First time user, please dont judge, need help with dosing

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Manu & Porto

Manu & Porto

Member Since 2018
Hello! I have to say I admire the dedication in all of you here, helping others, helping eachother for the benefit of our cats. Im not sure if any of you can help or advice in my situation, I need some help understanding what is happening to my cat who has been diagnosed with diabetes on 21.04.18. By then, her BG was 550, the diabetes was a result of prednisonol for his IBD. We weaned off pred and we started Lantus insulin, 1,5 ud every twelve hours and the vet also gave us dry food, Purina MD for diabetes. I remember asking for an option that wouldnt be dry, as lately, since on the pred, he was able to eat wet food and meat without causing loose tools but she said no, because thats how they know how to control, if he eats this food. So I went along with it. Started reading, and seeing that feeding a wet diet or raw would help the BG levels and mentioned it to my vet but she said no, now we are with the insulin, we gotta stick to this kind of control. I mention it because I am quite aware of the importance of an wet low carb diet and I thought I will switch to it at some point when I know what diabetes is all about but that point didnt arrive as his stools started being liquid again once I tried giving him wet food. So here we are, two months later, a few days ago we were on 3 ud dose every 12 hours and his levels were these (this is a curve we did three days ago, every 2 hours.) 438 - before pm insulin
second take. 355
third. 370
forth. 413
fifth. 398
sixth. 381
seventh. 368 - before am insulin.
she has been increasing little in the beginning, two units, then after another curve after 15 days, went to 3 ud. after the last curve, mentioned before, she uped to 4 units and he has been receiving this for the last three days. also, in the last few days, he didnt eat his whole dry food, as he is starting to dislike it I think, or I dont know why, but I started giving him a bit of boiled quial chest meat, tried doing a fair conversion to colesterol as to keep him within the same calories while fully realised he wont receive the same amount of carb. i was threading carefully, even tho the last few days, his levels have been high, around 400 and with all the precautions, the damnest thing, this morning my alarm didnt go off and instead of giving him the dose at 7 am I gave it at 8:30 when I woke up by chance. I had to run to work and when I got back, it was close to his next dose. I didnt know if I should keep the new time as to be safe, so I said that if it comes high, I will decrease the time by half hour at least. so i measured blood and at 7:30 pm and it was 270, and then at 8 pm it was 255, then at 8:30 242. and then at 21:40, i decided doing 1,5 only, being afraid of hypo (i have a hard, job, sometimes i work 12 hours at a time, it is stressful and tiring and it is not an excuse, but please dont judge, even tho i read and read I still dont know how to do this... ). at 24:20 it was still 245 but now, at 2:30 am it came up as 380. so he appears he is going high again and it makes sense. i panicked for nothing. it was the first time i saw th e measurement drop like that, before dosing, - 150.my question is, what do i do now? the next shot is at 9:30 am and the vet is still closed at that time. my vet finally responded last night with giving 3 ud but it was too late,by the time i read the email i have decided on giving 1,5 and was already off to work. i know i made mistakes but now please, i need to know the next shot for my baby as I dont want for him to suffer of my mistakes... should I give him 4 ud again if it turns out high? im sure it will as it is already high... thank you and sorry for any problems! english is not my first language so i hope i am understood.
 
My first thoughts.
  • You need to treat the IBD first. Did the vet move to budesonide? Is she doing anything to further treat the IBD.
  • If you have to...use the prednisolone. We dose around that.
  • For food...good food is food kitty will eat. Then what works for the IBD. Go back to your wet food.
  • That dry food is high in carb.
  • Dry food is not good for a cat already dehydrating for diarrhea.
  • Those are some big jumps in insulin dose. We recommend increases at .25 units.
  • If you are willing to home test which it sounds like you are...then I would set up a spreadsheet that we use here and start recording. It helps focus on a trend vs. a specific number. Then you can post for some dosing advice.
  • There are other people here that work and have long times away...we only do what we can. We will try to help with suggestions.
If it was my cat....set up the spreadsheet. Start feeding the low carb wet food. Test over the next few days. Post back with any questions.
 
