High Numbers

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Wendy&Neko said:
Hello and welcome from the west coast of B.C. :) None of us here knew much about diabetes when we started. It does seem overwhelming at first, it that’s why we are so willing to help new people.

I had to deal with urinary issues and diabetes at the start. My girl cat got her diabetes diagnosis and one week later my boy cat got his for cystitis. She wanted to wolf his food, but the CD was too high in carbs, so I switched him to a low carb, low phosphorus diet with water added to his food. I really needed a diet that worked for both. As others have said, once you are testing enough to keep your girl safe, you can think about changing foods. The vets sell you their food, so may not want you to change. It took a while for me to get my boy cat’s vet to come up with something both could eat, and she eventually suggested raw.

Changing to a good low carb diet has made a huge difference for many kitties, provided you are testing enough to do so.
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I'm Going to have to get use to the testing, before I can look at changing her food. I did switch her treats to freeze dried she loves loves them :)
 
MrWorfMen's Mom said:
Can you feed Molly half or 3/4 of her usual meal, then test her? That way she gets part of what she wants and then will come to see the rest of her food as a treat for being a good girl. This is a common problem and as long as you test immediately after she finishes eating, any food influence in the numbers should be negligible.
Did you warm her ear? That helps. Don't rub the ear......rather massaging it from the head up toward the poked spot. As you test more, the ears will grow more capillaries and blood samples will be easier to get. You may also find that one ear bleeds better than the other.
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I can give her a little of her moist food then test her. I can try that tomorrow morning. I tried the sock and rice yesterday afternoon. She didn't mind that but this morning she just wanted her breakfast lol. I'll try massaging her ear today. Yesterday I gad to poke in further, rather than on the edge of the ear. I got more blood to test.
 
Absolutely right. Being able to test reliably is necessary before making any diet change. I know it seems really hard right now but I guarantee it will soon become much easier and very routine for both you and Molly. :)
 
MrWorfMen's Mom said:
That's fine but try to avoid poking right on the vein unless absolutely necessary. Not only can it be messy but it's also more uncomfortable for Molly. :)
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The vets tech told me to test right on the vein. But after reading in here and seeing the sweet spot.I aim for there but not much blood yesterday when I tried that. I got use to needles I'm hoping the testing will become easier too. But she's a spoiled cat!
 
Kris & Teasel said:
Adrienne, you can keep posting here for now. If you're concerned about not giving the 5 u dose your vet recommended you can give it. I'd try 4 u if I was in your position. Keep feeding Molly the same way for now.

Were you able to get a pre shot test?
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I gave her 5 units this morning where her BG was higher than the previous day.
 
Kris & Teasel said:
Any luck getting an evening pre shot test? Not here to judge, just keeping an eye.

When I test Teasel I actually sit on the floor in my bathroom with him sitting up between my bent knees facing forward. I wrap a loosely rolled hand towel around his neck like a cervical collar people with a neck injury wear to keep his head steady. He's inclined to toss his head suddenly when I'm trying to poke and this restricts his movement gently. My bent knees act like a sort of wall on each side of him. He gets a freeze dried chicken treat before and after each test - also before and after insulin injections. I free hand the poke.

Try some different techniques with Molly to see what location, method of loose restraint, etc. makes it easier. The calmer the human, the calmer the kitty too. ;)
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No evening pre shot
 
Kris & Teasel said:
Some questions for you whenever you have some time:
  1. How was Molly's diabetes diagnosis arrived at? Did the vet do a fructosamine test or only a single BG test in the clinic?
  2. Did she ever have steroids to treat her asthma?
  3. When she developed urinary problems were crystals found in her urine? A lot of crystals?
  4. Did she every get totally blocked from her urinary problems?
  5. Did her urinary issues come and go over time, ie., flare up and then subside repeatedly?
  6. Was there any mention of something called "idiopathic cystitis" or "feline urinary syndrome" when she had urinary problems?
  7. Did the vet account for the extra stress when she was at the clinic to have a curve done? Did he mention that stress can cause BG to run higher?
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I suspected she had diabetes, I went get up in the morning and step in something sticky, she lost weight and her drinking water increased alot
Vet did a fructosamine test and the BG test.
Her asthma ( I have asthma too) she uses the Flovent and it's a steroid. But she may need it once a month now, not very often
Crystals were found in her urine and yes alot she would pee blood sometimes
I don't think she was totally blocked for urinary problems
She got her crystals in the month of August and it took 5 months for them to clear up. That was 5 years ago and nothing since then
No mention of idiopathic cystitis or feline urinary syndrome, she does get stressed easy and will pee in her carrier. When she knows she's going to the vet
Yes, the vet did account the extra stress when at the clinic, and that the BG can be higher because of that.
 
