Fluffy's back! Changes to food, insulin, etc?

[Natalie & Fluffy]

Hi guys I'm so glad to be back home with Fluffy and on the forum~ I think Fluffs and I are ready to start planning on switching his diet, insulin, and his glucometer.

Right now, Fluffy eats 1/2 cup of Purina One Indoor Advantage dry food at 7:30 am and 7:30 pm, and receives 1 U of Novolin N at 8:00 am and 8:00 pm. He uses the Alphatrak 2, but I want to switch to Relion brand.

I'm thinking of first trying to switch him to the Fancy Feast Chicken Classics since I've heard those are high in protein and low in carbs, and see how that works. What are some tips and numbers I can work with on how to gradually integrate his new diet (as well as to lower the chance of him throwing up, hypo, etc)?

I want to get started on Levemir or Lantus. It's expensive, but I've heard many of you sugar kitty owners getting yours from prescription from Canada at lower prices? How does that work? Do I have to talk to my vet about ordering it from him? I've also heard the pens are cheaper.

Alphatrak strips are getting way too costly and I'd like to switch to Relion, esp. keeping a close watch on BG during his insulin and food switch. Which brand should I get? Fluffy's ears bleed somewhat well, but I might just end up using the alphatrak lancets since I cannot for the life of me free-hand pick him!

(Also, some extra details, Fluffy has a very mild case of gingivitis. He eats his crunchy food with no problem, but I'm wondering, even if it is very mild, do you think it could slightly affect his diabetes?)

Any insight, personal experience, links to share... all is so greatly appreciated! Bombard me with information, the more, the better! Thanks guys

 

[blu]

Hi! I'm not as knowledgable as some of the other folks here that will be able to help you out in regards to being careful with insulin and food changes. I was able to change Blu from a primarily dry food diet to Fancy Feast Classics without any gradual steps, but he likes wet food better so it was easy. The important thing, and again someone will offer more specific advice, is that once he is off the dry and onto low carb wet food, his glucose will likely drop to some extent so being able to closely monitor his levels is important during the change over. It's wonderful you are making the change, as it could eventually lead to remission where Fluffy doesn't need insulin. Blu was able to be "food controlled" for a year and a half after receiving insulin for a few months. Every kitty is different. so paws crossed!

The Canadian pharmacy folks here found that have the (very!) low Lantus prices is here: http://www.marksmarinepharmacy.ca/about.html
The Lantus Solostar pens come in a five pack. you can use the pens just like a vial with a syringe. Keep the insulin in the fridge and handle gently and it will last longer, too. I believe you do need a Rx but your vet should be able to give you one.

Also, I use the Relion Micometer - I like it very much and the strips are very affordable. I had a different (more expensive!) meter and it needed so much more blood compared to the Relion.

Best of luck to you and Fluffy!

 

[Critter Mom]

Hi! I'm not as knowledgable as some of the other folks here that will be able to help you out in regards to being careful with insulin and food changes.

Tanya raises an important point, Natalie. You need to make food switches gradually in general so as to minimise the chance of triggering a digestive upset, but with a cat on insulin you really should be home testing blood glucose throughout the transition because the drop in carbohydrate intake may suddenly and significantly drop blood glucose levels. Therefore a dose adjustment would be needed. Home testing through the transition keeps a kitty safe.


Mogs
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[Natalie & Fluffy]

Hi! I'm not as knowledgable as some of the other folks here that will be able to help you out in regards to being careful with insulin and food changes. I was able to change Blu from a primarily dry food diet to Fancy Feast Classics without any gradual steps, but he likes wet food better so it was easy. The important thing, and again someone will offer more specific advice, is that once he is off the dry and onto low carb wet food, his glucose will likely drop to some extent so being able to closely monitor his levels is important during the change over. It's wonderful you are making the change, as it could eventually lead to remission where Fluffy doesn't need insulin. Blu was able to be "food controlled" for a year and a half after receiving insulin for a few months. Every kitty is different. so paws crossed!

The Canadian pharmacy folks here found that have the (very!) low Lantus prices is here: http://www.marksmarinepharmacy.ca/about.html
The Lantus Solostar pens come in a five pack. you can use the pens just like a vial with a syringe. Keep the insulin in the fridge and handle gently and it will last longer, too. I believe you do need a Rx but your vet should be able to give you one.

