Food and dosing question

[Di&Misho]

Good morning everyone! My questions today are with regard the amount of daily food our cats eat and dose of insulin.Are both dependant on each other and does much food means more insulin and vice versa? Do the drop of BG depends on how much food he had at his insulin shot ? Does it make a differencefor the insulin if I give Misho his food in one meal or feed him 3 meals- at shot ,+4 and +8 as I do now.
I ask this question because Misho lost again some of his weight . Part of this is may be because after changing his food from Interga to Granatapet I fed him less than the usual amount he received before. I try to follow the recommendtions of the producer but I know they are only that and nothing else .It is also true that Misho eats more food than it is normal for a cat at his weight but he definitely needs it.
I am happy now I will be able to monitor Misho's weight on regular basis( Aine THANK YOU :YMHUG: ) and will be glad if I have answers of my questions.

 

[Critter Mom]

Hello Di, :smile:

While Misho is unregulated it means that his body's cells aren't able to make proper use of the food he is eating because without enough insulin the glucose his cells aren't getting the energy they need to enable him to get the full benefit from the nutrients. That's why he's so hungry. As you gradually move him to better numbers the hunger will diminish as he starts getting proper benefit from all of the food he eats.

The general rule I have read on this board (and the advice given to me by my vets when Saoirse was underweight when she was unregulated) is to feed enough to restore the cat to ideal ideal weight and then adjust the amount to maintain ideal weight. As you've seen when helping Misho through lower numbers more food does raise blood glucose but I don't know how increasing Misho's food intake will affect his insulin requirements. I don't have any experience with Levemir and I'm just a novice sugar kitty parent so I don't comment on dosing but I'm sure other members will be able to help you with this.

As you already know, Misho will need to have enough food on board for the insulin to work on, especially during the peak period. With longer acting insulins there's more flexibility about when to feed. I'm not sure about the action profile of Levemir but hopefully other Lev users may be able to help with this. With Saoirse on Lantus, I feed her several small meals (to help with her pancreatitis) from PS through to +10 so that the next PS number isn't influenced by food. I know that because of your situation with Misho, that makes things trickier but hopefully between us all we can help you come up with a suitable feeding schedule.

Does Misho have any other underlying conditions at the moment? And how is is cough?

I've got to get some sleep right now but I will check back later. I'll have another look at the calorie content of the foods again. In the meantime, it would help if you could post a note to remind me of the Granatapet flavour(s) you're giving Misho, and also his current weight and what you think his ideal weight should be.

Hope the day goes well for you, and that it's not too cold over there. :YMHUG: cat_pet_icon

 

[Di&Misho]

Does Misho have any other underlying conditions at the moment? And how is is cough?

I've got to get some sleep right now but I will check back later. I'll have another look at the calorie content of the foods again. In the meantime, it would help if you could post a note to remind me of the Granatapet flavour(s) you're giving Misho, and also his current weight and what you think his ideal weight should be.

Hope the day goes well for you, and that it's not too cold over there.

After all tests we have done it seems he has no other health problem but this cough doesn't stop. He coughs now and then. Today Misho's weight was 3,740 kg I think his ideal weight should be something like 4-4,5 kgs at least. If I have to give him more food I will but I wondered if this will affect his BG numbers and if I will need to increase the insulin as well. I sometimes have thought to give him very small meal at high pre shot but I don't know if that is OK as my idea is that with high pre shot and big meal his numbers will rise a lot. I don't know if Misho have food spikes as sometimes he rises slightly and sometimes a lot after his meal at insulin shot. Sometimes at +4 his BG has already dropped and sometimes like last night at +5 it is even higher than the preshot. I never know with him. Before I fed Misho twice a day at shot time only ,then I read small meals several times a day are better and I now share it in three meals but I am not sure I see any difference :roll: I wish I could feed him very small meals 5-6 times a day but it is not possible for me.

