First time curving

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MrPou

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Hi me and my cat are very new to this...we started today.
7am 16.4 he ate 1/4 of dry hills w/d and 1/4 can wet w/d
8am 20.9 - He received 1 unit of Prozinc
9am 21.6
10am 18.5
11am 17.9
12pm 19.6
1pm 19.2
2pm 16.3
3pm 15.1
He looked unwell all day until about now
4pm 11.6
5pm 10.7
6pm 9.1 (gave him a few bites of canned food cause he's been a trooper all day and he was nibbling me)
7pm 9.0 he ate the wet food only (didn't have a full 1/4 can) I didn't give him the dry food because of all the reading I have done on these forums. I cannot believe the vet sold me this food!
8pm 10.3
He is due for 1 unit of Prozinc and I fear this is low to give it to him?

He normally grazes throughout the day but I was told to only feed him 2x a day.
Before today was on urinary SO (Royal Canin) because of urinary blocages he ate dry food his whole life and now I feel guilty :(

If anyone has any tips please reply. He's doing better at this than I am! He's not even fussy about the ear pricks.
 
Welcome! It sounds like you both are doing very well.

He is a little low to shoot. (We generally say shoot below 200 until you have data - 11.1 in European levels.). You can stall - wait 20 minutes without feeding and see if he rises a little higher.). And if he is higher then I'd shoot a little less - maybe .5.

It looks like the wet food may be lowering his levels so I would be careful with dosing. Check out the protocol and Beginner's Guide in blue in my signature.
 
Thank you!!! VERY APPRECIATED! He's only at 11.3 so I will give him his space for the night. Tomorrow is another day. His vet is not even open tomorrow either so I am very thankful I found this site!
 
Hi Mr. Pou's human,

You're both doing brilliantly with the testing! :)

I'm glad to see that Sue has been able to help you on the Prozinc side of things (I've not used that insulin) but I agree with her that you need to be very careful with dosing - and definitely don't try to switch him to a lower carb food until you have a lot more data. That is some drop in BG that you saw today.

You asked on the Welcome thread about water consumption. With the wet food and the better numbers Mr. Pou saw today that would account for his drinking less.

I see from your other thread that you're using a Contour Next meter. If you're using a human meter you do not want to see BG levels going below 2.8mmol/L (50mg/dL). If you're using a pet meter the lower limit is 3.9mmol/L (per the normal BG reference range my vet gave me - 3.9 - 8.3mmol/L for an Alphatrak veterinary meter).

Important safety information can be found at these links:

How to treat hypos (NB: reference numbers are for human meters.)

Hypo toolkit

Before today was on urinary SO (Royal Canin) because of urinary blocages
There have been many cats who have arrived here after being prescribed that particular veterinary diet, my own Saoirse included. :(

I can completely relate to the feelings of guilt that arise when one discovers that dry food is bad for cats. When I sought veterinary advice about diet when I adopted my first two rescues I was told that dry food was the best thing for a cat. I feel both angry and guilty that I fed mine the wrong thing. :( It helps to focus on all the things that you're now doing right! :)

I'm glad you've found FDMB; it's a great place to learn and get support for all things feline diabetes.

:bighug:


Mogs
.
 
@Critter Mom I am a little confused
and definitely don't try to switch him to a lower carb food until you have a lot more data. That is some drop in BG that you saw today.
So I should give him the kibble back? Even if I know its bad?

And I am so glad I found this site, I did lots of reading and couldn't find the answers I needed, you cat moms and dads are amazing!
 
I think it is safe to move to wet food, as long as you test often. Always test before each shot, as the wet food can bring the numbers down. (When we switched our Oliver to wet from dry, he dropped 100 points from one preshot to the next. If we hadn't been testing and had given our normal amount, he would have dropped too low.)

If you skip for this shot, he may be high for the next cycle, but I would reduce the dose a little. My thinking is that he dropped too low to shoot with the one unit, so I would give less than that.
 