Also, I use the Relion Micometer - I like it very much and the strips are very affordable. I had a different (more expensive!) meter and it needed so much more blood compared to the Relion.

Best of luck to you and Fluffy!

Thank you so much Tanya!! I am trying my hardest to get him started as early as I can before the chances of remission dwindle down, glad to see your kitty Blu was able to have a good transition! Hopefully Fluffs will be just as successful~

& WOAH that's so cheap compared to the ridiculous prices over here!!! This is a godsend! I do have a question though, do you have to use different syringes for the Lantus 10ml vial vs the Lantus Solostar 3ml pens? Or is that how much is insulin is contained in it? And how long does it last if handled well (vial or pens, depending on what you use?) And before you draw insulin, do you gently roll it? (I roll my vial of Novolin between my hands about 15 sec until it's milky white, I don'y know if you have to be more vigorous or whatnot with Lantus).

 

[Natalie & Fluffy]

Tanya raises an important point, Natalie. You need to make food switches gradually in general so as to minimise the chance of triggering a digestive upset, but with a cat on insulin you really should be home testing blood glucose throughout the transition because the drop in carbohydrate intake may suddenly and significantly drop blood glucose levels. Therefore a dose adjustment would be needed. Home testing through the transition keeps a kitty safe.


Mogs
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Thank you Mogs! Yes that's what I'm afraid of~ I tried switching him before, but I switched way too quickly and he got upset, but also, I wasn't able to home test him and watch him carefully. Learned my lesson I know I'll be home testing like crazy once I begin transitioning, poor Fluff's ear will be a bloodbath :K ~! What I don't know is how I should dose accordingly, but I'm figuring that I'll be testing about every two hours (is that a good amount?) throughout the week or two (?) I transition his diet. When I get Lantus within a week or two, I'm probably going to need the forum to handhold me on how to dose accordingly to his numbers. xD

 

[Critter Mom]

Lantus does not need to be rolled. You can use u100 syringes with the 10ml vial and with the pen cartridges. (The cartridges have a little grey rubber seal on the top where you insert the syringe needle.)

Here's a useful sticky from the L & L ISG board. Lots more at the top of that board.

Lantus & Levemir: Info, Handling and Proper Storage


Mogs
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[Critter Mom]

When I transitioned Saoirse she was on an in-out insulin (Caninsulin/Vetsulin) so it was relatively straightforward to reduce her doses on every cycle. Lantus is a depot insulin so it builds up a little 'tank' of insulin in the cat's body that is slowly released over time. Therefore there's a bit of a time lag between reducing a dose and draining the 'tank'. I'm not sure how one might manage dose reductions during a food transition. Certainly the slower the food transition the more manageable the dose adjustments should be, but one never knows how much or how quickly the cat's BG may lower when the dietary carbs start getting reduced.

@Chris & China - can you advise Natalie about how to manage a food transition safely on Lantus, please?

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[Deb & Wink]

The important thing, and again someone will offer more specific advice, is that once he is off the dry and onto low carb wet food, his glucose will likely drop to some extent so being able to closely monitor his levels is important during the change over.

Please note that even when your cat is not completely off the dry, the BG levels can drop dramatically during the transition from dry to wet food. Wink was a confirmed dry food addict so the switch took some time and his BG levels dropped dramatically even though he was still eating a lot of dry.

 

[Natalie & Fluffy]

Mogs, that video was INCREDIBLY helpful! I find that Fluffy can handle Novolin well for a while with some occasional whinyness, and then every week or so he bounces. It's too harsh! I've heard of "start low and go slow" with Lantus and Levemir (correct me if I'm wrong?)

Deb, yes! I've heard they can drop as much as two units! I'm probably overthinking this, especially since I have no way of knowing until I start, but I'm just wondering how I'm going to balance food/insulin dosage :/ Wink and Fluffs are same; addicted to dry food! He did alright with eating his wet chicken food but I think transition was way too fast and he had digestive problems when I experimented way early back.

