Changing diet, fighting neuropathy

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Teo

Teo

Member Since 2020
Hello everyone! I'm Teo from Argentina and I am new to this world of diabetic cats.

My big 10 year-old cat Viamo was diagnosed with diabetes three months ago, when we started noticing signs of peripheral neuropathy. His walking has only worsened since, despite being treated with a slowly increasing dosage of Lantus insulin (two times a day, started at 1 unit each time, now 4 units each time). He has been eating Royal Canin Diabetic dry food since. (I know, more on this later.)

Only recently have we bought a glucometer to test at home, and we are still getting a grip on it. We have tested him at various times of the day, (although haven't performed a complete curve spanning 12 hours) and today his glucose level was 435 mg/dL two hours after his morning shot. This seems his usual value: it has not decreased since treatement started.

When I found this site I was very frustrated as I noticed there aren't knowledgeable veterinarians in the field here in Argentina. As far as I have read here, I understand that it is important to try to switch his diet to one which is wet, less carbohydrates and more protein. But I do not know how to manage the transition while keeping the insulin dosage correct. This is my main worry now. Also, the lack of professionals who can help us directly is a major burden since I feel I am taking a path where veterinarians won't follow.

I arrived at this site by chance, by recommendation of someone to which it has helped a lot. Thank you in advance for the tremendous work done here.
 
I am not sure if I can help much, as I am also very new to the subject.

For Cedric, I made the transition from dry food to wet food yesterday. I was also looking for some kind of schedule to mix dry food, wet food and a reduced insuline dosage.

However I did not find the right information for this, nor did I get good feedback or suggestions. Most sites that give tips about the transition to wet food help with cats who do not want to eat wet food. I knew this was not a problem for Cedric.

So in the end, I took a cold turkey approach yesterday. Because Cedric required a relatively low dosage (1,5 IU insuline) on dry food, I knew witholding insuline for 24 hours would not be a huge risk to him.

So I'm sorry not to be able to offer any advice, I wanted to share that I'm going through the same with my cat and understand how uncertain this can feel.
 
Welcome Teo and diabetic cat Viamo. Glad you found us.

Since you only started to home test the blood glucose levels, DO NOT change to wet food only. You need to have more test data and be more comfortable with doing the home testing before you change the food.

I see you already have a spreadsheet setup and linked to your signature, have started to home test and are looking for more information. That is great and will help us to help you better.

Would you please go edit your spreadsheet and make a few changes and additions.

1. Add the number of units of insulin for each day. That information goes in the column labeled U.
2. If you could also rename the spreadsheet when you are over in google editing it, that would help too. Most people put their cats name in the title of the spreadsheet.
3. Up at the top, there is a place where it says Current insulin. For you, change that to say Current Insulin: Lantus
4. Up at the top, to the right of where you indicate which insulin you use is a place where it says Meter. For you, change that to say Meter and add the name of the meter you are using, both the brand and specific type.
 
Hello and welcome to you and sweet Viamo.

I would hold off doing any food transition to lower carb food, until you feel comfortable with blood testing, and get a better picture of what is happening on his current dose. Only then would I start a transition. And do it slowly, maybe starting with 25% low carb food and the rest the same. Keep at those amounts for several days before increasing the amount of wet food. It can take a few days for higher carbs to work out of the system. Once you start the transition, post here regularly, and we can help you decide what you need to do with the insulin dose.
 
Thank you all for the quick response.

I have updated my spreadsheet as instructed, and will not change the diet until I have a 12-hour curve tomorrow and recieve further information.

At least it is nice to hear that Matthijs is in a similar position. Viamo is also very keen on eating meat – in fact he goes mad every time we cook any. But it seems Viamo's BG is much higher than Cedric's.
 
Thank you for making those changes to the spreadsheet (SS is an abbreviation we use).

What to do depends on the insulin you are using and what food you are feeding and if you are home testing. Matthijs is using a completely different insulin than you are using so what might work in one situation would be totally wrong for another cat and may put them in danger.