You asked about levels on your other post. Note that you'll be using metric numbers; here's a chart that will help you convert.
http://www.diabetes.co.uk/blood-sugar-converter.html

We'd love for you to have a spreadsheet. We have a world version that will convert from mmol/L to mg/dL. The instructions are here :
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you need help, just ask. When you need help, we can get better advice when we know your cat's history of doses and levels. It is also handy for your vet and for you to see patterns.


These ranges are for human meters, which I think you use:

We generally say a cat is regulated when they are in the mid 200s for preshot and in the lower 100s or double digits at nadir (5-7 hours after the shot). But not under 50 which is approaching hypo territory. We suggest new members not shoot under 200 until they have more data. We consider a cat to be in remission if they are between 40-120 without insulin for two weeks.
 
@Bron and Sheba Yes this is the food the Vet sold me. I used to buy Urinary SO from them as well... I gather another change is on the brink of happening. I am about to test him one last time before I go to bed.

Today I only gave him W/D dry in the AM and W/D canned AM and PM

What is the best food I can put him on considering the diabetes and the urinary blockage he's had?

I have added the spreadsheet, can anyone see?
 
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@Bron and Sheba Yes this is the food the Vet sold me. I used to buy Urinary SO from them as well... I gather another change is on the brink of happening. I am about to test him one last time before I go to bed.

Today I only gave him W/D dry in the AM and W/D canned AM and PM

What is the best food I can put him on considering the diabetes and the urinary blockage he's had
I have added the spreadsheet, can anyone see?

No I can't see the SS....did you click share?
R the W/D.....it is very high in carbs and diabetic cats need to get food that is 10% or less carbs.
Many years ago one of my other cats had a urinary blockage and he was put on a special diet too of dry food and Sheba ate it as well for years...I am sure that contributed to her diabetes.
I am not a vet so I wouldn't like to tell you to change but I am sure the most important thing with urinary blockages is to give wet food which has so much more moisture in it. If you do change over to low carb food you will probably find a big difference in the numbers ....they will most likely be lower...so don't change over on your own without help from @Sue and Oliver (GA). Make sure Mr Pou is drinking plenty and you can add warm water to his canned food to get extra fluids into him.
See what others say about the W/D. You could ask on the main health page ..something like....'is it OK to go off W/D and onto low carb for a kitty who has had blockages?"
 
Even healthy cats have almost no requirement for carbs in their diet. Diabetic cats really benefit from having food that is very low in carbs, and in some cases diabetes can be controlled with a change in diet alone!

Here's some excellent information about cat food: http://catinfo.org/#We_Are_Feeding_Cats_Too_Many_Carbohydrates

But when you start feeding your cat a lower carb diet it is really important to keep close track of their blood sugar. If the change in food is enough to lower their blood sugar to normal levels adding insulin can bring it dangerously - even fatally - low.

This doesn't mean that your vet is giving you the wrong kind of food on purpose. They have to learn about all the diseases cats get, and most vets don't get a lot of education on nutrition so they rely on companies like Science Diet to get the food right.

Also your spreadsheet is still set to private. To make it so we can see it here in the forum using your link - click on the "file" settings, then scroll down to "publish to the web" and click on that. In the new box that opens, make sure "link" has the blue underscore, and "entire document" is selected then click "publish"

A better explanation with pictures is right here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/


There's a lot to take in when you first learn you have an extra sweet diabetic cat. But everyone here is really helpful, so never hesitate to ask questions :)


I missed that Mr Pou has had trouble with blockage in the past. I had a cat with bladder stones, but he passed from kidney disease, and never had diabetes. I'm not sure what would be the best low-carb food for a cat with a history of blockages, but I'm sure someone here has experience they can share!
 
My cat ate Royal Canin Urinary S/O wet food for a long time before his diabetes diagnosis. He had frequent bouts of cystitis even on that food. When he was diagnosed almost a year ago I switched him to a mixture of prescription DM low carb wet food and Friskies/Fancy Feast pates. I always add warm water to his meals to make a sort of stew. He's had no problems with cystitis all year.
 
We can see your spreadsheet but you put the metric numbers on the US section. So, go back to the original on your computer (the one in your signature is a read only) and change the tab at the top of the spreadsheet to world and add your numbers. Then when you hit the US version it should convert.