 

[blu]

Thank you so much Tanya!! I am trying my hardest to get him started as early as I can before the chances of remission dwindle down, glad to see your kitty Blu was able to have a good transition! Hopefully Fluffs will be just as successful~

& WOAH that's so cheap compared to the ridiculous prices over here!!! This is a godsend! I do have a question though, do you have to use different syringes for the Lantus 10ml vial vs the Lantus Solostar 3ml pens? Or is that how much is insulin is contained in it? And how long does it last if handled well (vial or pens, depending on what you use?) And before you draw insulin, do you gently roll it? (I roll my vial of Novolin between my hands about 15 sec until it's milky white, I don'y know if you have to be more vigorous or whatnot with Lantus).

Mogs posted a great link all about Lantus handling, but no shaking (actually want to handle it very gently) and yes it uses the same needles, essentially it is just a smaller vial of insulin encased in a pen.

I agree! The price is awesome! I wish I had checked out this board way back when Blu was diagnosed. I can't recall exactly what I paid for a 5 pack of the pens at CVS, but it was a LOT. Those 5 pens will last you a very, very long time too, just keep them in the fridge. One thing I noticed on the Mark's Marine site is a caution about shipping in very cold or very warm weather. (under 35 degrees, over 85 degrees I believe). Not sure where you live, but if your temps are out of this range I'd call first to see if anything can be arranged to ensure safe temperatures during the shipping process.

 

[Critter Mom]

I've heard of "start low and go slow" with Lantus and Levemir (correct me if I'm wrong?)

A lot of members here follow either the Start Low/Go Slow guidelines or the Tight Regulation Protocol guidelines when using Lantus. You can find stickies about them at the top of the Lantus and Levemir Insulin Support Group's board.

Tight Regulation is a somewhat more 'aggressive' approach to regulation than the Start Low/Go Slow method, but both are effective methods for treatment with Lantus.


Mogs
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[Natalie & Fluffy]

Tangy, yay ok no shaking~ I'm surprised at the longevity of those pens :O So basically, if these Lantus pens were unopened, they could last indefinitely?

Mogs, awesome, thank you for the post!! I'll look through it thoroughly!

I've talked to my parents about it, and they think that I should just experiment with slowly transitioning his food first (while on Novolin and using smaller doses) and see how that works before buying Lantus so they can save a little money.

What do you guys think? I want my best chances at remission and he is hitting close the 6 month mark :/ I think it will also save money in the long run. I don't have high hopes that the diet will completely cure him right away obviously. If my dad gets a lot of good reasons, he'll invest in the Lantus.

 

[Critter Mom]

Hi Natalie,

The unopened Lantus cartridges will come with an expiry date. Provided they're refrigerated properly (in the body of the fridge, not the door) the insulin should remain viable until the expiry date. Once a cartridge is opened, again provided it is refrigerated properly it should last several months although it may lose some of its potency as time elapses. Some members here have got 6 months out of a pen cartridge. I had a vial of Lantus for Saoirse the year before last and it was fine 3 months after opening - until I moved and it froze overnight in the fridge at the new property ... Luckily Saoirse was in remission by then so it wasn't needed.

I'm not familiar with Novolin but I'm tagging another member to see whether she can give you some input on whether it might be more straightforward to do the food transition while Fluffy is still on the insulin you're familiar with. (@BJM can you help, please?)

To the best of my knowledge based on what I've read here, Lantus has a gentler action than Novolin and I think its effect is longer lasting. With appropriate home testing it is possible to get to a stage where the cat is in normal numbers for most if not all of the day. That gives the pancreas more chance of resting and healing, and presumably that is what can enhance the kitty's chances of achieving remission. Do you have your Relion meter yet? (The Confirm and Micro are popular with members here.) If you have recent Alphatrak data, it would be great if you could put the current data into Fluffy's spreadsheet; it would help members to perhaps give you a better picture of how Lantus could help Fluffy more than the Novolin he's currently receiving.

BTW, I also use an Alphatrak 2 meter. I've learned to freehand the actual prick but I still put the lancet into the Alphatrak lancet device; I find it helps me aim the lancet tip better. You can use Freestyle lancets in the Alphatrak lancet device; they're identical to the Alphatrak-branded lancets but much cheaper.

Fluffy has a very mild case of gingivitis. He eats his crunchy food with no problem, but I'm wondering, even if it is very mild, do you think it could slightly affect his diabetes?

It certainly could. Diabetics are more vulnerable to infection and it can elevate their blood glucose levels. I'd suggest having a word with your vet about what to do.