Aine - you helped me with his new Granatapet food,explaining the callorie issue HERE

 

[MommaOfMuse]

Di,

Insulin is the key to the body cell doors. Right now Misho is buying food at the store (eating) but the door to his kitchen is lock and he doesn't have the key. So the food he is buying isn't doing him a lot of good, because he can't get into the kitchen to cook it. (unregulated diabetic). The rule of thumb around here is that you feed about 20% more than what is recommend for his ideal weight. But to directly answer your question. Yes, both the amount of volume as well as the carb % total have to balance with the insulin dose. They are the yin and yang of each other.

What some folks forget, myself included at times, is that the carb% is cumulative as well. Just because for example I feed Friskies Turkey and Giblets which is I think last I saw 7% carbs. Well that means that 7% of its calories are from carbs in that one can, so if I feed 1 cat regardless of how many meals I'm feeding it to him, I'm feeding him 7% of his calories from carbs. So, while this would be ridiculous to do in practice but it makes the math easy..lol If I fed that one can over 7 meals per day, I'm only feeding him 1% of his daily calories from carbs per meal. So his pancreas or the dose of insulin only has to process 1% carbs, verse feeding a half a can twice a day where the pancreas or the insulin has to process 3.5% carbs load at a time. But the reverse is also true, if the cat to maintain proper body wait like my Maxwell which is a big long, tall boy, requires 2 cans a day. Then in effect that cat would be getting 14% of his daily calories from carbs so for a diabetic you would need to at least stretch those cans out so he was getting no more than 7% carbs a meal. So with cats that require more calories you want to stretch the daily intake out over smaller and more frequent meals. And in general, but especially true with cats that are flirting with remission so that the newly healing pancreas doesn't have to work so hard to produce enough of its own insulin to handle the carb load.

Autumn was extremely underweight when I first adopted her. What I did with her is I basically free fed her, through the first 1/2 of her cycle. I would give her a full can at amps and when that can was gone, I would dump another one in front of her. Then I would give her until +6.5 to finish whatever she wanted then pick it up after that until pmps. But she was still on Lantus then. If I was to do it over and start her on the Levemir she's now on, I would free feed or in your case put down a full can at amps, +4, & +8 because of the longer onset and later nadir. Right now since he's unregulated, it's fine to let him graze and eat as much as he wants within reason, of course. Most cats by nature are pretty good about self regulating their food intake, you do get your gluttons, that are on a See Food diet, as in see food, eat food. lol But a fat feral won't be that way for long because they can't hunt quick prey like mice and birds ohmygod_smile :lol: But with a diabetic because you need a fasting number at preshot and you have to balance food verses duration and potency of injected foreign insulin rather then their pancreas doing it in reaction to food intake, you only want him to have access to food while the insulin is setting in and most effective.

Hope I didn't lose you in translation. nailbite_smile

Mel and The Fur Gang

 

[Critter Mom]

Hello Di and Misho,

Will be looking at the food stuff for you shortly. Just wanted to send you a :YMHUG: in the meantime.

 

[Di&Misho]

Aine and Mel thank you !

Hope I didn't lose you in translation. nailbite_smile

Mel and The Fur Gang

I am very sleepy right now but I think I can follow you just one thing was not very clear to me

I would free feed or in your case put down a full can at amps, +4, & +8 because of the longer onset and later nadir.

:roll: I feed him 1 can between AM shot and +8 and another can between PM shot and +8 200 grams in total

Just wanted to send you a :YMHUG: in the meantime.

Thank you Aine hug bug for you at home :YMHUG:

I have just come back home.Tested Misho at +4 - 378.... His numbers are going up . I don't know what is going on. I won't test later tonight as I know he won't go low. It is good I will sleep more hours and will stay at home but I am worried something is going on again :sad: I will read again your comments tomorrow and hope everything will be more clear in my head.

