Feeding Diabetic Cat

Hey everyone, long time no speak! I have been diligently tending to my old friend who I have been testing much more frequently. He has gone from 4U twice a day to 2 every 12 hours. I feel like this has helped with his numbers. Please understand that I have been testing him as frequently as I can- it is a two man process and the old boy, while not outright combative, is a bit flighty and hard to handle alone.
His most recent number after 4 hours of vetsulin yesterday was 302. Which is lower than the previous tests from days before of 358, 364, 362.

He eats 2 cans of friskies pate, the 5.5 oz cans, theoughout the day, portioned.

I am worried his appetite is increasing though as he has developed unique behaviors like trying to go through the cupboards for food. I am definitely worried about if this is due to his diabetes and I am not doing the best I can, or if this is due to hyperthyroidism ( his dose was increase to 2.5 mg in the am and 5 mg of felimazole in pm)

Should I increase his dose and food? I really wish I could understand cats meows...

 

300s are still high numbers for a cat and above the renal threshold.

If you could set-up a spreadsheet (we have a format) and enter your test data into it, we would be able to help you with dosing. We are very data-dependent here!
I can help you with setting up your Signature and Spreadsheet - won't take me a minute. Let me know if you need need any help.


Setting up the Signature:

• On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback. There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
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Link to your previous post - https://www.felinediabetes.com/FDMB/threads/introduction-glucometer-dilemma.245023/

 

Ahh, that is what I feared! Still very high!

I will definitely start working on the spreadsheet right now. I do not have access to a PC but I can give it a go on the tablet. Thank you for being patient with me!

A question: I noticed the +2 +3 +... intervals. Does this mean at the first hour after the shot, I test my fuzzy friend's glucose levels? I have been going to a vet for his diabetes work and diagnosis help, and they gave me a spreadsheet for determining how much insulin to give him based on his levels... which is how I had the first levels so high! They told me to test 3-5 hours after injection. Is it okay if I maintain that kind of timing? He gets very stressed during the testing. I dont want to seem neglectful either though; if his short term comfort is blinding my view on the importance of this data, I apologize!

 

+2 means testing two hours after giving insulin
+3 testing three hours after giving
and so on until you get to PMPS his first test at night

 

Hey thanks!

Is it still acceptable if I cannot test as frequently as hourly? I mean, I am thinking I could coax him if I buy some special pate for him (he does have a few favorites, it makes me so happy to see him happy!) but I worry if that would make the scores wonky.

When we were first getting him used to the injections, it was a little laborious, but I still cannot grab enough skin on any other area to inject insulin without him getting physical with me! He is so skinny, when I see others injecting their feline friends, his skin is just so taut compared to them!
Anyways, to conclude this winded tangent-- even the vet techs teaching me were met with my pal's furry fists of fury... he doesn't take the prolonged contact too well.

I just do not want him to get too resentful or aggressive, I suppose. It would break my heart! :0(

 

He is not gaining weight because his glucose is not controlled. He probably needs more food. In order to help with dosing we need the spreadsheet. You don't need to test hourly. To do a curve test every 2 hours for 12 hours or very 3 hours for 16 hours. Since cats often drop lower a night the 16 hour test would help if you don't want to plug in numbers for the last week. Which insulin are you giving him?

 

Thanks for the response!

I use Vetsulin.

I asked my vet folk about what I should do to make sure his levels are more controlled, and they said it goes by a sliding scale of how much he needs to eat vs insulin given.

My concern is that what if I am overfeeding him?

Typically, when I give him more food, he has a tendency to throw up. I don't know if it is because he is eating it quickly, but do you think I should add more food, just slowly portion it so he doesn't make himself sick? I'm only assuming that he is getting sick from eating too fast though, I worry it could be from a plethora of issues!

 

I have never used Vetsulin. It's mot as effective with cats as it is for dogs. Most with cats use Lantus, Levemir, or Prozinc. Have you considered changing to one of those?

 

I was not given the option of other insulins. Should I try to talk to a vet to get a prescription for a different one?

 

I would. Most cat owners aren’t successful with Vetsulin. Don’t feed a large amount at one time. Vomiting when eating makes me wonder if he has other issues going on.

 

My cat was on Vetsulin and while she did pretty well on it and did go into remission, it’s not the best choice for cats. It usually drops their blood sugar very fast at onset, which is typically 2 hours after injection, and wears off around 6-8 hours. Prozinc is a cat specific insulin that usually gets better duration. Lantus is a human insulin that also gets a better duration.

Good times to test your kitty’s blood sugar with Vetsulin are usually +2 which is typically the onset and then at around +3 to +5 depending on your cat, to see how low the dose is taking them. For my cat, her lowest point on Vetsulin was +4. It’s good to test whenever you can, but if you can’t test very often, I would recommend doing those times if possible (in addition to the preshot tests). I’m not sure what your feeding schedule is, but I found it helpful to feed my cat a snack at +2 after I took her BG to help slow down the huge drop that usually happened at onset.

As for the vomiting, it could be several things. My cat is a scarf and barf kitty - she eats very fast and then throws it all up. Because of that, I give her several small portions throughout the day and that helps her. I’m not sure how well controlled his hyperthyroidism is, but I believe that can cause vomiting as well.

 

IBD and pancreatitis can also cause vomiting.

 

I can set up your spreadsheet and signature. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

 

Hey all, thanks for the responses!

I am running out of lancets- I am gonna test at the +2 and +5 hours.

Do you think a grocery store will supply the lancets?

 

If the grocery store has a pharmacy and/or carries diabetic supplies, they should have them!

 

Hey everyone. Sorry for such a late reply. Here's an update.

