my post not make sense? What is wrong with " Unless you are using N insulin, you can feed when he finished eating."

You said: "Should I feed him exactly 1/2 hour after food". That does not make sense. Unless you are using N insulin, you can feed when he finished eating.

:lol: you didn't make much sense either, Larry.

It's test, feed and shoot. You want a number not influenced by food, so you withhold food 2 hours before the test. Lots of us shoot while the cat is busy eating. Some people feed twice daily, some three times (adding a nadir feeding), some give small frequent meals. What works for you and your cat. With ProZinc, people seem to have the most success with smaller, frequent meals.

Unregulated cats are more hungry; their bodies aren't metabolizing the food well. So, yes, you can feed more. The smaller meals, with some warm water added to make it gravy-like, may also help satisfy him.

 

[oreosmom]

Hi All ,

Thanks for your help....our vet said we needed to feed the cat, and wait 20-30 minutes to inject the insulin. He is on Lantus, 1 unit twice daily. Give him another injection 12 hours later 1/2 hour after dinner. He is still hungry a lot, so I have been giving him a couple teaspoons of canned food (Fancy Feast Classic or Purina DM Canned) when he is hungry. If we leave, I put down some Purina DM kibble.
The vet said to test ever couple of days ...but not to do it too often. (is this right?) And of course test if he looks "hypo". I wonder how soon after an injection a cat might become hypo? If you have a qualified pet sitter , how long should they be around to watch for this?

I look forward to your input.

Thanks,

Carol...Oreo's Mom

 

[BJM]

The 1 unit of Lantus twice daily is a good starting dose.

You should ALWAYS test before you give insulin, to make sure it is safe. You wouldn't give a human insulin without knowing if it was safe, so why would you do it to your cat?

Also, with Lantus, the dose adjustments are made roughly 5-7 days after a consistent dose has been given, based on the nadir - the lowest glucose level in the 12 hours. This usually happens somewhere between +5 to +7 hours after the shot. You need to get at least 1 test during that time, preferably each day, to make sure he isn't going too low.

When starting out, we recommend you not give insulin if the cat is below 200. After you learn your cat's insulin response pattern, you may be able to shoot at a lower level.

You do NOT have to wait a half hour after eating to give insulin. In fact, that lets the glucose level start rising before the Lantus kicks in and lets it spike a high level which may be unhealthy for the cat.

In my signature are links for some secondary monitoring tools; these are also helpful in seeing how the diabete's is being controlled, but they are not the gold standard - that is blood glucose testing.

And please, ditch the kibble. It has too much carbohydrate in it. You're better off with the Fancy Feast Classics, too, than the prescription stuff. The quality is better and in the Classics, the carb level is usually below 10%.

 

[Carl & Polly & Bob (GA)]

Hi Carol,
Most of us test, then feed, and then shoot. Your way works too, but the key is that you get the test number before feeding so the results don't include any increase in BG due to the eating.

The vet said to test ever couple of days ...but not to do it too often. (is this right?)

Bad advice! You should always test before giving insulin. Think of it this way... If Oreo was your infant, would you listen to a doctor that said "don't worry about it, just test him every couple of days"? You would want to make sure it was safe to give the dose, right? An adult human, on insulin, can feel when their sugar is high or low, but they still test before shooting themselves. But just like an infant, there's no way for your kitty to communicate if he feels like his BG is too high or too low, so you have to check for yourself.

With the insulin that you are using, you should actually be getting at least 3 tests per day in. You always test before the shots, and you should try to get a test either AM or PM at the midpoint between shots (called the "nadir") which is when the insulin should be at peak effectiveness. More importantly, the nadir reading is actually the number that a Lantus dose is based upon. So, at minimum, three times a day. Some people test more often than that. On a day when you are not working and have the time, you could actually do what we call a "curve", and check his BG every two hours from one shot to the next. That data will show you exactly how the insulin is working over the course of a cycle, and will help you make more sense out of this. Collecting data is the key to successfully managing the disease. So your vet is not quite up to date on FD management protocols.

And of course test if he looks "hypo". I wonder how soon after an injection a cat might become hypo?

The problem with that theory is that some cats don't exhibit outward signs that they are "hypo". My cat went below normal a couple of times and the only reason I knew that was I happened to catch it on the meter. The "lowest point" in the cycle is theoretically in the middle of the cycle. But cats don't follow the rules, and they don't read the manuals or text books. Occasionally, if you are testing often, you can see the BG drop early in the cycle which gives you a warning that he might go lower than normal later in the cycle. Again, the more data you have, the more you will come to know what to expect. You'll see patterns that indicate if the dose is too low, too high, or just right. And dose adjustments are all based on the data you collect. An occasional test that you just happen to get when his numbers are high could mistakenly be taken as an indication that the dose needs to be increased when it doesn't really need to be. Bottom line, testing every couple days is not a safe way to deal with feline diabetes.
If you have a qualified pet sitter, one of the qualifications you should insist upon is the ability to check blood glucose numbers.

As far as meals go, you can feed in between shots. It is best to feed most of the meals in the first 6 hours of a cycle, and you don't want to be feeding in the 2 to 3 hours leading up to the next shot so that the preshot test numbers don't reflect "food boosted" readings.
Carl

 

[Doug N Libby]

You've gotten great advice! I just wanted to add that 5 times Hershey has thrown me numbers less than (40), but never 'looked hypo,' so I wouldn't have known it if I hadn't been testing him. Once, he was (31) AT shot time, so it is REALLY important to test before giving a shot. :smile:

Take care -

Libby (and Hershey, too!)

 

[Julia & Bandit (GA)]

Why does my post not make sense? What is wrong with " Unless you are using N insulin, you can feed when he finished eating."

You said: "Should I feed him exactly 1/2 hour after food". That does not make sense. Unless you are using N insulin, you can feed when he finished eating.

:lol: you didn't make much sense either, Larry.

It's test, feed and shoot. You want a number not influenced by food, so you withhold food 2 hours before the test. Lots of us shoot while the cat is busy eating. Some people feed twice daily, some three times (adding a nadir feeding), some give small frequent meals. What works for you and your cat. With ProZinc, people seem to have the most success with smaller, frequent meals.

Unregulated cats are more hungry; their bodies aren't metabolizing the food well. So, yes, you can feed more. The smaller meals, with some warm water added to make it gravy-like, may also help satisfy him.

I think the confusing part is you can feed when he finished eating. I think you may have meant to say, "Unless you are using N insulin, you can shoot when he has finished eating."