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Welcome and please don’t be so hard on yourself. You are just trying to do what is best for your kitty with the circumstances you have been given. We have all been there. I see you have just been given some great advice! Please get a spreadsheet set up and keep asking questions. That how we all learned.:bighug:
 
Hi and welcome!
For now I would just add to Tracy's comments that it is important to dose Lantus consistently. Settle on a dose that seems reasonable (for example, 1.5 Unit) and stick with it for at least a week. During this time the "depot" will get established. (You can read about the "depot" in the Informational notes ("Stickies") at the top of this forum.) Try to avoid jumping around in dose, no matter what your vet says. Consistency is the key. Going up and down in dose by full units can cause problems. One of the reasons we raise and lower dose by 0.25 Unit is so that we don't bypass a good dose.

To answer your question about what dose to give tomorrow, I think I would stick with the 1.5 Unit that you just gave. To get back on your original 12-hour schedule, you can move the shot time by 30 minutes a day (either 15 minutes twice a day, or 30 minutes once a day) until you get back to your preferred shot time.

So, going forward: set up your spreadsheet (follow the instructions in the Tech Forum for setting up a Google spreadsheet and linking it to your signature). If you need help with this, just ask.

Again, welcome to you and your kitty. (Is Okarmae your kitty's name?) Everything must seem totally confusing to you right now, but remember that we have all been in your situation.
 
Just to welcome you and know this is a judge free zone. There are no judgements here just suggestions. We all love our kitties just like I can tell you love yours. You do what you can with what you have. Knowledge is key. There is alot here. As the others have stated lantus is a depot insulin and consistency is truly key in getting your kitty under control.
Diabetes is a marathon not a sprint so find yourself some patience pants and put them on. :) take some deep breaths. When I first came here I was in a similar situation where my vet was the one making all the decisions about how I was going to treat my kitty. Granted she knew some good things and I love my vet. But there was also some things she was not versed as these people here. Feeding dry food to a cat is not good for them, any dry food is not good for them. Wet food is the way to go and what your vet don't agree with you on, you don't have to tell her. You, know what's best for your furbaby.
Welcome to the best place you never wanted to be, but now that you are here, get settled in.
Setting up the spreadsheet gives everyone a chance to be looking at trends in the reaction to the insulin. Big hugs, you and your furbaby are in great hands here. It being the holiday weekend not as many eyes are here, but we will do what we can to help you.
Read the stickies in the Lantus thread, it will help give you that knowledge. At the end of my signature is a link to where can I find___. Remember breathing.
 
Hi and welcome!

As previously mentioned, we try not to judge here. We all have unique issues that affect what we are able to do regarding testing and shooting, etc. Some of us work very demanding jobs, some are disabled, some have small children, some have multiple pets with health issues, and some have combinations of these or other things! We just do the best we can. If someone suggests you do something that is not possible in your situation, just let them know. I think your English is very good.

You've been given some good information so far. It's wonderful that you are testing at home. If you can set up the spreadsheet that we use, we will be able to help you more, and I think you will find it helps you, too. Here is the link to the instructions: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/. If you are using a pet meter, be sure you use the instructions for that.

It would also be helpful to us if you can give us a little more information about your cat. First, what is his name? How old is he? How much does he weigh? Does he have any other health issues besides IBD? Is he on any medications regularly? What meter are you using? Where do you live? It helps us to know what time zone you are in, so you can just say the country, or if you're in the States, what state, etc. If you look at the bottom of other people's posts, you'll see they have a lot of info about them and their cat there. That's called a signature block. It keeps people from asking you the same questions over and over! To set that up, put your cursor over your user name at the top right of your post and click on Signature.