I'd like you to do one more thing for me if you would please. Add some more information to your signature.
Your first name, your cat's name, diagnosis date, insulin used, meter used are helpful, food fed, any other health conditions you are dealing with.

If you look at the bottom of my post, you will see some of the information in my signature.

More information on editing your signature is here.

There is a lot of information here in this post to help you out.
New? How You Can Help Us Help You!
 
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Please always test your cat at pre-shot. No food for 2 hours before, test, feed and shoot (give the insulin). You and we want to know that the blood glucose levels (BG) are high enough to safely give insulin. That is why a pre-shot BG test is important.

Then with Lantus, tests in the middle of the cycle around +3 to +7 can tell us how far the insulin is dropping the blood glucose levels (BG). That low point in the middle of the 12 hour cycle is called the nadir or peak of insulin action. Lantus dosing is based on that nadir which is why it is important to test during the mid-cycle.
 
Thank you for that advice, I will put it in practice tomorrow while I continue making measurements every two hours. I understand that every case is different. I also have read the info on the links you provided.

Immensely appreciated!
 
Teo said:
Glucose is 517 right now. What should I do? Is this the right place to post?
Click to expand...

That number is high enough to give insulin. If this is your regular shot time for the evening PM insulin shot, then I would feed and then give the regular dose.

Feed the food you have been using, the Royal Canin
 
Regular time for evening is in an hour. Do I give the shot right now instead? (After feeding)
 
No, wait until the regular shot time. Please test again at your normal pre-shot test time.

We want to keep the insulin shots on a regular 12 hour schedule as much as possible.

Wait to feed until after the regular test time.
 
I rushed and gave him some food. He didn't end the plate, I took it off him after I read your message. Will wait until regular PM shot time. Should I still feed him before?
 
While you are waiting , there is a lot more information to help you.

If I haven't already inundated you with too much information that is;). There is a lot of information over in the one of the Insulin Support Groups. The forum you want to look at is the Lantus/Basaglar (glargine) and Levimir (detimir) forum.

Take at look at the information at the top of that forum where the posts have the work 'Sticky' with a yellow background at the front of each post. These are pinned to the top of the forum for easy reference.

I'd suggest starting with reading the one labeled "The Basics: New to the Group? Start Here"

There is a lot of information there. Don't let it overwhelm you. Don't try to read it all at once. Reread it. Keep asking questions here. Those 6 stickies are years of experience from many different members here. It's like taking a college level course in treating feline diabetes, but focusing on only 2 different insulins.
 
It's ok that he ate a bit.

Wait until PMPS and test again
Feed him
Give him his shot.
Make a note in your SS that you fed at +11.

Will try to take this slow and easy.
 
Yes, please measure the BG (blood glucose) again before you give the insulin tonight.

Argentina is 2 hours ahead of where I live on the Massachusetts coast. So when it is 9 pm there it's only 7pm where I live. I should be able to help you for a few more hours.

Do you have plenty of test strips for your meter (glucometer)?
 
Your spreadsheet says you gave an extra shot of Caninsulin on the advice of your vet. Please confirm that you are using Lantus. Do you also have Caninsulin that you are using?
 
I am using Lantus regularly, and not using Caninsulin. But, as indicated, today I gave him that extra shot on advice of my vet. I have the Caninsulin because a while ago another vet wanted to find out if he would respond better to it, but it didn't change things either. He was on Lantus before, and has been on Lantus again for at least two weeks.
 
I don't even know what the effects could be by mixing Lantus and Caninsulin in the same dosing cycle. I'm going to tag a couple of other people and see if anyone has experience with doing that.

Please don't use anything but the Lantus (glargine) insulin for now. Not even if the BG numbers are high.

@Marje and Gracie @Sienne and Gabby (GA) @Bron and Sheba (GA)

This new person is from Argentina. Any help would be appreciated.
 