As I said, as long as you monitor carefully and make sure you always get a preshot number, reducing when it is lower than it has been, I think you would be safe switching to wet food. Just be prepared for the numbers to be lower. And as you are already giving a low dose, think about giving half units and under. If you are ever wondering what to give, post and ask. We'll ask our European members @Ruby&Baco and @Fabiënne to watch for you as we will all be asleep.

Some people make the food switch slower if their kitties have sensitive stomachs - doing 60 dry/40 wet and then 50/50 etc. Oliver could eat anything so we just switched.

The catinfo.org site that Kimi gave you had a great section on blocked cats and urinary tract issues and the best foods.
 
Here is a little more background as Switching foods is his new favorite thing to do. It was in fact his way of telling me something was wrong.... I wish I spoke CAT
He was on Urinary SO Diet (royal canin) and kept spitting out pieces of his food and not eating it even when he was VERY hungry. He lost weight but was more active (he was shaved for the first time this summer and it made him move around more and need more cuddles) and I thought it was his way of asking for regular food, so we changed from DIET SO (dry) to Regular non diet SO (dry). He LOVED the new food for a few days and then started doing the same thing so we bought WET SO food (gravy kind) and he did the same. Back when he was younger he was on Wet food and there was a massive recall with really bad cat death associated to it and it scared me away from wet food... But I still gave it a shot since I didn't want to venture to another kind of food..

He kept loosing weight and I rationalized that he was just not eating enough...I called pet food stores and a few Vets an no one suggested he sounded sick, just being an older cat would make him pickier?

He had rashes on his head (near the ear and eye head area) which seems to be an allergy, he scratched on things until he bleeds....he has no nails. Surprisingly (or not) they seem to have subsided since we started feeding him other food. He has had these rashes for years and we've tried pretty much anything except food switch, since my Vet didn't want to change his nutrition for urinary reasons.

He has a few lumps, one hard which the vet says "looks benign" and a few little ones that feel like fat or something squishy. One was much larger when he weighed more so I don't know maybe fat pockets?

He has had a geriatric blood panel and urine test since being diagnosed and the vet said everything looks good. I will ask for his results and post them here.
For the urine test, I am a little skeptical because normally the ask me to come deliver his urine within the hour he has peed. On this occasion I called 15 mins before they closed (7pm) and told me to put it in the fridge and bring it to them the next day, which happened at about 10am. Was this test valid, I'm not entirely convinced. They say the lab said the urine was still "valid".

Today:

As you can see in my SS (that I think is fixed now) his level was in fact higher this morning as predicted by you smart cat lovers. I gave him a lower dose today but unfortunately my syringes are 1 unit intervals so I went above the 1 unit. I can take a picture if that helps, I used a marker so I can remember how much it was in case its an appropriate dose.

He seems better today and loves the attention. I will be testing every two hours unless I see him go too low. He had about half a can of wet W/D this am.
Something I may have done wrong yesterday is inject him too late? Is that possible? My vet said up to an hour after he eats is ok so I did that yesterday, injecting him for the first time took a little longer.
Today I injected as he was eating and it didn't bother him one bit. His appetite was good, he had gone to pee in the night (much smaller than his latest lakes he's left for me) but any urine is yay! Today I have made a little bowl of water with a bit of food at the bottom and he finds it fun.
 
I know @Ruby&Baco feeds a raw food and often raw helps with allergies and finicky stomachs. I don't think she has to make it; it is available in Europe (or at least the Netherlands) in shops. That might be an option.

You definitely can feed and shoot at the same time IF you have already tested and know the dose you are going to give is safe. Often they don't notice the shot.

If you shot an hour late and your pmps was at its normal time (but +11) that could be part of your lower pmps. But it was still alower +11. We expect them to be moving back up by then. The usual ProZinc curve looks like a smile. If you waited the full 12 hours, then he was really low.

It sounds like you are getting this down! Hurray!
 