We have a lot of cats here that are on Pred. If he needs it to feel well, he needs it. You just adjust the insulin dose to accommodate it. My Harvey was on it for almost a year. He also became diabetic because of it. We just reduced his dose to the lowest we could while still keeping him comfortable.

It sounds like your vet does not know a lot about Feline Diabetes. That is very common. They only get about 5 hours of training on diabetes in vet school, and that covers both cats and dogs!

What wet food are you feeding your kitty that causes loose stools? There are a variety of wet foods out there that are fine for diabetics. You don't have to buy the prescription foods. In fact, many non-prescription foods are better! With the IBD, a lot of times trying a novel protein - something kitty hasn't had before - makes a big difference. Depending on where you live, we can help you find some options.

Keep reading all you can - the stickies at the top of the Forum page have an overwhelming amount of information. Ask lots of questions. We were all new and scared once, so we understand. We love to help!

That's enough for now. We're glad you found us and we look forward to helping you and your sweet kitty!
 
Thank you all!

I have been reading about diabetes and IBD since I got the diagnose for both. I am trying my best to cover this the best way I can, also, considering he doesnt react well to wet food. I write from Europe and I bought Catz finefood purr, I have little access to other brands that are mentioned around for those in Canada and USA, but Catz finefood is monoproteic, low carb and has various kinds of protein, so to try and find some common ground for diabetes and IBD but he gets loose stools from it. He gets loose stools from any kind of wet food. I sometimes try meat and it takes some days until he gets diarrhoea but eventually it appears. He seems to be doing fine on the dry, so far, I know it is a killer but it will take time to change his diet and I am trying as we speak... It seems do bother his levels a bit, tho but Im not sure that is the cause of it. I set up a spread sheet, I found it here, it seemed easier for me to set and understand... In case some of you can have a look, yesterday at the same time his BG was almost 400 and now is the lowest hes had and all of a sudden. What is going on?He also has a stone in his bladder that gave him a crisis, two days ago, it is not usual but it happened and went quickly and now he seems fine. I dont know to what extent this can affect, also I started giving him SEB... so maybe one of these things may have an influence on his BG? I dont understand how it fluctuates so much... Last night I didnt test between the shots because he was so uncomfortable and he fights me everytime that I said ok, his BG seems high, I will check in the morning. In the morning before the shot was 330 and now, pm, 127!
I will try to attach the spread sheet to google docs, Im not sure how but will try. I see it accepts it here so I hope it works.

Thank you so much for your help and understanding!
 

Attachments

I didnt give him his shot now, with these levels, I kow I shouldnt. But then, tomorrow morning what should I do? His BG escaltes without his dose, eventually, the day after.
 
When you get a low PS number, try to stall...20 mins - no food and test again. See if his BG's are rising are not. Post here with a title of - PMPS Low, shoot or no shoot?. Some one will hopefully respond and stay with you if it is decided to shoot that lower number. A low number is good and with Lantus you shoot low to stay low.



Make sure to have some extra carb type treats available that he can eat and not upset his IBD. Some honey or syrup to rub on his gums are put into his food. Lots of test trips and some chocolate for yourself when it is over.
 
Regarding your spreadsheet, I think you downloaded it and opened it on your computer with Excel.

did you find the spreadsheet instructions? http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you didn't download the spreadsheet into Excel and still have it in Google Sheets, then to share it on the forum you use the blue share button at the upper right and choose the "share with a link" option.

The ups and downs you are seeing are probably what we refer to as "bouncing". When a cat hits low numbers his liver can panic and dump glucose in the bloodstream, hence sending the BG up.

Your English is very good! Where in Europe are you?
 
There's nothing in your profile about where and when you are. It would be helpful to know what time zone you're in. Profiles don't have to be overly personal or even about you. They are one way we can read up on you're situation without you being logged on. Click on anyone's avatar, then Information and you'll see what I mean.
We have a few members in the UK, France and Switzerland so they may have some EU suggestions on food.
This site is all volunteer so remember if you're ever in a crisis in the morning the majority of us are asleep, there is no "board".
 