 

[Critter Mom]

Misho's Weight History:

Weight (measured at vets):

Dx (Apr '14): 2.70 kg
July: 3.20 kg
20 Oct: 3.90 kg
21 Oct: 3.70 kg (urinating a bit more)

Weight (measured on home scales):

08 Nov: 3.74 kg

Ideal Weight: 4.0 - 4.5kg

Di, next time you go to the vets if it's possible bring your own scale with you and weigh Misho on both his own scale and the vets' scale. That way you'll be able to relate his historical numbers to the numbers you get from now on and therefore have an indication of Misho's progress since his diagnosis. Minor differences between Misho's scales and the vet's scales don't matter in the grand scheme of things because you'll be monitoring weight changes from now on with Misho's own scales. I know that it's tough seeing Misho not yet at his ideal weight, but just look at the progress he has made since diagnosis! That's all down to your care, Di. :thumbup

Now to feeding.

Misho's weight in lbs = 4.5 x 2.2 = 9.9lbs so to make things easier let's say Misho should be 10lbs ideal weight.

Per Dr Lisa's formula, Misho's calorie requirements per day for his ideal weight are:

(13.6 x 2.2)lbs) + 70 = 206 kcal per day

Now using Mel's recommendation to add about 20% extra kcal/day to Misho's approximate calorie needs for his ideal weight we get:

206 x 1.20 = 247 kcal/day (250 kcal/day in round numbers).


From the info on the other thread, we can now calculate how much to feed Misho:

Granatapet Veal & Rabbit ( 0.943 kcal per g) / Daily food allowance: 250 / 0.943 = 265g (about 1 1/3 200g cans per day or 2 2/3 100g cans per day.)
Granatapet Pollock & Seafood ( 0.871 kcal per g) / Daily food allowance: 250 / 0.871 = 287g (about 1½ 200g cans per day or approx 3 100g cans per day.)

On days when you need to be away from Misho, perhaps if you split up the portions so that you maybe feed two same-sized meals and a slightly smaller meal at +8 that might work with the insulin profile. For the days when you may be spending a little more time with him maybe you could give him several mini meals during the time you are with him and leave the rest for him to finish in his own time? (Mel - maybe you could confirm whether these are good suggestions for Di and MIsho?)

As you go along, as well as recording his weight, here's a body condition chart for you to monitor his progress:

Body Condition Scoring Chart

Hope this helps a bit! I'm very relieved to hear that you're going to be able to get a bit more sleep. What you do to help little Misho is amazing! You have a wonderful heart.

:YMHUG: cat_pet_icon

 

[Di&Misho]

Thank you Aine for your help. As of yesterday evening Misho has 260grams per day of Granatapet Veal and Rabbit . I hope he will put some more weight and I will let you know of course when it happens.

On days when you need to be away from Misho, perhaps if you split up the portions so that you maybe feed two same-sized meals and a slightly smaller meal at +8 that might work with the insulin profile. For the days when you may be spending a little more time with him maybe you could give him several mini meals during the time you are with him and leave the rest for him to finish in his own time?

I am always away dear. I spend with him very little time but we see each other at his insulin shot , +4 and +8 both AM and PM . When I stay overnight we have enough time to spend together and Misho likes cuddling and purring- poor baby he needs company.
I follow the same schedule of feeding you suggested two same-sized meals at insulin shot and +4 and small one at +8 . I cannot leave any food for him to "graze" he will eat everything at once so this doesn't work with us.
I also browsed the link and Misho is definitely thin as he has hollow flanks . I believe that with the amount of food he has now he will gain some weight soon.
:YMHUG: cat_pet_icon

 

[Critter Mom]

I'm so glad I could do some little bit to try to help you both, DI. Wish I could do more... :YMSIGH:

Fingers and paws crossed in the Shire that Misho will start regaining weight with his yummy new food. I'm glad the body condition chart helped you to assess him. I see from Misho's spreadsheet that he's getting more blues and greens now. Well done you! :thumbup

When I stay overnight we have enough time to spend together and Misho likes cuddling and purring- poor baby he needs company.

Misho may lack quantity of company, but when it comes to quality he has got to be one of the luckiest kitties in the whole wide world: he gets to be cared for by you, Di. Company just doesn't come better than that.

:YMHUG: cat_pet_icon

 

[tibbs5]

hi Di
hope Misho starts to gain some weight for you. yes he is very lucky to have you. take care.