Diagnosed 09/28, help with home treatment

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kds0200

kds0200

Member Since 2014
Hi everyone! First a little background, since I'm new to the board. I'm Kellie, an English teacher and writer, and my cat is Bailey, a seven year old black and grey tabby who has been with me all his life (a little more background - he's always been a big cat, not overweight, just bigger than the average house cat. Back in February he weighed 15 lbs and now he's down to 11 lbs and looks like a bag of bones in my eyes, so that's a whole other worry right now...). He was recently diagnosed with diabetes and after a couple of bad experiences with the vet this past week, I've been reading and researching as much as I can - I know I'm already a "Bailey expert" so I want to be able to understand and work out what the best treatment for him is.

A month ago this started by switching his diet, per the vet's recommendation. That was before I knew about this wonderful website and message board (and Facebook group!). The vet put him on Royal Canin's diabetic formula, and he was eating mostly dry, with a can every other day just for variety. The vet wanted to see if we could get his numbers under control just by changing his food to this fancy prescription stuff (with no mention that wet might be better than dry). A month later, his number was higher than ever (407) so the vet had me start him on insulin N (two units, twice a day). That was when my concern went through the roof and I started reading up about all this on my own. The vet did a "curve" this past Saturday after a week of the insulin (only three tests, 338, 308, and 356 because, of course, he put up a fight and was completely stressed out at being there without me) and wanted me to increase his insulin to four units a day.

I'm looking at the insulin thing slowly. We've been home testing and I did my own curve on Sunday (his numbers were in the mid 200s, much better, considering how the vet was). Now his diet is mostly canned food (but still the Royal Canin diabetic formula - will be switching to Fancy Feast classic later this week), with dry down for him to munch on at night (he's always been a nighttime munchie cat). Doing another curve today because I'm trying a different feeding schedule. When I tested him this morning he was super high (542) though that was before breakfast and his morning insulin shot AND I think he was stressed because right when we sat down to test a neighbor dog started barking and Bailey got all squirmy in my lap and his eyes went wide and alert.

Anyway, I guess my main question right now has to do with feeding and high numbers. My family is offering all sorts of advice, my grandmother in particular - but all she knows is what her human friends who have diabetes do. She'll say, "So-and-so couldn't go too long without eating or he'd have trouble, maybe that's what the cat needs," or "I always heard a glass of orange juice would do a diabetic good - is there something like that for cats?" I just kind of smile and nod and tell her I'm doing my research and I have a plan for taking care of him.

So what is the connection between food intake and higher glucose numbers, especially when on insulin? After everything I've read I'm excited to do the curve today and see where he's at but still not quite sure what connections to make. Bailey seems to eat more regularly during the day (mostly because with canned food it's easier to control his portions) and the dry at night is harder to monitor. But he's still getting insulin twice a day (we're at ~3.5 units right now) and as I mentioned above, we're doing another curve today with a slightly different feeding schedule (1/2 can every four hours from 7am to 7pm, insulin after first feeding, testing every two hours). That 542 this morning really alarmed me. I know it was at the end of his last insulin dose and he was a bit stressed with the barking neighbor dog, but that still seems incredibly high. I stayed calm and got him to chill out and distracted him with his breakfast (he LOVES canned food and is thrilled to be getting so much of it every day now), and I know this is a long process and we're just at the beginning of it but...I don't know. It's a lot of variables to juggle and I'm making notes and keeping charts and that's giving me some peace of mind (and an outlet to write about everything that's happening) but at the same time I just feel constantly worried about Bailey.

Thank you all so much for your help, in advance! The Facebook group has been very helpful and I'm glad to join this board and learn more from your collective experiences.

With purrs and snuggles,
-Kellie and Bailey
 
Welcome Kellie and Bailey! You have done great research and have the hardest part of this sugar dance down -hometesting! I does not hurt cats to graze on wet food; some people think it helps support the pancreas. And he can graze at night too. Many of us use an automatic feeder (I love my PetSafe5) You can have it open during the night to feed him (some of us freeze the wet food and it thaws till he eats it) Using the feeder lets you have it go to an empty slot 2 hours before you get the am test, so it is uninfluenced by food.

