Hello-new member. Humans Danny and Kim, Cat Toby

[mellodc]

Hi everyone. We got the news about Toby's diabetes about 10 days ago. He's an orange tabby, 17 yrs old. Since then we've scrambled to get all the gear, insulin pen, syringes, monitors etc. We changed his diet to diabetic dry alternating with wet pate. He's always gotten wet dry, but we reversed the times so we could give him his shots 2 times a day morning and night etc. after the wet food. We will do the first monitoring starting Monday. It's been a week of shots today, and he seems a little better. But it's only 1 unit and he's still manic about eating, still drinking more water than he used to. Some of the eating craze we think might be changing the order he gets his food, but it could be that he's still hyper glycemic, and 1 unit 2x
for a week isn't enough to notice much of a change. We don't know, of course, this is all new for us. We want to help him as much as possible. We had some out of town trips planned but we cancelled those so we could be here to give him injections. Any suggestions about what we can expect going forward would be helpful. We are grateful to have a community to share. Hope everyone out there and all your kitties are doing OK!
Danny

Toby

 

[CORKY]

Welcome to FDMB
Toby is beautiful, we all become very overwhelmed when we hear that our precious fur baby is diagnosed with diabetes, but the good thing is that it is manageable, with the right diet a food schedule the right insulin, home testing, and of course lots of cuddles,
Diabetic cats need to have a wet can or raw food diet between 0-10% carbs, a feeding schedule, the need to eat 3-4 small meals or snacks during the day, beside the two main meals before shot, Grazing is not an option. if you are not home during the day, a wet food feeder is a great option, there are feeders with chips and cameras. The Diabetic dry food you are feeding is not healthy for Toby it contains between 20-30+% carbs, cats cannot digest carbs, removing this high carb food needs to be a slow transition not to upset the stomach and removing the high carbs to low carbs will most likely dive the glucose levels, this is where home testing comes into action. Most members use Fancy Fest Pates or Friskies between 0-10% most feed up to 5%, "prescribed or diabetic food" does not exist, this is only a commercial fraud, that has been in courts, is a way of sales person and Vets to make a commission, most vets do not even know the nutrients in these foods.
You should create a HYPO KIT this should have some medium carb foods between 11-15%, some high carbs foods between 16-24% carbs some KARO Syrup or honey, in case the glucose level is below 50, we can assist you if there's a hypo episode, is best to raise the BG with food rather than the karo or honey these two are just a quick fix. Also for home testing most members use the ReliOn premier human monitor and strips ( Walmart) or any human meter is good no need for a pet meter, the strips re very expensive, also a curve is best done at home it saves you money and stress on Toby, a curve is simply testing every 2-3 hours for 1 cycle (12 hours), there's also the option of CGM LIBRE by ABBOTT, link below
The best insulin for cats are Lantus and ProZinc they area 12-hour insulin and gentle on the cat, what insulin are you using on Toby?, it takes approximately 3 cycles (3days) to see the progress of the dose you are giving, but if Toby is still drinking and very hungry is due to high glucose levels due to the dry high carbs he's eating; or due to ketones, this also keeps the levels high. below is a Drs approved food list the third column contains the carb %s.
We are here for you, keep posting your concerns, we can assist you with dosing as well.
;
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

 

[mellodc]

Hello and many thanks, great info. Well at least we spent 50 bucks on supposedly healthier dry food , but we can always give him 1/2 can of pate at those times. We were following the vet prescribed food regimen, but as you say, we have seen negative comments about all dried food. And Toby likes wet food better anyway, so we could make that switch. He's getting Lantus insulin. We've read about the Hypo kit and the use of food to bring him up if need be, so thanks for the reminder. So far he's still acting hungry, thirsty and alert. But this is end of week one, with "diabetic" dry food on board and only 1 unit 2x daily of insulin after the big meals.

 

[CORKY]

To find the correct carb foods
0-10% low carbs
11-15% medium carbs
15-24% high carbs, (most gravy foods)
Is good to know you have done your homework; Toby is very much loved! it takes a lot of the stress out. We are very numbers oriented, if you would like us to help you and e do not have to as the same questions over and over, we would like you to create your signature and Toby's spreadsheet links below, also in our main menu there are sticky notes with much valuable information, also a carb food calculator, you will use the nutrients % of the label

Sticky - New? How You Can Help Us Help You!
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
Carb Calculator - Felinediabetes.com

 

[CORKY]