Thank you! I am still learning to use the forum, today is my third visit but finally with help from all of you, I got to do a Spreadsheet. Can someone confirm they are seeing what I am seeing when clicking the link? The spreadsheet loads for me, updated, but Im not sure if for everybody. Tonight I took the night off (I also work nights) to watch him but I cant always do that.. I live in Spain, Europe. Right now it is 23:49. I Will get around to completing info in my profile, its not a privacy issue, just lack of time to do it. Thank you!
 
You're off to a good start. Keep in mind this is the Lantus forum so me and many others seldom come here, I use Vetsulin/Caninsulin. Whenever you have a general question feel free to post it in the main forum Feline Health.
adiós por ahora :)
 
okarmae said:
Can someone confirm they are seeing what I am seeing when clicking the link?
Click to expand...

Good job!!

I really have to wonder if you went up in dose too much, too quickly. We only suggest increases in .25 unit increments, never by a whole unit.

Too much insulin can look like too much. It might be a good idea to drop back down a little and hold it for a few days while testing so we can really see how he's doing
 
Hello yes I'm in Spain, near Granada. On vacation right now in uk, my father in law's 80th birthday.
I'll post up some info for you about food choices that might help you in the next couple of days.


Hola cómo ya comentaron las compis vivo en España, cerca de Granada. Estoy de vacaciones en reino Unido, me suegro cumple 80. Cuando vuelva a casa en un par de días te mandare alguna información sobre posibles opciones de comida que quizás te ayuden.
Un beso :kiss:
 
Here are a couple posts you might find helpful. This one has some great tips on how to make testing easier on you and your kitty: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

This one is something we put together to help new members get comfortable using the forum: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/

Remember, don't be afraid to ask questions. We were all new and scared once, too, so we understand how it feels. We love to help!
 
Welcome to the group!

With an IBD cat, have you been giving Porto novel proteins? IBD is essentially an "allergy" to certain foods that causes the intestines to be inflamed. As a result, food isn't absorbed properly and you see problems like diarrhea and vomiting. Whatever you were feeding your kitty when the IBD was diagnosed, should be changed. My cat also has IBD. He was previously eating canned chicken or turkey. He now gets raw lamb or pork. There are also good canned foods (e.g., ZiwiPeak) that are novel proteins like venison, or rabbit and lamb.

There is a very good source of information about IBD on the web and on Facebook - Raw Feeding for IBD Cats. Even if you choose to not switch to a raw diet, their information on IBD and especially regarding supplements, is very good. I would encourage you to look for sources in Europe for probiotics. In particular, since Porto is having problems with diarrhea, look for S. boulardi. It is very good at helping with diarrhea. Also, switching foods can cause diarrhea. It will be best to stick with a food that your cat likes for a few weeks so he can adjust to a change.

Your vet is also wrong about giving dry food. In fact, the MD that you've been giving your cat is very high in carbohydrates which will cause high glucose levels. The only issue with switching over to a canned food diet is that you need to do so carefully and monitor your cat's blood glucose (BG) levels. Since you would be switching from a high carb to a low carb diet, BG number can drop.

How long was Porto off of prednisolone before the diarrhea started again? You need to try to sort out if the diarrhea is a result of the IBD, a change in food, or some other reason. If the cause is the IBD, then your kitty may need to be on the prednisolone in order to keep his gut healthy. You can manage diabetes if a cat is on steroids.
 
Gill & George said:
Hello yes I'm in Spain, near Granada. On vacation right now in uk, my father in law's 80th birthday.
I'll post up some info for you about food choices that might help you in the next couple of days.


