BG dropped and advice for high calorie/LC food

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Mackenzie Obermeyer

Mackenzie Obermeyer

Member Since 2016
Maytons BG dropped to 107 for his pre shot this morning, my dad was caught off guard seeing this so he took it again and it was 89. He then fed Mayton some grain free wet food with a sprinkle of dry on top. When he was almost done eating my dad gave him the full insulin shot. 2 minutes later he threw up all of his food!!! My dad doesn't know much about this stuff so he woke me up. I gave him his dry DM food after because I didn't know what to do and I didn't want it to go low since he got a full insulin shot. Is 89 a number for me to worry about? He is usually in the 300s but we are transitioning him to wet food so we expected his numbers to go down, but not this much! I posted this on the regular health forum and they told me to post here so that's what I'm doing.
 
Ok so while we're waiting for the next test let me write out a few things. Firstly, welcome to the group and good job testing. We use two protocols here
Start Low Go Slow which is used when a kitty eats dry food and Tight Regulation (TR). Either one always requires a preshot test before giving insulin (which you are doing most of the time) and at least 1 mid cycle test and always a test before bed. The reason is because Lantus dosed based on how low the kitty goes on the dose.

I see that Mayton has been in the hospital for DKA twice, that is very scary. Is there any reason why he's eating the dry food? Does he eat any wet food at all? When was he initially diagnosed?
 
Doodles & Karen said:
I see that Mayton has been in the hospital for DKA twice, that is very scary. Is there any reason why he's eating the dry food? Does he eat any wet food at all? When was he initially diagnosed?
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Well while he was not stable and having DKA he wasn't really eating so that kind of made everything worse. But the dry DM is the food that he was eating consistently after his last episode. So we just stuck with it. His numbers have been pretty regular for weeks now so we decided to transition him to wet food because everyone on here said to. We've only been trying it for 3 days but yesterday he ate some fancy feast salmon classics and some pure balance chicken and salmon (grain free). He is kinda weird about food so he might switch up on me and not like those anymore. He was diagnosed in October. Going to do a test now.
 
Doodles & Karen said:
Ok, looks like he might be heading for a bounce. I would check again in 2 hours to make sure he's still surfing.
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Okay. Any recommendations on what to feed him. Should I give him dry or wet food for lunch? We are trying to get him on wet food since it's better for him, but at the same time I want to make sure he doesn't go too low.
 
Mackenzie Obermeyer said:
We've only been trying it for 3 days but yesterday he ate some fancy feast salmon classics and some pure balance chicken and salmon (grain free). He is kinda weird about food so he might switch up on me and not like those anymore. He was diagnosed in October. Going to do a test now.
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Thank you for the information. It's very important to get mid cycle tests and even more so when you are switching food from Dry to wet. That alone can make his insulin needs go down pretty quickly and without more monitoring he could drop into very low, dangerous numbers.

Are you able to get one or two tests in during the day time every day and one before bed? If you keep posting here we can help you.
 
Mackenzie Obermeyer said:
Okay. Any recommendations on what to feed him. Should I give him dry or wet food for lunch? We are trying to get him on wet food since it's better for him, but at the same time I want to make sure he doesn't go too low.
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If you can monitor him today I would go ahead and give him some wet food. If you can look at those two links above that would be great. Because there is dry food in the mix you should be following the Start Low Go Slow protocol which means his dose should be reduced to 1.75 units twice a day. The only thing that concerns me is that he's had DKA twice. Taking reductions at 90 might not be good for him. Are you checking at home for keytones every day with urine strips?

I know I'm throwing a lot at you at the moment so try not to be overwhelmed and ask questions if I'm confusing you.
 
Doodles & Karen said:
Thank you for the information. It's very important to get mid cycle tests and even more so when you are switching food from Dry to wet. That alone can make his insulin needs go down pretty quickly and without more monitoring he could drop into very low, dangerous numbers.