FYI
There’s no such thing as a healthier dry cat food, sorry to disappoint you, they are all high carbs, they have dyes which can cause UTIs and many other risks factors such as large storage in warehouses causing bugs in the food, Etc, best to stick with the wet can foods one of the reason most members use Fancy Feast is because it is US made so it’s regulated and no waste goes into the food, so you will see a change in the litter box, were as with dry food having waste Toby probably poops every day and often, with wet food it will change to every other day once a day is a game changer

 

[mellodc]

FYI
There’s no such thing as a healthier dry cat food, sorry to disappoint you, they are all high carbs, they have dyes which can cause UTIs and many other risks factors such as large storage in warehouses causing bugs in the food, Etc, best to stick with the wet can foods one of the reason most members use Fancy Feast is because it is US made so it’s regulated and no waste goes into the food, so you will see a change in the litter box, were as with dry food having waste Toby probably poops every day and often, with wet food it will change to every other day once a day is a game changer

Yes, we believe this is true. We switched him to all wet, 3oz cans. Whole can, half can, alternating at 6 hour intervals. He weighs 13 pounds. He’s still bugging us after eating for more food. Could be the the time change or the diabetes, we don’t know. Monday will be the first monitor hook up, having it done at the vet, and will see what they recommend going forward, but we are open to all help, and very much appreciate your input.

 

[CORKY]

His desire for food will diminish as he’s glucose level lowers, since the vet is placing the new sensor for CGM, you should know that you can continue to change it at home without stressing him, it’s very simple, also please keep several sensors handy, they last 14 days, maybe less so is good to always have a hand held monitor at hand, to test especially if you come across low numbers, glad you will be feeding low carbs

 

[squeem3]

New diabetics are always hungry so you generally want to feed as much as the cat wants. Multiple small snacks spread throughout the day works. A programmable timed feeder works great for this purpose. The only thing to know is to not give any food 2 hours before insulin. Food can cause a bg spike. It's ok to ignore the vet's food recommendations and scheduling.

There's info about CGMs here: Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats If your vet didn't mention it, a CGM needs to be replaced every 2 weeks or sooner and a replacement is expensive. You'll need to keep a few on hand just in case one fails or falls off.

You can manually test your cat's blood glucose levels with any Human blood glucose meter. It's much cheaper. Even if you use a CGM you do need to know how to manually test if the CGM fails or reads LO. A drop of blood is taken either from the edge of the ear or a paw pad.

There's info on using Lantus here: Lantus / Levemir / Biosimilars

 

[mellodc]

Hi folks, Just an update on Toby. After giving him his insulin for a little over a week, we had the monitor put on and managed to get over 24 hours of readings before it fell off. The vet said that was enough to get an initial look at how he was doing, and indeed his initial blood work had showed his glucose at 490 (!), and after putting on the monitor we watched his level dip down to a low of 180, before leveling off, trending slightly back up and then the readings stopped. This was after only a week of 1 unit of Lantos 2x daily. The vet recommended we continue for three more weeks at that level, and then monitor again. Meanwhile, he’s obviously improved. He’s much calmer, drinking much less etc. That said, he still starts bugging us for food an hour or two before feeding and he’s still drinking and peeing a bit more than he used to. We will put on another monitor on the 21st so in about 10 days, and see how he’s doing. We have been trying to keep to the schedule of eating and injections recommended by the vet, which is the same as above. No dry food in his diet anymore. And the shots come shortly after his main meals. I know that seems to be not what some people here have said, but several vets have said injections during eating ( he doesn’t like that) or shortly after are recommended, so that’s what we’ve been doing. If someone thinks that’s wrong, please give us your reasoning and we will run it by the vet and check it out ourselves. We of course want to do the best we can for our boy! Thanks again to everyone here. And Toby thanks you as well!

 

[CORKY]

Welcome to FDMB
The CGM can be convenient to a point, yet you have found out early in the game, one of the flaws, Lantus is a good insulin for cats is a 12-hour insulin gentle on Toby, Lantus it is a Depot so when you first start insulin it takes 5-7 days to begin to see results on the glucose levels, 1 unit to begin is a good dose, however home testing is very very important before each shot to avoid hypoglycemia, and with another flaw of the CGM is that the low number will read lower than reality, so we recommend to re test manually and take the manual reading as value, most member use the ReliOn premier human meter and strips (Walmart) $9.00 for the meter and the strips $9.00 for 50 or $17.88 for 100, or any human meter is good, they are inexpensive and accurate, you do not need a pet meter, the strips alone cost $1.00 each, and you always need extra strips , is good to get 2-3 readings during the day, plus testing before each shot
Diabetic cats need to have a diet of wet or raw food between 0-10% most members feed Fancy Feast or Friskies Pates between 0-10% carbs most feed up to 5% , so grazing is out of the question, Toby should not feed two hours before testing or shot. the protocol for Lantus is TEST-FEED-SHOOT most members shoot while our cats face is in the bowl, then testing 2 hours after shot is important, this is when the insulin kicks in, Make sure your vet is updated on Feline diabetes procedures as well, let him know what you have learned here, most updated vets are aware of our Worldwide Forum, and support it. One thing to remember, You know Toby more than your vet does, you are in control, you want as you say the best for Toby, and regulate him as soon as possible, so his pancreas start healing. We are very numbers oriented so we would like you to create your signature and Toby's spreadsheet so we can all be on the same page, links below, also a Drs approved food list, the third column contains the carb % for each food. We are here for you, please keep posting