Hola cómo ya comentaron las compis vivo en España, cerca de Granada. Estoy de vacaciones en reino Unido, me suegro cumple 80. Cuando vuelva a casa en un par de días te mandare alguna información sobre posibles opciones de comida que quizás te ayuden.
Un beso :kiss:
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Hola! Muchas gracias, encantada de conocerte. Nosotros vivimos en Madrid! Thank you for your reply, I am still trying to figure out everything, little by little... Enjoy your holidays!!
 
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Sienne and Gabby (GA) said:
Welcome to the group!

With an IBD cat, have you been giving Porto novel proteins? IBD is essentially an "allergy" to certain foods that causes the intestines to be inflamed. As a result, food isn't absorbed properly and you see problems like diarrhea and vomiting. Whatever you were feeding your kitty when the IBD was diagnosed, should be changed. My cat also has IBD. He was previously eating canned chicken or turkey. He now gets raw lamb or pork. There are also good canned foods (e.g., ZiwiPeak) that are novel proteins like venison, or rabbit and lamb.

There is a very good source of information about IBD on the web and on Facebook - Raw Feeding for IBD Cats. Even if you choose to not switch to a raw diet, their information on IBD and especially regarding supplements, is very good. I would encourage you to look for sources in Europe for probiotics. In particular, since Porto is having problems with diarrhea, look for S. boulardi. It is very good at helping with diarrhea. Also, switching foods can cause diarrhea. It will be best to stick with a food that your cat likes for a few weeks so he can adjust to a change.

Your vet is also wrong about giving dry food. In fact, the MD that you've been giving your cat is very high in carbohydrates which will cause high glucose levels. The only issue with switching over to a canned food diet is that you need to do so carefully and monitor your cat's blood glucose (BG) levels. Since you would be switching from a high carb to a low carb diet, BG number can drop.

How long was Porto off of prednisolone before the diarrhea started again? You need to try to sort out if the diarrhea is a result of the IBD, a change in food, or some other reason. If the cause is the IBD, then your kitty may need to be on the prednisolone in order to keep his gut healthy. You can manage diabetes if a cat is on steroids.
Click to expand...
Hello! Thank you so much for your information. I have been on the IBD sites and searches for a couple of months now so I know a bit of everything but far from understanding very well. I have no access to raw commercial food, there is none in the shops here.
He was on the pred for one month and it went well but since the diabetes, I dread putting him on that again... Since before the pred I didnt try a lot of proteins, because of lack of knowledge, I am ready to try now but I have to thread lightly since these tests upset his diabetes and I kind of lose control. I dont switch foods all of a sudden, I am giving him SEB right now and trying to find capsules for Boulardii but so far, little luck. Also, for now, I can not do the tight regulation because I work and can not keep an eye on him as much as I would like for him to be safe and for me to be alright at work. I need the job so I have to compromise. Today I had to go to work and my mind was at home all the time, knowing he is alone. I can not leave the food out for him because he will eat it all (he has a lot of appetite, esp since the high blood glucose) and that will cause diarrhoea which could be even worse for his BG as Ive noticed it drops quickly when it happens. I have a feeder and that is how I ration the food, I give 8 meals a day, 4 between each dose. So in the event of him going hypo and me not being home, he would have to wait until his feeding time, which worries me but I dont have a better idea... I would first like to regulate him but with the IBD, is a bit of a problem, for ex today he had diarrhoea (is suspect turkey doesnt sit well with him so I will have to not give that anymore) and his BG dropped so much that I had to lower the dose by half, and now, 1 hour before the shot, it is back to around 400. He was doing alright on this dry food, I know it is poison, but raw would not sit well with him and wet food, complicated. He reacted well to quail, I prepared it boiled, but really, since Ive started giving him some aside and taking some dry off, his BG has started to fluctuate. Dont know if it is because of that or because of his new dose, it coincided in the same weekend. So now, I will have to go back to just dry and see if, at least, his BG keeps steady between the shots or so it was for the last first two months.
Chris and China mentioned that I may have upped the dose too quickly but there are 14 days s or so minimum between the dose changes (I am mentioning it just because the spread sheet is missing a lot of info in the beginning so maybe that is one details that can be missed.). The vet asked for curves before uping the dose. Yesterday I lowered the dose,from 4 ud to 3,75, but still there is a lot of fluctuation. The loose stool probably... Im not sure how much time I should wait to see how 3.75 work, if maybe I should go lower, to 3.5 and when?