The way I understood it yesterday (according to the vet's instructions) was we can feed him and since he doesn't eat his full portion in one shot, leave the food out for an hour and shoot after. The AMPS @ 295 was pre-food at 7am, I did another test before injection at 8am and it was 376.2

Thank you for the injection tip I will monitor him closely! I really hope we can get the hang of this soon enough, I am with him today and someone is with him tomorrow. I am in Law School so some days are much longer than others. I will try and spend as much time as I can with my fury study buddy!

How long can humans leave the house in the first while? It's like having new born..... :D

Another question, one of his ears is a much better bleeder, is it bad to always prick the same area?
 
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Hi Jamie,

I think it is possible that the food allergy may be related to the RC Urinary s/o food. After the vet prescribed it for Saoirse she started overgrooming her tummy. I took her back to the vets and they told me it was a behavioural issue due to stress from becoming an indoor-only cat. Like an eejit I believed them.

The belly grooming got worse and eventually Saoirse was diagnosed with both diabetes and pancreatitis. As soon as I switched Saoirse onto low carb, wet food all the hair on her tummy started growing back - immediately! Unfortunately she was left with chronic pancreatitis issues. :( (((Saoirse)))

I recommend you visit Dr. Lisa Pierson DVM's site catinfo.org for really sound information on feline nutrition. I suggest you look at the following pages first, but read the whole site because it's excellent:

- Urinary Tract Diseases

- Feline Diabetes (check out the important information about safe diet transitions!!!)

After changing to wet, low-carb food with a little water added (per Dr. Pierson's advice) there were no further problems with either struvite or oxalate uroliths.

You're doing a great job taking care of Mr. Pou; even got a shiny new spreadsheet going, too!!! :)


Mogs
.
 
With insulins that have a faster, harsher onset, it is better to feed first and then shoot so their tummy has food in it. But ProZinc has a slower onset (almost always) so as long as he eats something and doesn't throw up, it is okay to shoot. Then leave down the rest so he can eat it as he wants. It is better to stay with the 12/12 schedule as closely as you can. It makes dosing decisions easier and more predictable.

We think it is important in the beginning to always check levels before the shot, about +2/3 if possible (if you are going to have a lower cycle, it may show up then) and in the 5-7 hour to find the lowest point. That's ideal. But we know people have lives, so always before the shot and in the +5-7 when possible. If you can't get numbers during the day, try to get some before bed. If you have little data and worry he might go low while you are gone, leave out some food. (Automatic feeders are great for this) Cats usually will eat if they feel themselves going low.

It should be fine to poke the ear that works best. Hold it for a few seconds after the poke to minimize bruising. If you want, put on some neosporin with pain relief.
 
Mr Pou's numbers are looking really good, Jamie! Also the more you poke an ear the more tiny blood vessels grow in and the easier it is to get blood. Heating the ear a little bit before you poke it works really well too, I use an empty pill bottle with some warm water in it - it fits the curve of Hermione's ears perfectly :)
 
Thank you all!! Your advice is incredible <3

I use a sock with rice in the microwave. He likes it and cuddles with it after we're done cause its warm.

He's only having wet W/D for today and I will talk to the vet tomorrow to consider other wet foods with lower carb content. Also I will ask for the results of his blood and urine to add it to his SS. I could get a feeder but I'm sure he would eat even if he doesn't feel low, he is used to eating all day and this AM PM routine is not his favorite. His appetite was better this morning compared to yesterday.

And he's curving back up now, which I think is right on schedule? Today is soooo much better than yesterday. He's following me around and being himself again! I saw him dream and that was really adorable.

So to recap:
Yesterday he had 1 unit but I waited too long to administer it. He was unable to receive his PM dose because he was too low.
Today he received less than a unit at the time of feeding (like in the middle of it...he is a slow eater).
I will keep testing every 2 hours until bed time.

What are your ideas on what should be done tomorrow?
My mom will be here to take his numbers all day and we got syrup in case of a hypo event.

Thanks again all!
 
The lower dose gave you a blue nadir. It might be a higher pink needs a little more but hard to be sure because you are switching to wet and that can bring down his levels along with the insulin. I think it is better to be cautious while switching food - especially if you are able to find lower carb wet (we like to stay at or under 8-10% carbs). I think I'd stay with .75 till you get a few cycles of data and are on a lower carb completely. You can always raise the dose as your numbers indicate, but shooting too much can be a real headache with dangerously low numbers as a result.

