Feeding the right diet

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Kathryn & Nugget

Kathryn & Nugget

Member Since 2018
Hi everyone,

Nugget cat and I are new to the forum. She was diagnosed a few days ago. At our vet visit her sugar was 421, so they started her on 2 units, twice a day of Lantus. The vet recommended we change her diet in an attempt towards remission (someday I hope!).

Nugget was eating Purina One dry food. She had wet food as a treat. Now we have switched entirely to a wet food diet (Castor and Pollux Organix and Castor and Pollux Pristine). The vet said that 6oz of food a day would be sufficient to maintain her weight, which I was told is important because her insulin dosage is based on her weight (9 lbs 13.5 oz)

I am concerned that I am not feeding her enough as she is quite hungry when I feed her at 5:45AM/PM. The calorie counts in the different types of food vary greatly- do I need to take this into consideration? From my research I've seen that a cat her size needs between 200-250 calories per day. I am not sure how many calories she was taking when eating dry food as she was a grazer and I never really measured her food.

Another concern is the timing of the eating and the administration of the insulin. Recommendation from the vet was to give the insulin 30 minutes after feeding, and that it MUST be 12 hours apart. I have parent-teacher conferences coming up soon, and my SO is deathly phobic about needles so he can't give her the insulin (I am hoping this will change- anyone who has advice about overcoming this phobia I will gladly listen). I was thinking that I would feed Nugget later than I usually do (7:00 AM instead of 5:45, therefore a 13 hour difference from the last dose), so that when I get home at 7:45 from PTC I can feed and give the insulin again at 8:15 PM. There would be another 13 hour gap (approx) instead of 12. Is that an issue? Will it be an issue to go back to the normal 5:45 feed and 6:15 dose?

I also get nervous that she will become hyperglycemic when I am not home. Any suggestions on how to manage my nerves about that? She does have her own room and I do have a nanny cam to keep an eye on her- but I work over an hour away from home and am afraid I wouldn't get to her in time.

I've had many cats in my lifetime and even though each cat was special, Nugget is truly my most special cat and I am petrified she will get sicker and sicker or that I won't be here to help her when she needs it. Finding this website was a blessing, and already so many of you have welcomed me and reassured me!
 
Here's some general information that I post to new people - not specifically about Lantus but useful:

It would help us if you set up your signature (light grey text under a post). Here's how:

  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and will look at it before offering any dosing advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

.................................................................................................................................................................................................................................


Here's the basic testing routine we recommend:

  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
.................................................................................................................................................................................................................................


Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:

  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
.................................................................................................................................................................................................................................


Here are some tips on how to do urine ketone testing (VERY important of BG is high and kitty isn't eating well!):

  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
.................................................................................................................................................................................................................................

Hope this helps as a start. As you can see we take a very methodical approach to treating our kitties. Nugget is a very pretty girl! :)
 
Kris & Teasel said:
Here's some general information that I post to new people - not specifically about Lantus but useful:

It would help us if you set up your signature (light grey text under a post). Here's how:

  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and will look at it before offering any dosing advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

.................................................................................................................................................................................................................................


Here's the basic testing routine we recommend:

  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
.................................................................................................................................................................................................................................


Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:

  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
.................................................................................................................................................................................................................................


Here are some tips on how to do urine ketone testing (VERY important of BG is high and kitty isn't eating well!):

  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
.................................................................................................................................................................................................................................

Hope this helps as a start. As you can see we take a very methodical approach to treating our kitties. Nugget is a very pretty girl! :)
Click to expand...

Thank you.. I love to take her picture lol, she is one of the most uniquely patterned calicos that I've ever met! It helps that she is mellow and doesn't mind the camera in her face.

I added the information to my signature as you suggested!

I like methodical- it helps me manage my stress about this! We have not started at home testing yet, but I do keep track of the exact time I feed her, what type of food she eats and how much of it, and the exact time of the insulin dose. I have it on a google form so when I need the data I can export to a Google Sheet. I clearly have a lot to learn in terms of terminology, data, number crunching, etc.
 