Sticky - New? How You Can Help Us Help You!
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
Info - Dr. Pierson - new Food Chart

 

[CORKY]

Also keep in mind that cats are very sensitive to stress, and what bigger stressor than a vet visit, so when the vet test the glucose level it will not be a realistic level, this is why when a vet recommends a curve, which is testing every 2-3 hours during one cycle (12 hours) keeping the at in a cage, all day long the stress is even higher, so we suggest that curves should be done at home, at the vet the levels again will be unrealistic, causing for an unnecessary dose increase

 

[Sienne and Gabby (GA)]

Just to make a few corrections....

There are a few dry foods that are low in carbs. Dr. Elsey's Clean Protein and Young Again Zero Carbs are acceptable low carb options. Aside from the carbs in other dry foods (including the prescription diabetic kibble), the other issue with dry food is the lack of moisture. Cats have a limited thirst drive. It's one of the reasons that many cats develop kidney issues as they age. In addition, diabetes is hard on the kidneys. A canned food diet helps with kidney health.

A diabetic cat can graze. It's fine. You just want to be sure to not offer food in the 2 hours prior to shot time. One option is a timed feeder. There are several feeders that have space for an ice pack so you can make sure the food stays fresh.

I would encourage you to get a hand held glucometer and learn how to home test. While the CGMs are helpful, you need a back-up if it stops working. It's really important to know if. your cat is in safe blood glucose numbers before you give a shot. It's also important to know how low your dose is brining numbers. There is information on Lantus in the sticky notes at the top of the Lantus board. The notes will give you information about how Lantus works, dosing methods, etc.

 

[mellodc]

Just to make a few corrections....

There are a few dry foods that are low in carbs. Dr. Elsey's Clean Protein and Young Again Zero Carbs are acceptable low carb options. Aside from the carbs in other dry foods (including the prescription diabetic kibble), the other issue with dry food is the lack of moisture. Cats have a limited thirst drive. It's one of the reasons that many cats develop kidney issues as they age. In addition, diabetes is hard on the kidneys. A canned food diet helps with kidney health.

A diabetic cat can graze. It's fine. You just want to be sure to not offer food in the 2 hours prior to shot time. One option is a timed feeder. There are several feeders that have space for an ice pack so you can make sure the food stays fresh.

I would encourage you to get a hand held glucometer and learn how to home test. While the CGMs are helpful, you need a back-up if it stops working. It's really important to know if. your cat is in safe blood glucose numbers before you give a shot. It's also important to know how low your dose is brining numbers. There is information on Lantus in the sticky notes at the top of the Lantus board. The notes will give you information about how Lantus works, dosing methods, etc.

Thank you, Sienne. You've mentioned a few times about not feeding him ( 2 hrs) before giving him his shots, but several vets and others seem to think giving shots just after feeding is best, partly because the food makes the glucose go up, and you are less likely to give him too much insulin or drive his numbers too low if you give a shot at this time. What do you believe is wrong with it? Of course, at this stage we don't claim to know anything. he gets his shots at this point 1unit 2x daily just about 30 minutes after he eats his 3oz can of Fancy Feast pate.

Also keep in mind that cats are very sensitive to stress, and what bigger stressor than a vet visit, so when the vet test the glucose level it will not be a realistic level, this is why when a vet recommends a curve, which is testing every 2-3 hours during one cycle (12 hours) keeping the at in a cage, all day long the stress is even higher, so we suggest that curves should be done at home, at the vet the levels again will be unrealistic, causing for an unnecessary dose increase

Thank you, too! We haven't left him at the vet in a cage ever, and the first time we monitored him, all of the readings were done in a 24 hour period at home, so not in the more stressful vet situation-which is good advice, thanks for that. That will be our next move as well. We are pretty sure, even without readings, that he isn't getting too much insulin at this point. But he may be getting too little, but we really won't know until we monitor again. We didn't know that the CGM is less accurate/reads lower than the manual test, so we will check that out. Thanks again. We will try to get a spreadsheet together for Toby.