What are some tips and numbers I can work with on how to gradually integrate his new diet (as well as to lower the chance of him throwing up, hypo, etc)?

To minimise the risk of digestive upsets, you need to gradually switch the foods. Here's a good article on the subject:

How to Transition Your Cat to New Food



Mogs
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[Melanie and Smokey]

So basically, if these Lantus pens were unopened, they could last indefinitely?

No, all insulin has an expiration date on it, usually a couple years out on new pens though.

Fluffy is looking pretty good, especially if those are AT numbers as they are usually higher than a human meter. If you were able to transition Fluffy to a low carb wet food diet that might be enough that you may get him into remission without needing to invest in too many other changes.

 

[Natalie & Fluffy]

Mogs, Thank you!! Ahh wasted insulin is the worst :/ I'm at home all day and testing is usually no problem for me! I'll be getting the Relion Micro tomorrow morning. I have some of the numbers on my spreadsheet link below, although I haven't tested him for about more than two weeks because he's been boarding while I was forced to go on vacation far away (very anxiety-inducing haha)

I finally bought a Fancy Feast pack (24 cans of "poultry and beef feast variety" CLASSIC) with Tinder Beef Feast, Chicken Feast, and Turkey & Giblets Feast (all Classics). That should be the correct low carb food right? Thank goodness, I bought the last box o.o I think I might begin transitioning slowly tomorrow or the day after?

Melanie, thanks! I've been a little obsessed over his numbers haha~ Correct, I'm using Alphatrak 2, but now I'm going to ditch it because the test strips are just too much on my parent's budget (and I ran out of strips), and switch to Relion Micrometer tomorrow. Hopefully we'll see where these numbers go. I have my hypo kit, and I stay at home and take online classes so I'm very watchful!

Also, I remember there being a spreadsheet link for BG testing (like the one I'm using now, but it's for Alphatrak 2), do I need to make columns with new ranges for the different Relion Micro (since those tests a little lower than pet calibrated glucometers?)

 

[Critter Mom]

Hi Natalie,

I bet Fluffy was thrilled to see you after boarding for all that time!

I'd suggest getting several days' worth of blood glucose data with the new Relion meter before you start a food transition. I think it would be better to get familiar with what Fluffy's patterns look like on the lower-reading meter. I think it would be safer, not least of all because you can ask for help here if you have questions when using the new meter and getting experienced members to maybe check your spreadsheet before starting the switch.

I've just had a look at your spreadsheet and I can only see the +1, +2 ... +11 columns for the AM cycle on it. Have you hidden some of the PM columns (the ones that should appear between the second 'U' column and the 'Remarks' column? I think that needs to get sorted out so that members looking at the spreadsheet will be better able to see what's going on with Fluffy's BG.

In the meantime, in the row below today's row on your spreadsheet, can you colour it differently (the paint bucket icon at the top of the sheet) and in the Remark column put in all capitals "SWITCHED TO RELION MICRO" (maybe change the text size, too). That way you'll have a clearly identifiable break between the Alphatrak pet meter and Relion human meter readings. On the row below that one again, you can put tomorrow's date and the dose and BG data in the columns as normal.

I'm not in the US so can't confirm 100% that the FF Classic foods you've got are the right ones but they do sound familiar. Hopefully a US member will be able to confirm they're OK carb-wise.


Mogs
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[BJM]

You may change the food about 20-25% per day, while testing.

If you are changing from high carb to low carb, this may reduce the insulin dose by as much as 2 units and reduce the glucose by as much as 200 mg/dL (we even had 1 person report a drop of 300 mg/dL).

Given the relatively low numbers you were experiencing with the AT, I would reduce the insulin by at least 0.25 units, and maybe even 0.5 units for each day's switch of 25% different food to keep him safe. You may be able to get him off insulin with the food switch alone.

 

[Critter Mom]

@BJM - Thank you!

 

[Natalie & Fluffy]

Hi Natalie,

I bet Fluffy was thrilled to see you after boarding for all that time!

I'd suggest getting several days' worth of blood glucose data with the new Relion meter before you start a food transition. I think it would be better to get familiar with what Fluffy's patterns look like on the lower-reading meter. I think it would be safer, not least of all because you can ask for help here if you have questions when using the new meter and getting experienced members to maybe check your spreadsheet before starting the switch.