Did you get a test this morning? If so can you put the AMPS reading number on your spreadsheet. We rely on that data when making dosing decisions so anytime you get a reading, put it on your sheet as soon as it's convenient to do so.
I have no experience with urinary crystals or cystitis so I can't comment on that but I am sure Kris will chime in when she sees your response. Good to know a fructosamine test was done to make the diagnosis and not just a random BG test in the vet's office.
 
MrWorfMen's Mom said:
Did you get a test this morning? If so can you put the AMPS reading number on your spreadsheet. We rely on that data when making dosing decisions so anytime you get a reading, put it on your sheet as soon as it's convenient to do so.
I have no experience with urinary crystals or cystitis so I can't comment on that but I am sure Kris will chime in when she sees your response. Good to know a fructosamine test was done to make the diagnosis and not just a random BG test in the vet's office.
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I tried to get a test done this morning. She wasn't cooperating but I will get a test done today. Tomorrow morning I will feed her a little bit, then test her. See how that goes!
 
Adrienne Vanderhoning said:
She got her crystals in the month of August and it took 5 months for them to clear up. That was 5 years ago and nothing since then
No mention of idiopathic cystitis or feline urinary syndrome, she does get stressed easy
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Sometimes crystals show up in cats that have idiopathic cystitis, as in Teasel's case. He was put on RC Urinary S/O canned food for that reason and ate it for several years. I had some dry food that I used only as a treat, not as part of regular feeding. When he was diagnosed with diabetes in January of 2016 my vet recommended a switch to low carb canned food and removal of all dry food. The S/O was too high in carbs for a diabetic. She put him on prescription Purina DM pate (6% carbs) and he ate that for a long time. I'd mix in other low carb canned food to vary the flavour and I added extra water to all his wet food meals. I've continued to do that and Teasel's cystitis issues have essentially disappeared. His meals are like soup but he eats them willingly. Diabetics are often dehydrated so any extra water I can get into him is a bonus.

I suggest you give more thought to switching Molly to just the canned S/O for now. Down the line a switch to low carb food would be best because the S/O is about 20% carbs.
 
Adrienne Vanderhoning said:
I did Molly’s BG this afternoon. It was 15.2 I increased to 5 units this morning. Would it work that fast?
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Not necessarily. The only way to see what's going on is the try that testing routine I outlined above. You can't draw any good conclusions from one BG number unless it's really low. You have to see the whole picture, the patterns over time to know if a dose is working. That's the reason for the testing routine we promote here.
 
Yes, I fed her last night the S/O wet. But I can’t test her BG in the morning. She eats a little then I test her. I see her numbers are higher in the morning. Why?
 
Higher numbers in the morning is very common. It's related to the changes in other hormone levels that happen in the AM. I suggest you continue feeding more of the canned S/O until that's almost all she gets. It'll make introduction of low carb canned food easier. Do what you can to desensitize her around the ear pokes and get you more comfortable with it too.

One thing that's suggested if the kitty is ravenous before a meal and is fighting the BG test because of that is to feed a small amount of the wet food (maybe a tablespoon?) and test right after that's been consumed. It can take the edge of kitty's hunger but there won't be enough time to allow the food to affect the BG reading. Maybe try that when it's time for the pre shot BG tests.
 
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Adrienne Vanderhoning said:
I did switch her treats to freeze dried she loves loves them :)
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Bear loves his freeze dried chicken treats too, so in the mornings when he thinks he is starving and won't hold still I give him multiple treats to take the edge off.
The benefits are he gets something in his stomach immediately plus the chicken treats are ZERO carb so it doesn't effect his BG and he is in position for me to test him.
 
Kris & Teasel said:
Higher numbers in the morning is very common. It's related to the changes in other hormone levels that happen in the AM. I suggest you continue feeding more of the canned S/O until that's almost all she gets. It'll make introduction of low carb canned food easier. Do what you can to desensitize her around the ear pokes and get you more comfortable with it too.

One thing that's suggested if the kitty is ravenous before a meal and is fighting the BG test because of that is to feed a small amount of the wet food (maybe a tablespoon?) and test right after that's been consumed. It can take the edge of kitty's hunger but there won't be enough time to allow the food to affect the BG reading. Maybe try that when it's time for the pre shot BG tests.
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I fed her some of the wet this morning. Then tested her. I didn’t do anymore tests today. Wasn’t feeling well myself. She’s playful tonight and I fed her more of the wet this evening. Tomorrow is test day where I’m feeling better. . I also noticed she’s not drinking as much water.
 