Please don’t give caninsulin and Lantus together! That was not a wise thing for your vet to suggest at all.
Only ever give one lot of insulin in the 12 hour cycle.
The only exception is when R insulin is sometimes given in special circumstances but only when you have a very experienced person with you who had discussed it in full. And at the moment you are not in those circumstances.

How long since the dose of caninsulin was given? Can you tell us how many hours since that dose please?
Please don’t give the next dose of Lantus until we have established when the dose of caninsulin was given.
 
I have just given the regular dose of lantus, before I read your message. I can measure again if you tell me, his PMPS was 540 minutes ago. The dose of Caninsulin was given at +6.
 
Teo said:
I have just given the regular dose of lantus, before I read your message. I can measure again if you tell me, his PMPS was 540 minutes ago. The dose of Caninsulin was given at +6.
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Ok. You will need to monitor this cycle to see that the BG levels don't drop.
I would get a +2 and see how he is going. Then if that hasn't dropped a lot,get a +4.
I will watch for updates. Please keep the SS up to date.

We can help you get Viamos BGs better controlled but it will take a bit of time as the food needs to be swapped over and you need to be testing well before that. Just hang in there and keep posting and we will help. If the vet suggests anything else, please ask us first.
 
Please do not change the food yet. Please do not give anything but the lantus insulin.

I'll try to stay awake until your +2 test, but I will not be able to help you later than that.

Do you know how to change the title of your post and ask for more help?

Do you know how to tag someone for help? Type in the @ sign followed by the first few letters of the persons name and it will give you a list and you can select from that list.

So to tag myself it is @Deb & Wink
 
Understood, I will not change food nor insulin. I will perform +2 test which is in an hour from now.

I changed the title of this thread but I don't really know where to focus the attention because the information here is so overwhelming. And now i know how to tag. Thank you, @Deb & Wink

Viamo seems normal as of now. Relaxed and awake.
 
While we sometimes use a bolus insulin (as your vet is having you use Caninsulin), we usually use one that is short duration (4 hours). Using a bolus insulin requires very specific parameters as to when it is given.

I agree with the others that I would not use Caninsulin as a bolus with Lantus. Once you are here for a bit and we have a chance to help you, if we determine that he might need a bolus insulin, we will work with you as to how to use it. For right now, can you please mark on his SS exactly when you gave the Caninsulin as in hours from when you gave the Lantus so if you gave Caninsulin six hours after the Lantus, please put in the +6 cell “1u Caninsulin”. Thank you!
 
Welcome to FDMB. I think everyone has offered excellent guidance.

I do want to reiterate that combining Lantus and Caninsulin is not a strategy I've ever seen. There are sone situations where combining a long-acting insulin (such as Lantus) with a bolus, short acting insulin is feasible but it would not be Caninsulin. Generally, Humulin R is what is used and even thought it is a strategy we use here, we only do so if a member is working alosn with someone who is experienced in using those two typed of insulin in combination. Frankly, it can be dangerous and we want to insure that Viamo is safe.

(Marje and I were posting at the same time.)
 
I updated Viamo's +2 PM measurement in the SS. It was 453.

Hi everyone who joined the thread, thank you very much for the support and opinions.
 
Teo said:
I updated Viamo's +2 PM measurement in the SS. It was 453.

Hi everyone who joined the thread, thank you very much for the support and opinions.
Click to expand...
Thanks for keeping the SS updated. It helps a lot.
Dropped 90 points in 2 hours. are you able to get a +4?
 
That is a good BG reading for +2. Keep posting, and another test at +4 please. That was a 100 point drop in 2 hours from the lantus insulin. Another 100 point drop at +4 would be ok.

Maybe get a BG test at +6 too. That is often the lowest BG reading of the cycle, but with the Caninsulin used also, who knows what you'll see.

I'm off to sleep, but there will be other people here to help if needed. I'll check on Viamo in the morning, look at the post and check his SS.
 
Good. Sorry for the late reply.

I will do a test at +4. Can't promise I can do a +6 measurement –that would be at 3 am– but I might.
 