Are you able to get one or two tests in during the day time every day and one before bed? If you keep posting here we can help you.
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Usually I am at school, and right after that I pet sit for a dog so I don't get home till 3:30. I am off of school for the next 7 days though so I will be able to do it this week. My mom is home during the day but she doesn't feel comfortable doing the blood test. Would it be okay if the mid day test is it 3:30?
I could do a night one, probably +4, every night.
 
Mackenzie Obermeyer said:
Would it be okay if the mid day test is it 3:30
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That would be helpful and maybe you can work with Mom to teach her how to test Mayton too. How many hours is after the morning shot is 3:30? If you can get a +2 and a +4 in the evening most nights that would be great too since many kitties go lower at night.

You're doing a great job and Mayton is sure lucky to have you. Do you think you're able to measure the 1.75u dose? If you're sryinges have 1/2 unit markings we eyeball the dose between the 1.5 & 2u lines.
 
Doodles & Karen said:
If you can monitor him today I would go ahead and give him some wet food. If you can look at those two links above that would be great. Because there is dry food in the mix you should be following the Start Low Go Slow protocol which means his dose should be reduced to 1.75 units twice a day. The only thing that concerns me is that he's had DKA twice. Taking reductions at 90 might not be good for him. Are you checking at home for keytones every day with urine strips?
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Yes I do have a ketone test. I usually don't test everyday, more like once every 3 days because he hasn't had them for a month and a half. Plus it's sometimes hard to catch him peeing.
 
Mackenzie Obermeyer said:
Yes I do have a ketone test. I usually don't test everyday, more like once every 3 days because he hasn't had them for a month and a half. Plus it's sometimes hard to catch him peeing.
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Ok, that's good too.

So I think some of the higher preshots you have been seeing are because he's gone lower mid cycle and has been bouncing. That's why those mid cycle tests are super important. If you do a curve like you did recently it's possible you're doing that on a bounce day and it will look like he needs more insulin when in fact he might need less. Does that make sense? This is the reason for mid cycle testing since again, Lantus is dosed based on how low they go during a cycle.
 
Doodles & Karen said:
That would be helpful and maybe you can work with Mom to teach her how to test Mayton too. How many hours is after the morning shot is 3:30? If you can get a +2 and a +4 in the evening most nights that would be great too since many kitties go lower at night.

You're doing a great job and Mayton is sure lucky to have you. Do you think you're able to measure the 1.75u dose? If you're sryinges have 1/2 unit markings we eyeball the dose between the 1.5 & 2u lines.
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Well I've offered to teacher my mom how to but she says she doesn't want to hurt him, even though I told her it's helping him. I leave for college in August so hopefully she will do it by then.
We give him the shot at 6:30am so that's 9 hours after.
I could probably do the 1.75. And yes we do have the sryinges with half markings.
 
Nan & Amber said:
I don't want to interrupt all the great guidance you are getting from Karen, but I just had to say: Mayton looks adorable in your profile pic!
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Haha thank you! He is such a cutie. I bet you will like this one... I taught him how to stand up on 2 legs!
 

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Mackenzie Obermeyer said:
I leave for college in August so hopefully she will do it by then.
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With any luck...a food switch and all you're doing for him there's a possibility we can help you get him into remission by August. It's not always possible but if you post often, start getting those mid cycle tests as often as you can and keep working on Mom to help we an sure try.
 
Hi Macenzie and welcome to the group and congrats on testing Mayton and taking such good care of him . Karen has given you a lot of good info so far. And OMG so cute the photo you just posted of him standing on two legs. :cat::cat::cat::cat::cat::cat::cat:

It is going to be really important for you to get mom on board testing him because with him transitioning him from dry to wet, he could come racing down the dosing ladder. It is best that you feed all wet low carb but if dry is all you can get him to eat, it is more important that they eat and the dry can be your "ace in a hole" so to speak.

While in a bounce like he is in now, a curve won't be as helpful , so save the curve for another cycle. A bounce can last up to 3 days or 6 cycles. You will know the bounce is breaking when you see the numbers starting to come consistently down.
 
