andiecu said:
The vet is making the decision to change the dose based on the pre-shot levels on the chart (I gave them a link so they can look at it whenever they want).
Lantus is dosed based on a daily nadir value, not the preshots. Here is a link to the Lantus dosing protocol for you to print and give to your vet:
http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf (There's a more user friendly version that we use on the boards
here).
With Lantus, you need to test at least 3 times a day--once before each shot to make sure it's safe to give insulin, like you've been doing, and then a third test about halfway through either cycle. That third value will show you how the insulin is working. Of course, you can always test more than that because any tests you can get will help you piece things together, but those are the minimum number of daily tests, preferably with a curve once a week.
andiecu said:
My husband asked when we first changed foods. First of all, we decided to change to wet food because of all the information on this site. The vet doesn't seem to think dry or wet matters, as long as it's D/M. Secondly, regarding "why" D/M is so much better, her answer was that "they have found the perfect blend of carbs and protein", but didn't seem to have any other answer. To me, it seems like the Purina rep has convinced her it is the only way to truly help your cat. If she continues to insist, we will require more information than that though.
Here is a link to the
American Animal Hospital Association diabetes guidelines, and I've also attached an article on how to safely and effectively use Lantus to treat diabetes in cats. Both documents discuss that a low carb, canned diet is needed. I would print these as well for your vet. I would also direct your vet to
http://www.catinfo.org, which explains why prescription diets are unnecessary, and has a nutrition chart with the protein/carb/fat values of many commercial cat foods in the bar on the right hand side of the page. Purina DM canned isn't a bad food for diabetics at 3% carbs (it's the only prescription food that is suitable for a diabetic)--but it's WAY overpriced for what you're getting. As you discovered, you can get a better quality low carb food like EVO for less than what you're paying for DM. If you look at the ingredients:
Liver, poultry by-products, meat by-products, water sufficient for processing, chicken, salmon, oat fiber, salmon meal, guar gum, potassium chloride, carrageenan, salt, Vitamin E supplement, calcium phosphate, taurine, thiamine mononitrate, zinc sulfate, ferrous sulfate, niacin, calcium pantothenate, copper sulfate, Vitamin A supplement, manganese sulfate, menadione sodium bisulfite complex (source of Vitamin K activity), pyridoxine hydrochloride, riboflavin supplement, Vitamin B-12 supplement, biotin, folic acid, Vitamin D-3 supplement, potassium iodide. I-4573
It's nearly the exact same thing as Fancy Feast Liver and Chicken, also made by Purina, so all you're doing is paying a huge markup for the prescription label:
Liver, meat broth, meat by-products, chicken, poultry by-products, artificial and natural flavors, calcium phosphate, guar gum, potassium chloride, taurine, salt, magnesium sulfate, zinc sulfate, thiamine mononitrate, Vitamin E supplement, ferrous sulfate, niacin, manganese sulfate, calcium pantothenate, Vitamin A supplement, copper sulfate, menadione sodium bisulfite complex (source of Vitamin K activity), pyridoxine hydrochloride, riboflavin supplement, Vitamin B-12 supplement, biotin, folic acid, Vitamin D-3 supplement, potassium iodide.
The dry DM contains soy flour and the highly glycemic corn gluten meal, two ingredients a diabetic cat should never have, and is too high in carbs. Also, a diabetic should not eat dry food because it dehydrates cats, and dehydration is one of the ingredients for a deadly complication of diabetes called diabetic ketoacidosis.
andiecu said:
We feed Miles twice/day at 8:00 am and 8:00 pm. I'm a stay-at-home mom so smaller meals throughout the day isn't out of the question. Is that a better method for treating him?
Cats have metabolisms twice as fast as people or dogs, so it's best if you feed them (and especially diabetics) at least 4 times a day, or more if you choose. I feed Bandit every 6 hours, and I work two jobs, so when I'm not home or want to sleep in on the weekends I freeze his portion of food and put it in an auto-feeder to go off at his scheduled meal time. I also always wanted to make sure he had food available during the day when I was at work at his usual nadir (lowest point of the cycle, about 6 hours after the shot) in case his BG dipped a little too low--low carb food will give a nice small, natural boost to BG that wears off in just a couple hours.
andiecu said:
he is quite uncomfortable with us using a "human" glucose meter instead of the feline model. Despite her obvious "brain-washing", we are still comfortable with our vet treating Miles because she is allowing us to push her out of her comfort zone for treating a sugar kitty. I'm really hoping Miles can show her Purina D/M and feline glucose meters aren't the only options.
I would show him both the study I attached and the Lantus protocol I linked to up top--both of these speak to using either human or pet meters, with human meters being the preferred choice because of the availability and price. It makes no difference which you use in terms of the protocol--if you look, the first part of it is written for human meters, and the second part is adjusted for pet meters. All you do is change your target ranges--so 50-120 is normal BG on a human meter, and 80-150 normal on a pet meter. It is far more important that you be able to afford to test as frequently as you need to (at least 3 times a day). Not that I'm questioning your vet's priorities, but I would like to point out that his office makes money selling you both the DM and the Alpahtrak meter and strips, so he does have a financial motivation to convince you that you need these things. However, I don't want that to sound like I'm badmouthing your vet, because he may not be doing it consciously because both the meter and food reps are very aggressive in convincing vets these things are necessary, and your vet has you started out in a much better place than many new people who show up here (good insulin, home testing, low carb food).