Taking away the dry may really help his numbers, but you will want to be very careful. Dropping his numbers by 100 points or more is possible and he is on a high dose of insulin. You might want to lower the dose a few cycles, go to all wet and test carefully, especially for preshots and nadir (the lowest point)

If you have been reading, you know N is not popular here. It has a rapid, harsh onset in many cats so they reach the nadir early in the cycle and start back up fast. It usually only lasts 6-8 hours. We prefer Lantus, Levemir or ProZinc which are milder and tend to last 12 hours. The fast onset and short cycle makes it very hard to regulate with. One of the only ways to keep the cat in lower numbers is to dose every 8 hours during a 24 hour period which is hard for most people. And even then, you have that rapid onset.

I'd try N for awhile, take away the wet, and if he doesn't respond with longer, milder cycles, consider a different insulin?
 
Hey Sue, thanks for your reply! I've been reading up on the different kinds of insulin but I'm also looking for a new vet so I'm kinda waiting until that gets sorted out. Had a very bad experience with the vet who diagnosed Bailey so I'm hoping to find one who is willing to work with me instead of just expecting me to do whatever they say, no questions asked. Until then it seems like keeping him on the N is better than nothing, especially with his numbers being so high.

Bailey tends to not like cold food but I've never seen an automatic feeder that could be used with canned food. I'll have to look into it!

Thanks again :-)
 
Another option could be Young Again Zero Carb dry food. It's only available online and it's pretty spendy. You should be able to get a free sample. Although dry food isn't good for cats in general, it might help in a pinch.
 
Hello and welcome. Great job doing your research and starting home testing! I feed raw food with my automatic feeder. You can get some feeders that have a place for ice packs, or you can put an ice cube on the food to keep it cool until the feeder rotates around. It's always good to add water to wet food to keep diabetics well hydrated anyway.

There is another possible reason for Bailey's higher number this morning. We call it a bounce. It could be possible that the insulin sent him lower than what he is used to last night, and his liver panicked and sent out extra sugars to balance it. Over time as he gets used to lower numbers again, he'll bounce less.
 
Kellie and Bailey,

Welcome to the group! As you have probably already figured out, you will get great advice here! You should definitely switch your cat to all wet food. Even just a few bites of diabetic dry food can seriously increase BG levels. Before we switched Tisha off of dry food completely, we were increasing her insulin dose. We have been decreasing it ever since, and may be able to try going with no insulin again soon. (The first time we tried, she had a very serious bout of pancreatitis that was unrelated, but being sick increased her numbers too much to do the trial. By the way, the advice I got here may well have saved her life during that time, both because we knew when to avoid insulin and because people were so helpful with pancreatitis advice and advice on how to get her to eat.)

We have a wonderful and supportive vet. When you're looking for one, you may want to consider a vet that specializes in cats. That made a huge difference for us when we switched. Our vet has told us that canned food is safe at room temperature, and that the cat will refuse to eat it because it is too dry before it gets to a point where it is dangerous for them. We leave open cans out on the counter with a plastic lid on them for the next feeding, which seems to work well. We also free feed Tisha night and day with wet food. We just throw away any food that is left every morning so that we know that nothing is out that is more than 24 hours old. That might help you at night. Since we transitioned to wet food, Tisha won't even touch dry food unless she's starving.

The spreadsheet that most people use here is also very helpful. Here's a recent post from BJM with the info on the spreadsheet:

BJM said:
Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

Once that is done, you might like to update your signature to add a few things, including your spreadsheet link.

Editing your Profile signature block.
Go to the top left of the screen.
Click on User Control Panel.
Click on Profile
Click on Edit Signature
A test box displays.
This is where you may paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name, cat's name,
city and state,
date of Dx (diagnosis)
insulin
meter
any other pertinent issues like food issues, allergies, IBD, etc.
Click to expand...


Good luck! You are motivated and doing research, so you will get this!
 