I've been testing my boy a little more frequently. I'm starting to worry about the numbers. They're definitely really high, and following the instructions that the vet gave me, I'm starting to worry if I'm doing something wrong. It seems as if his glucose levels are rising even though his units have been the same? I have concerns that maybe 2U is too much.

I give 2U at 12A and then 2U at 12P with his hyperthyroid medication, which has to be taken with food.

06/17 - 3PM glucose test: 418
06/17 - 5PM glucose test: 422



Sorry if I seem so clueless. I've been trying to make things right for months now. I've completely cut out all of his dry food, and he eats only pates and canned food with no gravy content. I try to regulate his feeding but it seems as if he is just going backwards.

 

All tests you are able to get are fantastic, but unfortunately only two tests is not enough data to know how he is responding to the dose. Is he pretty good for tests? It's super important that you test before every shot if you are able to. The numbers you got are very high, but without knowing what his BG was before you gave insulin, it's hard to know why it's that high.

Also, in the politest way possible, that is very bad advice from your vet. It sounds like maybe they are used to dealing with dogs, not cats. Unless there are very specific circumstances, you should never increase the dose by a full unit and definitely never by 2. In most cases we recommend only changing the dose by 0.25 units - cats are tiny animals!

This is the guideline for changing the dose from the Vetsulin sticky, if you haven't checked it out yet:


The general guidelines for making dose changes are:

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
• HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may race past the right dose for your cat.

 

This is very comprehensive -- thank you so much! I really do appreciate it. It is definitely discouraging to hear that the vet is probably not the best informed when it comes to my boy's situation.

I've tested him before his medication (including food) and got a result of 409.
I will keep you all updated!

 

Hey everyone.
Hopefully responding to my own thread bumps it, as I have an update.

I've been doing the testing.
His blood glucose levels seem persistently high and he has been displaying a lot of hungry behavior. I have been giving him 2.5U in the AM, and 2 in the PM dose. I don't know if this is because his levels are bouncing back, or if he doesn't have enough insulin for how much he eats. My boy eats every three-four hours, he has 1/2 of a 5.5 oz can of pate. Except during insulin times, we try to give him a little more. It seems as if this isn't enough food for him, but I am worried that if I'm overfeeding him. He gets very vocal and quite the mischievous boy when he is displaying the hungry behavior - jumping on counters and slamming cabinets where the food is.

12-1
4-5
9-10

Those are the feeding times, interchangeable with the morning and night. We give him insulin 12AM - 2U; 12PM 2.5U

 

I'm going to tag
@JanetNJ
@Deb & Wink
for you

You said you have been giving him
2.5U in the AM, and 2 in the PM dose but then after that you said
We give him insulin 12AM - 2U; 12PM 2.5U ??









How many cans of Friskies Pate are you feeding him per day? You say he's very hungry
Do you have readings for the 6-26 PM and all of 6-27 ?



Then you said in:#16
I give 2U at 12A and then 2U at 12P with his hyperthyroid medication, which has to be taken with food.

06/17 - 3PM glucose test: 418
06/17 - 5PM glucose test: 422

Nothing is filled in on 6-18 thru 6-22 ?

Plus we increase by 0.25 units at a time



Thank you
@JanetNJ

@Deb & Wink

 

Hi there, thanks for the reply! Sorry for the misunderstanding- 2 U at midnight and then 2.5 at noon.
We feed him 2.5 - 3 cans a day. He eats it very quickly and within the next hour he seems to want to eat some more. I don't know if I should feed him more or less, but he seems so ravenous!

His glucose levels are very high for the past few days, we have only been able to see a slow decrease as of lately. I don't know if it's going to stick though.
For June 26th, these are the readings I have. I'm sorry, I have work so I have only been able to test as much as I can lately. Please don't be too hard on my data, I've been trying to test him a lot more frequently as he has been tolerating them a little more. He doesn't bat at me anymore, which is a good thing!

06-24
1P: 395
4P: 337

06-25
1A: 432
4A: 354
6A: 316
11A: 455

06-26
2AM: (after he was fed) 443
12P: 427
1P: 447
2P: 426
5P: 348

06-27
12A: 343

06-28
12A: 469
2:52A: 365
9:30A: 456 (he ate around 8a)

 

I understand you are working
One thing when you get a chance can you fill in the spreadsheet for the 26th, 27th and 6-28. It makes it easier than going back and forth looking at the numbers on your post .Thanks
I'll tag
@Deb & Wink to also take a look at your SS , she will be on tonight

 

Will do!

Thank you for your understanding. I definitely want to make things better for my boy.

 

I don’t think Rudy is getting enough insulin. I think you need to increase the dose.

You want to see those BG levels down much further than they are. You want to see them down in the yellows and then down in the blues.

 

Hey there! Thank you so much.
Should I increase by half a unit? How long should I maintain the new dose if the numbers still show to be that high?

 

Thank you Deb
I hope your kitties are doing well
@Deb & Wink

 

One thing when you get a chance can you fill in the spreadsheet for the 26th, 27th and 6-28 and 6-29 this mornings dose It makes it easier than going back and forth looking at the numbers on your post .Thanks

I would increase by 0.25 units but let's see what others have to say
I'll tag
@Deb & Wink

@JanetNJ

to see how much you should increase and how long to maintain that dose

 

https://felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

Link about Vetsulin

 

So looking at your spreadsheet you only just increased to 2 units. I think you need to hold it a few days and give it a chance to work.


You can delete the unused cells before when you started putting in data. Good job getting that set up.

How much does your cat weigh?

One thing you could do to fill him up more is add some water to each can of food.