Bobbie And Bubba said:
it is going to be really important for you to get mom on board testing him because with him transitioning him from dry to wet, he could come racing down the dosing ladder. It is best that you feed all wet low carb but if dry is all you can get him to eat, it is more important that they eat and the dry can be your "ace in a hole" so to speak.

While in a bounce like he is in now, a curve won't be as helpful , so save the curve for another cycle. A bounce can last up to 3 days or 6 cycles. You will know the bounce is breaking when you see the numbers starting to come consistently down.
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Okay. We can probably get him on a wet food only diet. That's what my other cat eats so it will work out for leaving it out at night.

What exactly is a bounce and how did he get into it?
 
A little off topic... how much is a normal serving for fancy feast classics (for a meal). We want to put Mayton on it but I'm not sure how much to feed him. Especially because he has thrown up the wet food twice. I think he eats too much too fast.

My other cat (13 pounds) eats only 1/4 can of fancy feast for breakfast and for dinner. Which I think is not a lot.
 
Hi Macenzie, and welcome to the group, good job getting those tests.

Just wondering when you say you have transition from the DM dry to wet in the last 3 days, is he having any dry now? (assuming he keeps playing ball and eating up his fuds)
It seems you gave him some DM dry earlier with those lower numbers, so that may have contributed to his numbers coming up as it has more carbs than the wet food. Not a bad thing as you were concerned about him dropping too low. But would he have normally had some dry for his breakfast?

What would be really useful, both to you and to those helping you, might be to note in the remarks section on the SS what and when you are feeding Mayton. As others hve already said getting him into a low carb wet diet can really make a big difference.

One important, thing that Karen has already touched, is his recent episodes of DKA, while LC wet would be better for him it is very important that he is eating enough and getting enough insulin, so while your dad shooting a green number like that this morning might have nearly given you a heart attack, it was probably a good idea, as was your instinct to give him some dry to stop him from dropping too low.

With DKA recently in the picture the last thing you want to do is not shoot enough insulin.
I also think that it would be good idea to start regularly monitoring for ketones.

George is a guzzler too, less so now he is regulated, have you tried feeding Mayton small amounts but regularly, to try to stop him scarfing and barfing??
 
Mackenzie Obermeyer said:
What exactly is a bounce and how did he get into it?
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Mayton's body isn't yet used to the lower numbers he saw this morning (or that he's possibly getting mid-cycle on other days, as Karen said). Even though a BG of, say 89, is perfectly fine (it's great, actually!), his body perceives it as "too low" and sets in motion some countermeasures to try to get the BG back up to what he is used to. That is likely what you are seeing now with that 198 (it's also possibly influenced by the dry food he ate), and also may be why he continues to have high pre-shot values most days.

Bounces are one of the things that make it so hard to get insulin dosing right, especially at first-- it's not just a matter of, "insulin in, BG goes down", there are a lot of different factors pushing and pulling and interacting all the time. Dosing based on the nadir (lowest BG point, usually sometime mid-cycle) helps to clarify things because those readings are better than pre-shots at revealing what a particular dose is actually doing. Although today, having gone so low this morning, he may be all-bounce, all-the-time!
 
Mackenzie Obermeyer said:
What exactly is a bounce and how did he get into it?
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Below is an explanation of bouncing which is found in the The Basics New To the Group Sticky

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Mackenzie Obermeyer said:
Would it be helpful if I just did a curve on him today?
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No need for a full curve but do get that +4 to make sure he's staying up and the +2 isn't just food influenced.
 
I see Karen and Nan gave you a bounce explanation. As far a food amount, how much does Mayton weigh and is he at his ideal weight right now?
 
Gill & George said:
Hi Macenzie, and welcome to the group, good job getting those tests.