I've just had a look at your spreadsheet and I can only see the +1, +2 ... +11 columns for the AM cycle on it. Have you hidden some of the PM columns (the ones that should appear between the second 'U' column and the 'Remarks' column? I think that needs to get sorted out so that members looking at the spreadsheet will be better able to see what's going on with Fluffy's BG.

In the meantime, in the row below today's row on your spreadsheet, can you colour it differently (the paint bucket icon at the top of the sheet) and in the Remark column put in all capitals "SWITCHED TO RELION MICRO" (maybe change the text size, too). That way you'll have a clearly identifiable break between the Alphatrak pet meter and Relion human meter readings. On the row below that one again, you can put tomorrow's date and the dose and BG data in the columns as normal.

I'm not in the US so can't confirm 100% that the FF Classic foods you've got are the right ones but they do sound familiar. Hopefully a US member will be able to confirm they're OK carb-wise.


Mogs

He was!! Dropping him off was awful, he got so nervous that he pooped in his cart... haha. Okay, sounds great, I'll hold off on the diet switch until I get a good curve. I've heard the numbers on human meters are generally about 20 pts below the pet meters or in that range. And yes, sorry about that, I was thinking that it look cluttered and I don't do BG checks during the night but I put it back on there just in case he gets in an emergency. Excellent! Already got the cell merged. Yay!

You may change the food about 20-25% per day, while testing.

If you are changing from high carb to low carb, this may reduce the insulin dose by as much as 2 units and reduce the glucose by as much as 200 mg/dL (we even had 1 person report a drop of 300 mg/dL).

Given the relatively low numbers you were experiencing with the AT, I would reduce the insulin by at least 0.25 units, and maybe even 0.5 units for each day's switch of 25% different food to keep him safe. You may be able to get him off insulin with the food switch alone.

BJ! Happy to see you! Excellent, I'll be starting that in a few days then. How much would you say is 20-25% of FF would be? About half a can or so per feeding? While removing 20-25% of the dry food meal (as he eats 1/2 cup per meal)? He's about 15 lbs~ I'm just wondering when he makes his full transition that how many cans should he eat to maintain a constant healthy weight.

I'm confident about getting him off the insulin-- it's happened before for a little bit I think but I wasn't sure about the wet food's carb content. Fingers crossed with this variety!

 

[Shenandoah]

I finally bought a Fancy Feast pack (24 cans of "poultry and beef feast variety" CLASSIC) with Tinder Beef Feast, Chicken Feast, and Turkey & Giblets Feast (all Classics). That should be the correct low carb food right? Thank goodness, I bought the last box o.o I think I might begin transitioning slowly tomorrow or the day after?

Do the comparison at your store, but I've found buying the boxes is more expensive than the individual cans. Makes no sense to me, but that's what it is...
For example, at PetSmart the individual cans are $0.59 each. The box is $15.99 for a 24 pack, or $0.67 each.

 

[BJM]

...
How much would you say is 20-25% of FF would be? About half a can or so per feeding? While removing 20-25% of the dry food meal (as he eats 1/2 cup per meal)? He's about 15 lbs~ I'm just wondering when he makes his full transition that how many cans should he eat to maintain a constant healthy weight.
...

Find out the calories in what you are currently feeding.
Find out the calories in 1 can of Fancy Feast .
You want to replace the same number of calories, whatever the volume turns out to be.

 

[Natalie & Fluffy]

Do the comparison at your store, but I've found buying the boxes is more expensive than the individual cans. Makes no sense to me, but that's what it is...
For example, at PetSmart the individual cans are $0.59 each. The box is $15.99 for a 24 pack, or $0.67 each.

Huh, what a ripoff... o.o I'll be buying individual's in petsmart then!

Find out the calories in what you are currently feeding.
Find out the calories in 1 can of Fancy Feast .
You want to replace the same number of calories, whatever the volume turns out to be.

BJ, awesome! Fancy Feast chicken classics has about 91 kcal per can, and his dry food is about 400 cal per cup. I hope I haven't been overfeeding him o.o He gets adequate exercise though.

Starting testing later today and at the very latest tomorrow morning!