Kathryn & Nugget said:
Thank you.. I love to take her picture lol, she is one of the most uniquely patterned calicos that I've ever met! It helps that she is mellow and doesn't mind the camera in her face.

I added the information to my signature as you suggested!

I like methodical- it helps me manage my stress about this! We have not started at home testing yet, but I do keep track of the exact time I feed her, what type of food she eats and how much of it, and the exact time of the insulin dose. I have it on a google form so when I need the data I can export to a Google Sheet. I clearly have a lot to learn in terms of terminology, data, number crunching, etc.
Click to expand...
BG testing is the thing most new people find the most daunting but they soon learn it's a lot easier than they think. The peace of mind that comes from it is invaluable. :)
 
Kathryn & Nugget said:
Nugget cat and I are new to the forum. She was diagnosed a few days ago. At our vet visit her sugar was 421, so they started her on 2 units, twice a day of Lantus. The vet recommended we change her diet in an attempt towards remission (someday I hope!).

Nugget was eating Purina One dry food. She had wet food as a treat. Now we have switched entirely to a wet food diet (Castor and Pollux Organix and Castor and Pollux Pristine). The vet said that 6oz of food a day would be sufficient to maintain her weight, which I was told is important because her insulin dosage is based on her weight (9 lbs 13.5 oz)

I am concerned that I am not feeding her enough as she is quite hungry when I feed her at 5:45AM/PM. The calorie counts in the different types of food vary greatly- do I need to take this into consideration? From my research I've seen that a cat her size needs between 200-250 calories per day. I am not sure how many calories she was taking when eating dry food as she was a grazer and I never really measured her food.
Click to expand...
Glad you switched to wet food. I'm not familiar with Caster or Pollux food. what country are you in?

2 units is a high starting dose. The recommended starting dose is 1 unit twice a day. Keep a CLOSE eye on your cat. the high starting insulin dose plus lower carb food may sugnificantly drop the bg level. The last thing you want is a hypo on your hands. Do you have honey or karo syrup on hand just in case?

You can feed throughout the day, just no food 2 hours prior to the preshot test. What many of us do is get a timed feeder for a mid day and mid night meal. or you could add a little water and freeze a portion of food so it is fresh a few hours later when it defrosts. If she's hungry, feed her.

Kathryn & Nugget said:
I also get nervous that she will become hyperglycemic when I am not home. Any suggestions on how to manage my nerves about that? She does have her own room and I do have a nanny cam to keep an eye on her- but I work over an hour away from home and am afraid I wouldn't get to her in time.
Click to expand...
Hypos are serious. This is why home testing is important. I know you said in your intro your vet wasn't super supportive of it, but the truth is it's not up to him. I'm sure if he had a kid who was diabetic he would NEVER give that kid insulin without testing. Same goes for your cat. If you want I can write you up a list of what to buy. It does not hurt the cat at all... honestly my cat enjoys the extra attention. You can see in the video she's purring right through it. Testing takes all of 45 seconds each time out of your day... so once you get the hang of it it is seriously NO BIG DEAL. and it can literally save your cats life. It definitely has saved my cat... just recently in fact. I would have had no idea she was hypoing..... no symptoms at all, yet she was in a dangerous state. I tested, caught it, and was able to get her to an emergency vet right away. had I not tested her that time she may have had serious problems. The best way to calm your nerves is to test. It will put you so much more in control.

Lantus isn't as flexible as some other insulins, but you can adjust it in 15 min increments as needed. That being said, sometimes life just happens. All we can do is the best we can do. Sometimes you miss a dose. sometimes you get a fur shot. sometimes you have teacher conferences. It is what it is.
 
Kathryn & Nugget said:
Thank you.. I love to take her picture lol, she is one of the most uniquely patterned calicos that I've ever met! It helps that she is mellow and doesn't mind the camera in her face.