Hi Kellie,

I just wanted to add my welcome. My name is Shelly, and my cat's name is Jersey. Your story sounds so very similar to our own. Jersey was diagnosed in November 2013 and the vet put her on Hill's w/d dry food, indicating that the food change may be enough to bring her into remission. In January of this year, the food change hadn't helped, and he prescribed 2 units of N twice a day. That's when I started doing research and found this site. I quickly learned that the w/d was just as bad as the Meow Mix she had been eating and that N was not a good insulin for her. Needless to say, the vet wasn't happy when I took Jersey back in for a checkup, told him I wouldn't be feeding her the prescription food anymore, and had only been giving her a quarter of a unit of N rather than the 2 units he had prescribed. He also was not supportive of home testing, which had shown me that just that quarter of a unit got Jersey into the "normal" range. I knew I wouldn't be able to continue to see him, so I went to a different vet. He immediately prescribed Lantus for us, but he wasn't knowledgeable about dosing. That's when we started relying on the people here for dosing advice. After about 2 months on Lantus, Jersey went into remission and is now diet-controlled. I tell you all of this because I can completely relate to how frustrated you are right now. I was frustrated with my vet and even with myself for not doing my research earlier.

You've gotten great tips so far, so I won't add to that right now, other than to say that testing before each shot, as well as at nadir - the low point in the cycle, really is the key to keeping Bailey safe and getting him regulated...and perhaps even into remission.

Just don't be afraid to ask whatever questions you have. We all know how overwhelming it can be when you're first starting out, and we'll help you however we can.

BTW - I'm a psychology instructor, so we even have teaching in common! :-D
Shelly
 
Thanks, Shelly, Tisha's person, Wendy, and Tara! I'll definitely get my data in a spreadsheet and start keeping it updated. Right now I'm just using a plain pen and notebook method (and graph paper for curves) but it'll be good to get it all computerized.

I just tested Bailey again before giving his evening insulin shot. He was at 557 which is alarming to me, but I gave 4 units of N (which is what the vet recommended this past Saturday). The more I read up though, the more I'm ready to switch to Lantus. First I need to find a better vet though, one who supports home testing and is willing to work with me more closely. I'm off work tomorrow and finding a new vet is at the top of my "to do" list. I just don't understand vets that push some company's specific product on clients if that product really isn't all it's cracked up to be! And since every cat is different (at least that's what I've gathered from all my reading), it just doesn't make sense to expect the same procedure to work for everyone. This early in the process of getting him better, I'm open to all the options it takes in finding what's right for Bailey.

Thanks again, everyone, for being so welcoming and helpful and generally awesome. I was very upset when Bailey was first diagnosed but knowing there are so many kind people here to talk with really makes a big difference.


EDIT: Signature updated with SS all my data points (only been home testing for a week). That was easy! Wish everything else were so... ;-)
 
Your signature is fine. You followed the instructions perfectly.

You need to log back into Google drive, select, and edit your spreadsheet by
Select File, Publish to web..., Start Publishing, and copy the box labelled Get Link to Published Data
Then click on Close.

Also, here is a primer on Humulin/Novolin N.
Most importantly, feed 30 minutes before giving insulin to make sure that food is on board as N insulin hits hard and fast.
The nadir, or lowest glucose level, is around +3 to +4 hours after the shot.
N may last only 6-8 hours in the cat; you'll see how it works in your cat by testing.
If possible, pick up the food at +6 hours after the shot, as the glucose will often race back up high when the insulin wears off.
If your schedule allows it, you may get better control shooting roughly every 8 hours.
Please don't give insulin if the glucose is below 200 mg/dL when starting out. As you collect mid-cycle and dose-response data, that number may be slowly and carefully lowered to 150 mg/dL.

With any food changes, it is best to do them gradually so you can observe the effect on the glucose levels as well as avoid the GI problems of nausea, vomiting, or inappetance. Try changing out roughly 20-25% per day and watch for GI or glucose issues.

And just in case (be prepared), here are some instructions for handling hypoglycemia. We hope you never need them; print them just in case.
 
Thanks, BJM! I think I got the SS set up correctly now.

This morning testing didn't go well (wasn't able to get enough blood and didn't want to over-stress today) but he had breakfast and then 3.5 units of N. His numbers are so high that I haven't been worried about him going hypo, but I've bookmarked that link too and will read up ASAP, just in case!

Calling a new vet for an appointment today. He's got rave reviews online and my mom has a friend with a diabetic dog who goes to this vet. Here's hoping we can switch to Lantus and see some better results soon!
 
I can now see your spreadsheet using my PC!

You've noted you'll be using ProZinc which is a good one. We have a protocol for using it here.
 
Thanks, BJM! I read the protocol sticky for ProZinc as soon as we got home from the vet and then posted a couple of questions in that forum. Sue and Rachel have been very helpful over there too :-D
 
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