Just wondering when you say you have transition from the DM dry to wet in the last 3 days, is he having any dry now? (assuming he keeps playing ball and eating up his fuds)
It seems you gave him some DM dry earlier with those lower numbers, so that may have contributed to his numbers coming up as it has more carbs than the wet food. Not a bad thing as you were concerned about him dropping too low. But would he have normally had some dry for his breakfast?

What would be really useful, both to you and to those helping you, might be to note in the remarks section on the SS what and when you are feeding Mayton. As others hve already said getting him into a low carb wet diet can really make a big difference.

One important, thing that Karen has already touched, is his recent episodes of DKA, while LC wet would be better for him it is very important that he is eating enough and getting enough insulin, so while your dad shooting a green number like that this morning might have nearly given you a heart attack, it was probably a good idea, as was your instinct to give him some dry to stop him from dropping too low.

With DKA recently in the picture the last thing you want to do is not shoot enough insulin.
I also think that it would be good idea to start regularly monitoring for ketones.

George is a guzzler too, less so now he is regulated, have you tried feeding Mayton small amounts but regularly, to try to stop him scarfing and barfing??
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Before trying to get him on wet food, we fed him dry DM for every single meal/snack. But since we are trying to get him to wet, we have been feeding him wet food wth a sprinkle of dry on top for the past 4 meals. We put the dry on so he doesn't go to low right away but I guess we werent putting enough. I will start putting in what he eats in the notes of the spread sheet.

We feed Mayton breakfast, lunch, dinner and leave some out over night. We used to put out kibble so he could snack in between. Haven't been doing that with wet food though.
 
Bobbie And Bubba said:
I see Karen and Nan gave you a bounce explanation. As far a food amount, how much does Mayton weigh and is he at his ideal weight right now?
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Hmmm the last time he was at the vet was 12/08/16 and he weight about 11 pounds. He has definitely gained some weight back though. He probably weighs about 13-14 pounds now. Before diabetes I think he weighed like 18 (pretty sure he is part Maine coon). He has a large structure so the best weight is probably around 15.
 
http://petsci.co.uk/feline-calorie-calculator/

The above link will allow you to calculate the calories for Mayton, I just put the details you gave, if he was at his ideal weight 15lbs and you wanted him to maintain it comes out at 354kCal, but since he is a little below, you might want to give him a teeny bit more, until he gets to a good weight for him.

Bear in mind that how much he needs will be individual for him, the way to monitor if he is getting enough would be to regularly weigh him, I do this with George, I haven't got a special scale, just use the human scale hop on with him, then subtract my weight to get Georges weight, you will need to let the scales be your guide.
Another thing to note on the SS is when you've got ketone test and what the result is, great that he has been negative for a while.

How's Mayton overall now, I read through your earlier posts and it seems he was a very poorly kitty back in Novem/december?
Is he peeing lots? Less now than before?
How about drinking?? hanging out at the water bowl loads? or has he began to behave more normally?

You've been doing a great job with the tests amps and pmps and running the curves, but I would recommend getting spot checks as and when you can and if you could get mum on board, all the better, getting a before bed test every night would also be really helpful.
Running curves once a week, with no other midcycle data on other days can be deceiving, if the curve is run on a bounce cycle, what you'll get is relatively high flat numbers, so it can make it seem as though kitty might need more insulin, some cats BG can drop hard and fast in the first half of the cycle and be right up into the pinks by next ps, as the dosing is based on how low the dose can get kitty, it is useful to get those spot checks in they will help when it comes to the point of making a dosing change.

I would encourage you to look at the ss in other peoples sig blocks, some of us test more, others less, but it will give you an idea of what we are talking about. The stickies that others have pointed out are also full of lots of great info and pointers, keep asking questions.

Oh and one last thing, guess in all the excitement we forgot to give your dad the BOS award, given when CG shoots their first green:p:D;)

upload_2017-1-19_16-4-8.jpeg
 
Gill & George said:
I just put the details you gave, if he was at his ideal weight 15lbs and you wanted him to maintain it comes out at 354kCal,
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That is likely WAY too many calories. How old is Mayton? The average cat needs about 6-8oz wet food a day, some less, some more. Since you're feeding two kitties it might be worth trying the Friskies Pate as they are 5.5oz cans for the same price of 1 30z FF can.
 