It's great your Mom can help!

Some cats do well with a sliding scale - so maybe one unit on a higher pink preshot and .75 on a yellow. Some like to have the consistency of the same dose each time. Not enough data yet to know.

If he'd dip in the 60s, sliding toward the 50s, try his regular food first and retest in 20 minutes. Sometimes food is enough to bring up the levels. If he continues to drop, try some gravy off a higher carb food (just a few teaspoons) and retest. Save the syrup if he is dropping below 50 and food doesn't bring him up.
 
Hi again,

We're not used to feeding with 12 hour intervals.... he will definitely lose more weight and we don't want that. I feel like he's not getting enough food. He doesn't eat large portions naturally because he is so used to eating whenever he wants. Before, I would feed him 1/4 cup dry food upon waking, again at 5-6pm and once before bed and he ALWAYS left food in his bowl. He really wants to eat. How does one not feed a hungry cat? He started being hungry at about 1pm today and has begged for food during human food times (of course we gave him nothing).

Can I incorporate a low carb snack during the day? If we do insulin at 7am and 7pm, what time can he have it and what do you suggest?

Thanks!
 
Lots of people do not feed just two times a day. It is up to you - some people feed at preshots and nadir, some let their cats graze. When they are unregulated, their bodies do not process their food efficiently and they are continually hungry. As long as he is not overweight, I'd consider increasing the amount fed (so he can graze after the feeding) or feeding more often. Once he is in regulated numbers and feeling better, he should need less food.
 
Hi again,

We're not used to feeding with 12 hour intervals.... he will definitely lose more weight and we don't want that. I feel like he's not getting enough food. He doesn't eat large portions naturally because he is so used to eating whenever he wants. Before, I would feed him 1/4 cup dry food upon waking, again at 5-6pm and once before bed and he ALWAYS left food in his bowl. He really wants to eat. How does one not feed a hungry cat? He started being hungry at about 1pm today and has begged for food during human food times (of course we gave him nothing).

Can I incorporate a low carb snack during the day? If we do insulin at 7am and 7pm, what time can he have it and what do you suggest?

Thanks!
You can start a new routine of small meals fed more often through the day. This works better for many cats. I know you're going to transition to low carb wet food so maybe you can buy some and use small amounts of it as treats for when he's hungry and then slowly introduce more of it into his diet over time. The important thing is to not give any food for 2 hours before you test BG in the AM and PM. You want to know what it is without no influence from food.
 
OK Thank you! I gave him the same since I have school tomorrow AM, I won't be up too late.. I will test him +1 and +3 tonight.
He had a great meal! I gave him a full can and saved what he didn't eat. At first I gave it to him room temp, he ate about half. Then I mixed a bit of cold water with a little bit to trick him in drinking, he did! And with the rest I stuck an ice cube in it and he almost finished it. I am saving the rest in the freezer and will leave it for his nadir tomorrow. He loves cold food, that's how we kept his treats.
 
It's ncie that he likes cold food! My cats all prefer their food room temp or warm. I add water to every single meal in an attempt to make sure they get plenty of water in their diets. I mix in enough that their food is kind of gravy like which they seem to like...they won't eat it now without the water!
 
Best PSAM so far 261! His BG went down to 133 yesterday too :D My mom was with him while I was away and got scared so she gave him 2 treats and food.
We bought an automatic feeder yesterday since he will be on his own for nadir today. I am pretty sure he recognizes the sound already, I am around this morning so I will time it and make sure he knows the drill. I am happy he is feeling better and hopeful for the future!
 
Very nice. It looks like he should be in good levels if we look at yesterday (not always a one on one relationship, but sometimes a reasonable guide.) He is running 20-30 points lower than yesterday so if his nadir is in that range, he should be fine. But glad you are leaving out food - best to be safe.
 