I do have some questions, about dosing. From one day to another I was forced to lower to dose to 2 ud from 4 ud, this morning, because his pre shot BG was low. Mid week it happened also and I worry because Ive read that the doses should not be changed like that, too many changes between the units... The vet gave me some data on how I should proceed with the shots, depending on his bg levels before shooting ( lower than 180, no shot, between 180-260 2 ud, higher than 260, 4 ud - i am giving 3.75 and will comment on tuesday) So it leaves me no other choice, than to do it like this, it is either a lower dose or none... Ive noticed his Bg raises after those 2ud, so much that by the next shot, I would have to dose 3.75 again. Jumping like that from 2 ud to 3.75ud, is it alright? Preferable to give 2 ud if I can instead of no dose when low bg?
Secondly, I would like to know, maybe someone can tell me, how does no carb food affect his diet and his BG. Can I give him steamed quail breast for ex, that Ive noticed he handles well, without being worried that it will affect his BG levels in those 12 hours? How can it affect giving him protein only, as treat or anytime he is too hungry? I should look after his weight, because if that grows, it will also affect the way the insulin works on his body?
How long does it take for dry food to be processed... ?

I have a lot of questions, even tho I dont stop reading... My head is a mess. Im not even sure how I should reply to each of you, maybe I should create a different post for each reply? I have the spread sheet updated and am trying to make sense of it. On tuesday we go to the vet to check some levels, for liver, kidneys... The vet said there is no need for checking for EPI or vit B12 even tho I asked for it (for his IBD). They did suggest that if the diarrhoea can not be controlled, we should go back to pred. I would like to try boulardii first, since Ive read good things and also, Sienne and Gaby recommended it.
I appreciate all your help! Thank you so much!
 
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Keep reading and keep asking questions!

I would see if you can find probiotics like S. boulardi on Amazon. If there are health food stores anywhere near you, they may be a resource. You may need to order though other European sites, though.

As far as food, quail may be fine. The problem, though, is it is not nutritionally complete. Cats need a number of supplements to their diet -- taurine, for example, is very important. The raw diet I use involves my buying ground pork or lamb at the grocery store. There are "pre-mixes" that are available in the US. (I use EZ complete from FoodFurrLife. Alnutrin is good. I just don't know if any of these suppliers ship outside of the US or if there is something similar available in Europe.) A better option may be to make your own cat food. It's a bit more complicated but it will work. The hard part is finding the supplements. There is an excellent website written by a vet, Lisa Pierson, DVM, who provides detailed information on using a raw or home cooked diet along with all of the supplements you will need and a recipe for a homemade diet. This is a link to her website on feline nutrition, specifically the section on making cat food. Many cats do well on a 0-carb diet. Others need a bit of carb. It's really an individual thing.. The bottom line, though, is that it's not healthy for your cat to be on a diet of only meat without supplements.

Having a diabetic cat on a steroid is not ideal. However, if any medication is necessary for your cat's health, you can work the insulin dose around the other medication. It may mean that your cat's chance of remission is reduced but it does not mean that you can't get your cat well regulated. If your cat has recurrent diarrhea, is losing weight, etc., and all of this stopped with steroid treatment, and the symptoms returned when you discontinued the steroids, Porto may need to be on a hopefully small dose of prednisolone to keep him healthy. Do not get overly focused on his insulin dose if this ends up being the case.