I have a question (please tell me if this belongs somewhere else): at what times should I feed Viamo in the middle of the 12-hour cycle? What we usually did before was free feeding him, but make shure he ate after every insulin injection. The advice here was to feed him before, I will adopt that –but is it important at which other times I do it?
 
You need to feed him BEFORE the shot to make sure he will eat. Then if you want to free feed you can. But you will need to pick up the food for the last 2 hours before Preshot so the BG isn’t food influenced.

OR you can feed at say +2 +4 and +6 (as well as before the shot)
You need to work out what suits you. But it is a very good idea for the cat to have food during the first half of the cycle when the insulin is strongest.
If you want to make sure Viamo gets some food I would look at a auto feeder that has a chip. That way only he will get the food. But of course they are more expensive than ordinary feeders.
 
Good, that is valuable information. Making him eat is not a problem for us: he has great appetite and will eat at any time he hears the sound of the plastic food bag. Also I doubt auto feeders are easy to find in my country, but great suggestion.
 
Teo said:
Good, that is valuable information. Making him eat is not a problem for us: he has great appetite and will eat at any time he hears the sound of the plastic food bag. Also I doubt auto feeders are easy to find in my country, but great suggestion.
Click to expand...
If auto feeders are not an option, you may like the idea of freezing some food and putting it out for later in the day, if the weather is hot.
Having a diabetic cat who is a good eater is a bonus!
 
Hm, I understand you are thinking wet food, right? We are still feeding him dry, as recommended earlier in this thread. But once we start changing the diet we will certainly have things prepared beforehand for him.
 
Teo said:
Hm, I understand you are thinking wet food, right? We are still feeding him dry, as recommended earlier in this thread. But once we start changing the diet we will certainly have things prepared beforehand for him.
Click to expand...
Of course!
I mean when you have swapped over to a wet diet.
In the meantime it is not hard to leave out dry food.
 
Updated SS to show +4 PM measurement. Exactly the same number as before, strange.

(Additionally, today I did a quality-test for my glucometer with the included control solution. The test was within the correct range, so my glucometer should be working fine.)
 
Successful early morning measurement! It was 489 mg/dL. He doesen't seem to be getting a lower value at night. I need to sleep so the next test will be just before his morning insulin injection.
 
Well done.
Tomorrow is a new day!
If I had to stay up at night to test Sheba... which I had to do a lot... I used to set the alarm and sleep inbetween tests. It was the only way I could get enough sleep.
I could always wake with the alarm. If you need to test overnight again ( which I’m sure you will;)) if you think you will wake with the alarm, try sleeping between tests.
 
We were worried a little because you gave 2 different insulins. So seeing those numbers on the SS that stayed in the red and black ranges is good. We worry a lot more if the BG readings fall a lot lower, a lot faster.

Yes, we think we can help get those BG's a lot lower with a food change.

Get some sleep. We'll try to get you more information on how to get your Viamo's diabetes better controlled with diet.

In order to do that, we need to know some things.
Will he eat canned food? or only dry food?
What canned cat foods are available in Argentina? at your local grocery store? at the vet? at pet food specialty stores?
Do you live in or near a medium or big city so you have more options of where to shop for food? Can you order online from a pet specialty store?

Over the years, we have put together lists of cat foods available in the US, Canada, United Kingdom (some from Europe by mail order), Australia, New Zealand but we don't have any information of what foods are available in South America or more specifically Argentina.

You want to look for canned cat food that is low in carbohydrates (carbs). Reading labels is a good starting point. You do not want to see many ingredients like corn, wheat, rice, potatoes, peas. Sometimes a little bit of grain or vegetables are ok if it appears later in the list of ingredients. Meat or meat-by-products should be the first ingredients on the food label.

Foods in a gravy or sauce are often too high in carbs. We may be able to help calculate a general level of the carb content of a food if we can see some nutritional values on a manufacturers website.
 