Just popping in to welcome you and say you are doing a great job with your handsome boy. Do you have a scale? You could weigh yourself with and without him to get a weight. It's hard to guess. I even have a baby scale that I use. Each can of fancy feast is about 85 calories. How old is he? Is he active or a couch potato? Right now it sounds like he needs to eat as much as he wants until he is at his ideal weight.
 
Hi there :cool:

You've got a lot of moving parts here.
With a history of DKA it's critically important that the following be kept front of mind:
  • Any infection and/or inflammation be addressed
  • Your kitty gets enough insulin
  • Your kitty gets enough calories
I would go with at least 1.5x the calories required to maintain optimal body weight at least until the transition from dry to wet is complete and possibly beyond. You do not want to give any advantage to ketone development.

Monitoring daily for the presence of ketones is also a must.

Hang in there and hang in here. We will help you as you learn to keep all the balls in the air. This is the best place to be.
 
Gill & George said:
How's Mayton overall now, I read through your earlier posts and it seems he was a very poorly kitty back in Novem/december?
Is he peeing lots? Less now than before?
How about drinking?? hanging out at the water bowl loads? or has he began to behave more normally?
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I weighed Mayton like you said and he is 13.6.

Mayton is acting pretty normal. He was all over the place in November. It was thanksgiving weekend when he went in to the hospital for his second DKA. Our pet sitter had to bring him in because we were out of town, so that was scary. She told us he was barley moving and was laying inside the litter box :(

I would say he still pees a lot but not nearly as much as he did in the beginning. We brought him in to the doctor in October because he was peeing not in the litter box... he peed everywhere!!

As for drinking he still drinks a lot and is quite obsessed with water, BUT it's hard to tell if that's from diabetes or not because he has been obsessed with water his whole life. He always is playing with the water. He drinks the water by dipping his paw into the bowl and licking the water off his paw... he is so weird haha
 

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tiffmaxee said:
Just popping in to welcome you and say you are doing a great job with your handsome boy. Do you have a scale? You could weigh yourself with and without him to get a weight. It's hard to guess. I even have a baby scale that I use. Each can of fancy feast is about 85 calories. How old is he? Is he active or a couch potato? Right now it sounds like he needs to eat as much as he wants until he is at his ideal weight.
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Yes I just weighed him he is 13.6 pounds. He is probably About 11 years old. I would say he is a couch potato more so than not. He sits a lot but he also moves to sit in different places very often If you consider that active!
 
Doodles & Karen said:
That is likely WAY too many calories. How old is Mayton? The average cat needs about 6-8oz wet food a day, some less, some more. Since you're feeding two kitties it might be worth trying the Friskies Pate as they are 5.5oz cans for the same price of 1 30z FF can.
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He is about 11 years old. I think I'll try to give him half a can at meals and over night. But I may have to stop him in the middle so he doesn't eat too much at once. Then I can give him the rest 20 minutes later.. so he doesn't throw up again.

I think my other cat is just weird because he eats so little but he is pretty chunky lookin... He gained a bit of weight since he has been on wet food, before he ate dry food all his life. We switch Cooper to wet when Mayton was diagnosed.
 
If you are home do you think you could check his BG, reckon it is about +4 for you just to be sure that he doesn't drop when his insulin has onset (it is likely that he is bouncing but better safe than sorry)

Doodles & Karen said:
That is likely WAY too many calories. How old is Mayton? The average cat needs about 6-8oz wet food a day, some less, some more. Since you're feeding two kitties it might be worth trying the Friskies Pate as they are 5.5oz cans for the same price of 1 30z FF can.
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he's a big cat, Mackenzie reckons healthy weight 15lb
From what I have read it's reckoned between 20 to 30 cal per pound of lean body weight is the appropriate amount, depending on activity level indoor/outdoor cat and other factors.
I've just double checked on some vet sites to make sure I wasn't remembering wrong.
 