The information your vet gave you about altering the dose depending on the pre-shot numbers does not apply to Lantus. It is the way shorter acting insulin (e.g., Caninsulin) is dosed. With Lantus, your dose is based on the nadir (lowest number in the cycle) and not on the pre-shot number. There may be times you adjust the dose at shot time for safety reasons but overall, you hold the dose until a dose reduction is indicated by a drop in numbers or you increase based on numbers not being in the range you desire. One option is to lower Porto's dose to a level you are comfortable with. We can always increase his dose a bit more quickly if his numbers are high. This will give you more information and greater confidence with shooting.

When you do drop the dose out of concern for Porto's safety, the next pre-shot number may be high. Another factor to consider is that when you change the dose frequently (lower it for safety reasons, next shot time numbers are high so you increase), the depot doesn't have time to catch up with the changes in dose. The depot may then contribute to less than wonderful numbers.

As for the times when you're feeding Porto, several small meals a day is good. It will help if you have a good idea when his nadir falls. Generally, feeding your cat the majority of his food prior to nadir means that food is offsetting the effect of insulin and helping to prop up the numbers. It may take a little while to get the data you need to figure out where Porto's nadir falls. Also, you do not want to feed 2 hours prior to shot time.

Do not create a separate post to reply to each person. You want to open one thread (we call a thread a "condo") per day. This is a busy forum. If you created a reply every time someone posted, you would have who knows how many threads running at the same time. Instead, we link the previous day's condo to the current condo so everything is in one place and you can find the information about about your cat

.
 
Another alternative for making your own if you want to try raw is TC Feline. They are in Germany and will ship. We had a French member use their product.

My girl Neko also had IBD or lymphoma, we couldn't do the test due to her heart. Anyway, her heart also meant she couldn't do prednisolone so she was on budesonide instead. It's a steroid that is more specific to the gastro intestinal system. And did not impact her blood sugars.
 
Sienne and Gabby (GA) said:
Keep reading and keep asking questions!

I would see if you can find probiotics like S. boulardi on Amazon. If there are health food stores anywhere near you, they may be a resource. You may need to order though other European sites, though.

As far as food, quail may be fine. The problem, though, is it is not nutritionally complete. Cats need a number of supplements to their diet -- taurine, for example, is very important. The raw diet I use involves my buying ground pork or lamb at the grocery store. There are "pre-mixes" that are available in the US. (I use EZ complete from FoodFurrLife. Alnutrin is good. I just don't know if any of these suppliers ship outside of the US or if there is something similar available in Europe.) A better option may be to make your own cat food. It's a bit more complicated but it will work. The hard part is finding the supplements. There is an excellent website written by a vet, Lisa Pierson, DVM, who provides detailed information on using a raw or home cooked diet along with all of the supplements you will need and a recipe for a homemade diet. This is a link to her website on feline nutrition, specifically the section on making cat food. Many cats do well on a 0-carb diet. Others need a bit of carb. It's really an individual thing.. The bottom line, though, is that it's not healthy for your cat to be on a diet of only meat without supplements.

Having a diabetic cat on a steroid is not ideal. However, if any medication is necessary for your cat's health, you can work the insulin dose around the other medication. It may mean that your cat's chance of remission is reduced but it does not mean that you can't get your cat well regulated. If your cat has recurrent diarrhea, is losing weight, etc., and all of this stopped with steroid treatment, and the symptoms returned when you discontinued the steroids, Porto may need to be on a hopefully small dose of prednisolone to keep him healthy. Do not get overly focused on his insulin dose if this ends up being the case.

The information your vet gave you about altering the dose depending on the pre-shot numbers does not apply to Lantus. It is the way shorter acting insulin (e.g., Caninsulin) is dosed. With Lantus, your dose is based on the nadir (lowest number in the cycle) and not on the pre-shot number. There may be times you adjust the dose at shot time for safety reasons but overall, you hold the dose until a dose reduction is indicated by a drop in numbers or you increase based on numbers not being in the range you desire. One option is to lower Porto's dose to a level you are comfortable with. We can always increase his dose a bit more quickly if his numbers are high. This will give you more information and greater confidence with shooting.