 

[Natalie & Fluffy]

I bought the Relion Micrometer! It's been so long since I've tested him, his ears healed up :/ I've got the warm sock and I think I'll just start poking him every two hours just to get his ears used to it, and get a good amount of blood for the test strips. Oh man. Poor kitty

UPDATE: Micro requires a lot more blood than Alphatrak! I'm not very successful at this... Maybe I'm just being impatient; I remember it did take a few tries over a few days to draw blood successfully from Fluffy, but the Alphatrak strips seem to require much less blood.

 

[Critter Mom]

Try warming his ears for longer, Natalie. (And remember to kiss them better afterwards! )

 

[Natalie & Fluffy]

Try warming his ears for longer, Natalie. (And remember to kiss them better afterwards! )

I think that was the trick!! I warmed him up for a good minute and got enough blood! 129 @+6.5! I give him a verrry tiny snack reward and lots of love! I need to have more confidence in drawing his blood. I think it makes a good difference! So, do you think I should do a full curve tomorrow and see what kind of numbers I get on this meter before transitioning soon? I know I should be patient haha xD

 

[Critter Mom]

Excellent news, Natalie.

The confidence thing is very true: I had to use the 'fake it till ya make it' trick with Saoirse when I was learning to test. Helped a lot.

Good news that you're planning to get a curve done tomorrow. Be sure to post when you have the data in Fluffy's spreadsheet.

Warms my heart to see how much you love your boy.


Mogs
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[Natalie & Fluffy]

Absolutely Mogs! He's absolutely spoiled o.o All sugar kitties like him and Soairse (btw what a BEAUTIFUL name) should! So today was pretty successful in terms of his curve; I was stupid and distracted by a date with my boyfriend that I left the insulin bottle out overnight! Very angry with myself

So far, it seems like it did no harm in being effective, and Fluffy's had his best day yet since coming back home so far, behavior wise. I think I will start transitioning his food tomorrow! I have a plan though; I know BJ says I can do 20-25% per day, but Fluffy has a history of being quite delicate to food changes (he'd throw up only once if we changed his food, but otherwise he'd be okay; of course, this way before he had diabetes). I'm wondering if I should reduce it to about 10% a day, and then have a full complete transition within about ten days to be extra sure? Or is this too slow of an approach?

But if you (or anyone else) would prefer I stick with the 20-25% plan, definitely please let me know! This is my first time here so I need to listen to the experts haha.

 

[Deb & Wink]

The 20-25% change to new food a day that BJM suggested is only a guideline, not set in stone. A slower changeover in food helps to minimize stomach upset, diarrhea, etc.

Some cats are slower to realize that canned food is yummy stuff and it can take quite a while to get them switched over. (I think Wink took about 30 days to transition).

So, it's really up to you as Fluffy's caregiver to decide how fast or slowly you want to do the food change. If you want to take it slower, than please do. If Fluffy seems to be doing ok, eating ok and not throwing up the food, all will be well.

 

[Natalie & Fluffy]

Thank you so much Deb!

 

[Critter Mom]

Hi Natalie,

I'd have said the same as Deb. Take the time that Fluffy needs to transition.


Mogs
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[Natalie & Fluffy]

Thank you both! Well it seems he was THRILLED to eat his classic FF turkey giblets, if he's stomach seems to handle it within these few days, I'll speed it up!

 

[Critter Mom]

Thank you both! Well it seems he was THRILLED to eat his classic FF turkey giblets, if he's stomach seems to handle it within these few days, I'll speed it up!

Not too fast, though, Natalie: you have to make sure the FF Turkey & Giblets likes Fluffy back! Keep an eye to the quality of his poops for the next couple of days. If they get a bit soft it's an indication that his GI tract needs time to adjust.


Mogs
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[Natalie & Fluffy]

Not too fast, though, Natalie: you have to make sure the FF Turkey & Giblets likes Fluffy back! Keep an eye to the quality of his poops for the next couple of days. If they get a bit soft it's an indication that his GI tract needs time to adjust.


Mogs
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oOoops! Haha will do! His poops seem so far good quality

 

[Natalie & Fluffy]

Okay so I've got a few days worth of data, what do you guys think so far?

He was doing so great and I think at +7 today he may have bounced? I'm not so sure. I'll test in an hour or two to see if his numbers go down. I'm considering that tomorrow I may just take him off the insulin, to see how he'll do, but is that a wise choice?