I added the information to my signature as you suggested!

I like methodical- it helps me manage my stress about this! We have not started at home testing yet, but I do keep track of the exact time I feed her, what type of food she eats and how much of it, and the exact time of the insulin dose. I have it on a google form so when I need the data I can export to a Google Sheet. I clearly have a lot to learn in terms of terminology, data, number crunching, etc.
Click to expand...
great! Google sheets is what we all use for your spreadsheets so we can share our numbers! (you can see the links in our signatures below)
 
JanetNJ said:
Glad you switched to wet food. I'm not familiar with Caster or Pollux food. what country are you in?

2 units is a high starting dose. The recommended starting dose is 1 unit twice a day. Keep a CLOSE eye on your cat. the high starting insulin dose plus lower carb food may sugnificantly drop the bg level. The last thing you want is a hypo on your hands. Do you have honey or karo syrup on hand just in case?

You can feed throughout the day, just no food 2 hours prior to the preshot test. What many of us do is get a timed feeder for a mid day and mid night meal. or you could add a little water and freeze a portion of food so it is fresh a few hours later when it defrosts. If she's hungry, feed her.


Hypos are serious. This is why home testing is important. I know you said in your intro your vet wasn't super supportive of it, but the truth is it's not up to him. I'm sure if he had a kid who was diabetic he would NEVER give that kid insulin without testing. Same goes for your cat. If you want I can write you up a list of what to buy. It does not hurt the cat at all... honestly my cat enjoys the extra attention. You can see in the video she's purring right through it. Testing takes all of 45 seconds each time out of your day... so once you get the hang of it it is seriously NO BIG DEAL. and it can literally save your cats life. It definitely has saved my cat... just recently in fact. I would have had no idea she was hypoing..... no symptoms at all, yet she was in a dangerous state. I tested, caught it, and was able to get her to an emergency vet right away. had I not tested her that time she may have had serious problems. The best way to calm your nerves is to test. It will put you so much more in control.

Lantus isn't as flexible as some other insulins, but you can adjust it in 15 min increments as needed. That being said, sometimes life just happens. All we can do is the best we can do. Sometimes you miss a dose. sometimes you get a fur shot. sometimes you have teacher conferences. It is what it is.
Click to expand...

I am in the US, New York City. My boyfriend's father feeds his Bernese Mountain Dog the Castor and Pollux food, and that dog has exceeded his lifespan by several years, so when I saw they made it for cats, that's what we switched to. I have been buying it in Petco to test out the flavors, and then I will buy from Chewy- much more affordable that way. I will look into a timed feeder.

I have maple syrup on hand, just in case. The vet said to smoosh it on her gums if she starts staggering around or acting "drunk". The first vet that I took her to said that she would only need insulin once a day. The second vet (who I felt more comfortable with because she did a much more thorough exam) is the one who prescribed 2 units twice a day. I thought it seemed like a lot, but they made it seem like her sugar was in the crucial danger zone that night. She was not in ketoacidosis however.

I will have to tell the vet that I need to start home testing, I'm a big girl and I can handle the testing procedure. I watched the videos, and I know I can handle it. My SO can't (yet), but I need the peace of mind. I worry way too much to begin with! If there is a way to ease the anxiety, then I would be stupid not to take advantage of that. You made a good point that the vet wouldn't give their kid insulin without testing- she is my furry kid, so home BG testing is now going to be a must. I would appreciate the list of what I need! That way I can order it right away and have it when I go to the vet to make a point that I am ready to handle all of this.

Good to know that "it is what it is". I want to give her the best care possible, but I suppose I need to learn that sometimes there are things that are out of my control. Thanks for all of your advice... it truly helps relieve some of the stress!
 
For what it's worth, on rare occasions when I couldn't be home at the usual injection time for Teasel (out for dinner, at a wedding, etc.) I just skipped the shot and picked where I left off next shot time. It hasn't been a problem.
 
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