When you do drop the dose out of concern for Porto's safety, the next pre-shot number may be high. Another factor to consider is that when you change the dose frequently (lower it for safety reasons, next shot time numbers are high so you increase), the depot doesn't have time to catch up with the changes in dose. The depot may then contribute to less than wonderful numbers.

As for the times when you're feeding Porto, several small meals a day is good. It will help if you have a good idea when his nadir falls. Generally, feeding your cat the majority of his food prior to nadir means that food is offsetting the effect of insulin and helping to prop up the numbers. It may take a little while to get the data you need to figure out where Porto's nadir falls. Also, you do not want to feed 2 hours prior to shot time.

Do not create a separate post to reply to each person. You want to open one thread (we call a thread a "condo") per day. This is a busy forum. If you created a reply every time someone posted, you would have who knows how many threads running at the same time. Instead, we link the previous day's condo to the current condo so everything is in one place and you can find the information about about your cat

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Thank you for your replies! I will check the websites of course but am a bit worried of making a dfinite change with a diet I dont have close to home in case at some point something happenes and I cant get it. I will look into the home made... see if I could put it together.
I can find Boulardii, no issue, what I didnt find was the empty capsules for it. I did find some in France but this week I am waiting to see if I may get lucky in finding them here.
Sienne, I was wondering, about his diet, if, aside from his 95 gr of kibble a day, I could add some quail breast for when he is really hungry. Assuming he accepts it well and doesnt cause loose stools (which we already tested), could I give it to him? Lets say a small amount a day, 30-40 gr. In adding that, should I retain some of his dry food? Is this safe to "play" with diet? Just because he has started with Lantus on this diet and on these amounts of calories and carbs a day, changing it a bit (for now only the quail breast) may affect negatively his BG?
I think the vet calculated his dose changes based on the curves I sent but the measurements she gave me posteriorly are for safety, for when his BG drops all of a sudden. I see now that so far, between last night and today, his numbers stay high. No more drops.
So, prior his shot time, I shouldnt feed for two hours? But I should feed with his shot time, right?

Thank you, all the best!
 
I don't put the S. boulardi in a capsule. I sprinkle on Gizmo's food.

Most of us test, feed, and shoot all within about 5 - 10 min. I would give Gabby her food when her head was in her food.

My guess is that the higher numbers are due to a "bounce." Because numbers fell into the 100s yesterday, Porto's system overreacted by dumping a stored form of glucose and counterregulatory hormones into his system.This caused the high numbers. it's normal -- just annoying.

 
Sienne and Gabby (GA) said:
I don't put the S. boulardi in a capsule. I sprinkle on Gizmo's food.

Most of us test, feed, and shoot all within about 5 - 10 min. I would give Gabby her food when her head was in her food.

My guess is that the higher numbers are due to a "bounce." Because numbers fell into the 100s yesterday, Porto's system overreacted by dumping a stored form of glucose and counterregulatory hormones into his system.This caused the high numbers. it's normal -- just annoying.
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I could try sprinkle, I thought by sprinkling it, would lose efficiency. Gizmo is a good boy for eating it like that :)
What do you mean by: “I would give her food when her head was in her food?” I dont understand, sorry :)
Thank you!
 
Also, another question. With all the bounces and depot changes, right now, can I still search for the Nadir? Would a curve tell me where it is or it would be false data? Thank you!
 
I would test Gabby at pre-shot. Then I would put her food down for her. Once she started eating - and while she was eating -- I would give her her shot of insulin. She was a very food motivated cat and her meal was a reward and kept her distracted when I was giving a shot.

There isn't a completely accurate answer to your question about nadir. A lot depend on your cat. Chances are that it won't be "false" data but it just may not be entirely clear. If numbers are higher due to a bounce, The nadir may not be easy to define.
 
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