With Max I fed him some amounts spread out over the first 5 hours of the cycle. I know you have school but they make auto feeders you can set to go off. They have 5 spots for food.
 
Gill & George said:
he's a big cat, Mackenzie reckons healthy weight 15lb
From what I have read it's reckoned between 20 to 30 cal per pound of lean body weight is the appropriate amount, depending on activity level indoor/outdoor cat and other factors.
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Sigh, it's all debatable I guess. Doodles IM vet indicated 15 cal per pound for an adult kitty. He currently was eating about 250-275 calories and is 18.2 lbs. I'll be cutting back a bit because diabetics specifically should be leaner in body weight.
 
Doodles & Karen said:
Sigh, it's all debatable I guess. Doodles IM vet indicated 15 cal per pound for an adult kitty. He currently was eating about 250-275 calories and is 18.2 lbs. I'll be cutting back a bit because diabetics specifically should be leaner in body weight.
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True. I think the issue here is that Mayton needs to gain weight to get to his ideal weight. Once close to that I don't think he will need higher calories.
 
Mackenzie Obermeyer said:
+4 is 268
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Ok, he's bouncing. You don't need to test anymore until shot time.

tiffmaxee said:
I think the issue here is that Mayton needs to gain weight to get to his ideal weight
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Missed that....sorry. The DM dry although not ideal is 600 calories per cup of food and would give Mayon a better chance of gaining the weight back. If you can get Mayton to eat 12 oz of wet food a day to help gain weight...I'd be amazed which is what it would take to bring in those close to 300 + calories noted above. Even if Mayton is part MaineCoon, 15lbs is likely a good weight for his age.
 
Doodles & Karen said:
Doodles IM vet indicated 15 cal per pound for an adult kitty.
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Interesting, Dr Piersons site she quotes that number as a minimum for kitty not developing fatty liver disease, or at least that's the way I read it, specifically when you are putting kitty on a diet to loose weight. The tricky thing is figuring out what their lean body weight is.:confused:

From Catinfo.org
Hepatic lipidosis can also develop when a cat consumes 50% or less of his daily caloric requirements over a period of many days. The definition of “many” varies from cat-to-cat. For this reason it is important to understand that you need to have some idea of the calories from canned food combined with the calories from dry food that your cat is consuming on a daily basis while you are implementing the transition to canned food.

I have never seen a cat develop hepatic lipidosis when consuming at least 15 calories per pound per day. This number is figured on lean body weight, not fat weight.

If your cat weighs 18 pounds but really should weigh 12 pounds, please make sure that he is consuming ~180 calories per day. (12 pounds lean body mass X 15 calories/pound/day = ~180 calories/day)

Mackenzie Obermeyer said:
+4 is 268
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Well he looks like he has decided to have some fun on the trampoline.
You can give him and yourself a break from the pokes till pmps.
 
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Doodles & Karen said:
Ok, he's bouncing. You don't need to test anymore until shot time.


Missed that....sorry. The DM dry although not ideal is 600 calories per cup of food and would give Mayon a better chance of gaining the weight back. If you can get Mayton to eat 12 oz of wet food a day to help gain weight...I'd be amazed which is what it would take to bring in those close to 300 + calories noted above. Even if Mayton is part MaineCoon, 15lbs is likely a good weight for his age.
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I just gave Mayton some Fancy Fesst salmon classics. He is eating it so that's good! Hopefully I found a winner for him. I do not think I could ever get him to eat that much wet food... I just gave him 1/4 can for a snack and he may not even eat that much!
 
Max used to be a dry food junkie. Pancreatitis and diabetes changed that. He became very hungry in normal numbers and ate only canned. Lisa Pierson has ideas on how to transition to canned. I feel it's more important right now that he eats. Fatty liver scares me and eating enough is how to avoid it. Losing weight too quickly can cause it.
 
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