EDIT: So Fluff's PMPS was an unexpected 230!? He was doing so well! This morning was by far the BEST morning and afternoon he's had, seemed like his normal self, all happy like a non-diabetic! But I'm wondering, why? Is he bouncing because his BG gets *too* low? Old Somogyi effect? I gave him 0.5 tonight... I don't know if that was a wise choice but I guess we'll see how tomorrow he turns out I don't know if I should have otherwise shot ~.25 or not at all... Maybe it's the harsh insulin behind all this; that it drops TOO low and the afternoon too quickly, so his body is like MUST PRODUCE EXCESS GLUCOSE? Not sure :/

I wonder if I should also go ahead and order Levemir because this really discouraged me that maybe his remission won't be a thing with just the wet food diet. Better to be prepared than to not!

 

[Critter Mom]

Hi Natalie,

Sorry that no-one has yet replied to your thread questions. I don't know about Novolin but maybe @BJM might be able to help if she's around. If you don't get responses to this thread, I suggest starting a new one on Feline Health asking for help with Novolin dosing and duration.

Just looking at Fluffy's spreadsheet his numbers are running in a fairly well-regulated range and it's great to hear how much happier and healthier he is acting; after all, that's what all of this poking and prodding is about!

I know you're disappointed about the 230 reading, but try to look at the overall trends in data, not the occasional wobbler. Sometimes something as mundane as brewing up a poop can be enough to temporarily elevate BG levels.


Mogs
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[BJM]

If you're doing a food change, then that higher morning number could be from going lower than usual, maybe even too low, last night, while you were asleep. how much have you cut back on the insulin while switching?

 

[Critter Mom]

@BJM - Thanks for replying.

 

[Natalie & Fluffy]

@Critter Mom Hi Mogs! No it's all good! I what happened was that his numbers got way too low with the insulin. I took him off it for good last night, and then did a AMPS twice at the same time (got 145 AND 171?) but he appeared absolutely normal, which I haven't ever seen in a long time, before he had diabetes! :O I don't know what's up with different numbers, but I don't expect the Micro to be accurate, but the trends seem to be going normal from what you guys think, so it brings me great relief!! He's eaten his food so well, actually for the last day or two didn't even bother to eat all his dry food, just eating his wet food, which made me think his numbers got way too low too fast and he bounced.

@BJM I believe his numbers were getting high because from the rapid drop of the insulin! I'm almost certain maybe he didn't even need insulin when I started to change his diet. In fact, I think his numbers were getting so low early on that insulin was unnecessary. I tried to cut back about for every 20-25% of food change, I'd reduce his dose by .25. But still I think that was too much insulin, so I made the jump to just take it off him completely.

As we speak, Fluffy is napping peacefully outstretched, he looks so happy and content!! Maybe it's too soon to be sure, and I'll have to be prepared to buy insulin in the future if it comes back, and if it does, I'll make a new board. I'll be frustrated too xD but for now, I'm so happy Thank you guys so much for all the help!! I'm forever thankful!

 

[Critter Mom]

Can you keep doing spot checks for the next few days and post updates please, Natalie. I'm not sure about how things would work with your insulin but with Lantus the FDMB recommendation is to taper off the insulin (makes for a more solid remission). If you keep monitoring over the next few days (and updating your spreadsheet) it will give you a better idea of how Fluffy is progressing and whether you may need to continue insulin treatment.


Mogs
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[BJM]

As we don't recommend giving insulin when the glucose is below 200 mg/dL new users and not below 150 mg/dL for established users with good test data, you've made the right call.
Take care of any dental infections or ginigivitis or any other kinds of infection whenever detected. the glucose may come down further over time or go up again if any kind of autoimmune process or pancreatitis is happening, so continue testing for a while and also see my signature link Secondary Monitoring Tools for other assessments which may be helpful in monitoring your cat for issues.

 

[Natalie & Fluffy]

Mogs, will do! knock on wood. And thank you BJ! I hope so. His gingivitis is so mild, and my vet last mentioned that it's not really worth it to clean, but I'll bring it up next time I see him, especially if his numbers get weird. In the meantime, I have no clue if this will help, but I do have a special cat brush and toothpaste and I will attempt to clean his teeth every night after his meal; I've tried it before and he HATES it (no surprise) but it's for his own good! I don't know if over time it will help reduce his gingivitis.