Food and insulin dosage for Hansel, advice needed.

[Zekono]

Hi

Previous thread for more info, I tried to include the important stuff in this post though.

We see a clear trend of his average BG getting lower the more wet food we give him.
He eats less dry food voluntarily since we give him wet food. Sometimes he "steals" a bit from the other cats when they have leftover wet food in their bowls.

He still has these symptoms:
- Huge amount of urine (pees for 20+ seconds)
- Diarrhea (exlusively)
- Vomiting (a few times a week, almost always at nighttime)
- Staying near a water source (way less than my last post, at that time his average was 25~ mmol/L or 450 mg/dL. At this time it's 19.5 mmol/L or 351 mg/dL)

Right now he is getting wet food, 3 bags combined in total each day:

- Sheba selection poultry in sauce 9% dry matter carbs - 85gr/3 oz

Spoiler: Sheba selection poultry in sauce

- Felix sensations variety pack 12% dry matter carbs - 85gr/3 oz

Spoiler: Felix sensations variety pack

and free access to dry food:
- Ultima Urinary Tract 42.4% dry matter carbs

Spoiler: Ultima Urinary Tract

There's a clear lowest point BG around 4-6 hours after his food. (Spreadsheet in signature)
We'd like to give him more wet food to regulate this but we're afraid his BG will drop too low and would get a hypo.
(He might need a lower insulin dose the more wet food he gets or rather the less dry food he eats?)

We need advice how to get his wet food up while bringing his BG down.

Thank you for reading and a purr from Hansel.

 

[Chris & China (GA)]

We'd like to give him more wet food to regulate this but we're afraid his BG will drop too low and would get a hypo.
(He might need a lower insulin dose the more wet food he gets or rather the less dry food he eats?)

9.5 is WAY higher than you need to worry about. We recommend intervening with high carb canned food (like Fancy Feast Gravy Lovers....beef is 20%) only when they drop below 3.8 on a pet meter.

The reason we keep pushing that you test every day is that no one day tells the whole story. If Hansel is bouncing on the day you happen to test, he could be going much lower and you don't know it.

As long as there's any of the dry in his diet, it's going to be nearly impossible to get him regulated, much less into remission so keep working on getting rid of that. If you must use it to feed your other cats, you need to stop free-feeding. They will whine, moan and groan, but they can get used to being fed on a schedule. That way you could keep Hansel in one room while he eats his canned while the others can eat the other. After 15-20 minutes, you take the dry food away until the next feeding time.

It can be helpful to read other people's posts and look at other people's spreadsheets. I learned a lot doing that because others would ask questions I never thought to ask and I'd learn from what worked for others so I could use it on mine.

 

[Diane Tyler's Mom GA]

Your previous post you have didn't work, it said site can't be reached
Here it is
https://felinediabetes.com/FDMB/thr...eadsheet-and-give-advice.296505/#post-3232072

 

[Zekono]

9.5 is WAY higher than you need to worry about. We recommend intervening with high carb canned food (like Fancy Feast Gravy Lovers....beef is 20%) only when they drop below 3.8 on a pet meter.

The reason we keep pushing that you test every day is that no one day tells the whole story. If Hansel is bouncing on the day you happen to test, he could be going much lower and you don't know it.

As long as there's any of the dry in his diet, it's going to be nearly impossible to get him regulated, much less into remission so keep working on getting rid of that. If you must use it to feed your other cats, you need to stop free-feeding. They will whine, moan and groan, but they can get used to being fed on a schedule. That way you could keep Hansel in one room while he eats his canned while the others can eat the other. After 15-20 minutes, you take the dry food away until the next feeding time.

It can be helpful to read other people's posts and look at other people's spreadsheets. I learned a lot doing that because others would ask questions I never thought to ask and I'd learn from what worked for others so I could use it on mine.

Thank you for the information and insights!

We are indeed planning to get them fed on a schedule!
One problem is that one of our other cats (Schmidt) needs full-day access to food. He has a tooth problem and he only eats in small bits.
He will get dental surgery for this at the beginning of March.
If our finances allow next month, we will get an automatic feeder for Schmidt and/or Hansel.

I think IF Hansel has enough portions of wet food during a day, he won't really be going for the dry food.
What we could do is give him more wet food every few days and keep tracking.

I suppose once the BG gets too low, we need to do tests closer to eachother. I'm unsure how it works though.
Can the BG for example go from 8 to 3.8 in an hour or less? What if it drops from 5 to 3.2 or so in between the measurements?
I'm not trying to nitpick here, just thinking of the best way to do it without endangering him!

Spoiler: Hansel

 

[Chris & China (GA)]

One problem is that one of our other cats (Schmidt) needs full-day access to food. He has a tooth problem and he only eats in small bits.

If I remember right from browsing through your past post, I would suggest getting him off the dry food and onto canned only. It's a myth that dry food does anything for teeth and canned is better for urinary tract disease (especially stones) since the more water you have flowing through the urinary tract, the less likely it is for anything to have time to develop.

Can the BG for example go from 8 to 3.8 in an hour or less?

Anything is possible, but this is VERY unlikely. One of the things I like to do is try to always get a +2. In a lot of cats, that can almost predict where they will go later in the cycle. If the +2 is lower than the PS (more than just meter variance), that's your early warning that he might be dropping lower later in the cycle. If he's dropping too fast early, you can feed him to slow him down and plan on testing more frequently.

What if it drops from 5 to 3.2 or so in between the measurements?

Any time he drops below 3.8, you will want to intervene with some high carb food to nudge him back above 3.8 and keep testing for the next few hours to make sure he doesn't drop back down again when the high carb food wears off. He will also "earn" a reduction in his dose. He's already on a huge dose that he may not need (no way to know without daily testing). Most cats top out around 3U (although there are cats that do require more...it's just what I've seen in all the years I've been here).

By reducing his dose if he drops below 3.8, what we are hoping is that they will keep "earning" reductions until they're on zero (although the dose can be reduced and then increased again, then reduced, etc.) Take a look at some other spreadsheets and you'll see doses can change quite frequently.