WOW! lowest reading so far!!! 121 at +4, should I have any concerns @Sue and Oliver (GA)? At +2 he snacked on water diluted wet food (w/d wet). I will be away from +6 to +10.... He has feeder going at +6, +8 and closing at +10. I am happy this is working!
 
I think he should be okay. It is hard to predict with a brand new diabetic. Is there anyone who come just come by and see that he is sure acting fine around +6? An abundance of caution- the food should keep him numbers in higher ranges.
 
Hi and welcome. Sorry I wasn't around during the weekend! Thanks Sue for the tags!

If you need me i'm here (european time) to help you with your dose!

About the raw food, i do feed my Baco raw food prepacked and it's great! It has all the vitamines and other supplies in it that a kitty needs. Where do you live? I can have a look for you if they have it in your country!

:bighug:
 
Oh and I must say, the raw food does help with allergies and stuff like that. Baco was also a little itchy for a while and her fur wasn't great but now she looks beautiful because of being on that raw food diet.
Also it helps with being hungry all the time. We have a kitty on the Dutch board who was also hungry all the time and after switching from normal food to raw food he wasn't hungry anymore like he used to be! It is very satisfying for cats and makes them full for a longer period of time!
 
@Ruby&Baco I'm in Gatineau Quebec in Canada also on the border of the province of Ontario.
His AMPS is 101???? Obviously not injecting him this am, I will be away from +5 to +10. His appetite is super good!
 
@Kris & Teasel That's AWESOME :)
No shot is good? I'm confused cause he had a low and really high number yesterday. It's so yo-yo....
So I presume since we skipped this dose, I would only shoot at his next scheduled time right, and not in between cause then his routine is all messed up?
 
@Kris & Teasel That's AWESOME :)
No shot is good? I'm confused cause he had a low and really high number yesterday. It's so yo-yo....
So I presume since we skipped this dose, I would only shoot at his next scheduled time right, and not in between cause then his routine is all messed up?
I mean that he's responding to the insulin in this dose range. It's still very early days for you and MrPou and it takes some time to get settled on insulin. Right now it looks like 1.0 u is a bit high for MrPou. I suggest giving him 0.75 u for several cycles in a row. It might settle him down. We don't know yet whether he's a kitty that likes dose consistency or whether he can handle sliding scale dosing (changing dose based on pre shot number). If you find he needs smaller fractions of insulin than what's possible eyeballing your U40 syringes, it's possible to use U100 syringes and a conversion chart. Ask for help if you want to try this later.


Yes- wait until the next shot time to give insulin. The every 12 hours schedule is important right now. Slight deviations from that are possible once you have a lot of data.

Is he still getting dry kibble and high carb wet food? Changing food and insulin dose at the same time can be very tricky. I see that there's been lots of discussion above about food, feeding schedule, etc. I highly recommend adding warm water to all of MrPou's wet food meals if he's prone to blockages. I mentioned earlier that Teasel was on canned Urinary S/O for a long time but I stopped it at diagnosis and switched to prescription DM mixed with Friskies/Fancy Feast pates, always with warm water added. He hasn't had a cystitis problem since.
 
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@Ruby&Baco My Fault! I saw the metric and the later and earlier posts, the French and assumed France. Still, good to see you!

I am with Kris with a dose reduction. This is good news!. Looks like he is responding well to the insulin and the switch off dry.

Today, because you skipped, you could shoot earlier than usual. You just want to be sure he is rising and I would say, above 200. And if you shoot early be sure it doesn't mess up your schedule going forward. So, say you shoot today 8 hours after the amps. Then you want to know you could shoot 12 hours from then and be happy with the schedule going forward. Make sense?

Or you can just shoot a little early, like 11 hours after the amps. And in the am, shoot 30 minutes early to get you back on schedule. (Assuming high enough and rising)
 
Perfect thank you! I will test him before I leave for school and when I come back, it will tell me what I've got to do. Thanks again for all your support, I don't know what I would do without it! He is only on wet and I always add water, feeding is a process, first he eats the paté and whatever is left I add water to it and mix and he enjoys drinking the last drops out of it. His urine is consistent, though much smaller which is usual I presume, since he's not drinking 3-4 cups of water anymore.
 
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