Before you try the food change, we want you to have supplies on hand. We don't know how low the BG will go with the food change, and it may take some time to better regulate the diabetes for your cat Viamo even with the food changes.

1. You want to have plenty of test strips so you can monitor. Having 100 or more test strips is a good idea.

2. You need to have a hypo tool kit with items that can help if the BG readings get very low (<99 mg/dl). Understanding some symptoms of low blood sugar would be good.
Here is a link to a post that talks about what should be in a hypo tool kit. Keep some of the Royal Canin diabetic dry food in your hypo tool kit. Here in the US, that food is called Royal Canin Glycobalance. Does the bag of food you have say that?

3. Second link is to general information on symptoms and treatment for low BG (blood glucose).

If possible, I would print out these 2 documents and keep them in a folder where they are easily accessible.
 
Hello! Good morning.

Viamo will eat almost any food. He has a big appetite and always asks for more food than what we give him. (And he's well fed!)

Regarding the availability of canned foods in argentina: I do live in a big city but the offer here in Argentina is certainly a bit more limited than in the other countries you listed. Here is what I have found on the internet so far:
  • I think Fancy Feast –whose name I have read a couple of times here– is not easy to find or not sold at all.
  • Pouches from Purina are easy to find but always have gravy and I don't find any on the lists I am reading on this site.
  • Royal Canin also has some "veterinary" cans or pouches here.
  • Here for example is an argentinian brand I just found on the internet with a can that doesen't seem to have wheat or peas, but its protein content isn't great either.
  • In this other site I found some variety of other brands. (Whiskas, Iams, etc.)
There are two other things to be considered:

First, yesterday my mother read the article at catinfo.org about preparing wet food at home and actually prepared an interesting mix that we now have in the freezer: a whole chicken's meat with grounded neck's bones, chicken liver and hearts. Maybe we took things a bit too fast, but we didn't give it to Viamo (only a bite to see if he liked it – he did). Also, we still don't have vitamins to put in that homemade food, and I would like your opinion as to wether it is a good plan to continue with that plan, specially if we fail at finding good canned food.

Second, we will be out for vacation during the last week of january, so it would be ideal if by that time we have reached any sort of stability in Viamo's daily routine. Someone will be here to care for him, but it wouldn't be good to expect much from an occasional caretaker (such as frequent glucose tests or food changes).

That's all. I have spent quite a bit of my morning delving into this, so I might not be as active in the next few hours.

Oh, should I continue the curve today?
 
No reason to do a curve today. You basically did a curve last night.

Do get the pre-shot BG test both AM and PM and try for at least 1 mid-cycle test each 12 hour cycle. As your work and life schedule permits of course. We know you are low on test strips and won't get more until Monday.

Back in a bit with info on food. I need time to check things out.
 
Food info reply part 1:

Making your own cat food is certainly an option, but cats need certain vitamins and minerals such as Taurine that need to be added to the food. All ready prepared mixes of these essential vitamins and minerals are available here but not sure of availability in Argentina. Even commercially made dog foods have differences from cat foods. Some cats got really sick a number of years ago because there was not enough Taurine in the food.

It may be possible to buy the individual vitamins and minerals and add them to the food you made. Here is one recipe (from catinfo.org) that lists the vitamins and minerals needed.
  • 3 pounds of whole fowl or rabbit, including bones, organs, and skin
  • 1 cup water
  • 2 eggs (use raw yolks, and lightly cook the whites)
  • 2000 mg wild salmon oil
  • 400 IU vitamin E (powdered E in capsule form works)
  • 100 mg vitamin B-complex (start with a smaller amount when beginning a raw meat diet; the vitamin has a strong odor)
  • 2000 mg taurine, powdered
  • ¾ tsp lite salt with iodine (when using chicken parts)
  • Liver (add 4 oz if the meat you are using does not include organs)
  • Psyllium (add when first introducing the raw meat diet to your cat.
Carefully handling of raw cat food needed, so you don't make you or your cat sick with bacteria contamination.
 
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