Bear & Lora said:
Bear loves his freeze dried chicken treats too, so in the mornings when he thinks he is starving and won't hold still I give him multiple treats to take the edge off.
The benefits are he gets something in his stomach immediately plus the chicken treats are ZERO carb so it doesn't effect his BG and he is in position for me to test him.
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I bought a small bag of the beef. She loves it I’ll try the chicken next. She looks for them now after I test her.
 
Adrienne Vanderhoning said:
I bought a small bag of the beef. She loves it I’ll try the chicken next. She looks for them now after I test her.
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I buy the (Purebites Freeze Dried Chicken Breast for Dogs) and break them into cat size bites to save $. Not sure if that is available in Canada.
They do have the large bag size Purebites Ckn Breast on Amazon @ $24.99
Bear thinks they are ambrosia from heaven, lol.
In fact don't throw away all the crumbles and powder in the bag when it is empty.
I put them in a small container and when Bear's appetite is low I sprinkle them on top of his wet.
When I open the lid to the crumbles he will literally run to me and cry for the food insistently while I am adding it. :D
 
Congrats on getting an AM pre shot test and one more done. Slow and steady wins the race. :)

What does she think of wet food for breakfast and supper? I'm glad the freeze dried meat treats are a hit!
 
Kris & Teasel said:
Congrats on getting an AM pre shot test and one more done. Slow and steady wins the race. :)

What does she think of wet food for breakfast and supper? I'm glad the freeze dried meat treats are a hit!
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Thanks, I’ve been so stressed this past week. That I pretty much slept all day yesterday . But today I have tested her. Her numbers are still high. I’m going to test again at 3:30. She is liking the wet for supper.but I think she misses her other treats. I have her 3 today. She does eat the freeze dried treats. I think she likes her old better. How long before the 5 units takes a hold? Vet said usually a week?
 
Adrienne Vanderhoning said:
Thanks, I’ve been so stressed this past week. That I pretty much slept all day yesterday . But today I have tested her. Her numbers are still high. I’m going to test again at 3:30. She is liking the wet for supper.but I think she misses her other treats. I have her 3 today. She does eat the freeze dried treats. I think she likes her old better. How long before the 5 units takes a hold? Vet said usually a week?
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I think she'll get used to the increased wet food feeding over time. It's definitely the way you want to go.

The 5 u dose is likely not enough because the food she eats is high carb. There will be a dose that gets her down to better BG levels but it'll be driven by what she's eating. It's quite likely that if she was eating low carb wet food only her dose would be lower. If you're seeing your vet tomorrow you might want to revisit the food issue with him. He probably wants Molly on it because of the episode of crystals but that was a long time ago if I understood you correctly. Many crystal prone, cystitis prone kitties do well on wet food only and you can get her used to having water added to wet food meals. The S/O acidifies the urine and that can help with dissolving crystals but my experience with Teasel has shown me that wet food with added water can work well.
 
Kris & Teasel said:
I think she'll get used to the increased wet food feeding over time. It's definitely the way you want to go.

The 5 u dose is likely not enough because the food she eats is high carb. There will be a dose that gets her down to better BG levels but it'll be driven by what she's eating. It's quite likely that if she was eating low carb wet food only her dose would be lower. If you're seeing your vet tomorrow you might want to revisit the food issue with him. He probably wants Molly on it because of the episode of crystals but that was a long time ago if I understood you correctly. Many crystal prone, cystitis prone kitties do well on wet food only and you can get her used to having water added to wet food meals. The S/O acidifies the urine and that can help with dissolving crystals but my experience with Teasel has shown me that wet food with added water can work well.
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I email the numbers to him tomorrow. He usually calls and suggests what to do. Probably up it to 6 units I’m guessing. I’ll mention the food again tomorrow. But I know he won’t want to change it.
 
Adrienne Vanderhoning said:
I email the numbers to him tomorrow. He usually calls and suggests what to do. Probably up it to 6 units I’m guessing. I’ll mention the food again tomorrow. But I know he won’t want to change it.
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As far as food goes, think about it yourself. If you decide you want to try something different you have every right as Molly's owner to do that. It's stressful to go against the vet so it's your call.
 
Kris & Teasel said:
As far as food goes, think about it yourself. If you decide you want to try something different you have every right as Molly's owner to do that. It's stressful to go against the vet so it's your call.
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I want to change her food. But I’m scared how’s the numbers going to be? What happens if they go too low?
Do I keep her at 5 units and can still introduce her to low carb?
 
Adrienne Vanderhoning said:
I want to change her food. But I’m scared how’s the numbers going to be? What happens if they go too low?
Do I keep her at 5 units and can still introduce her to low carb?
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If you go that route we'd likely suggest a drop in dose to keep her safe. If the lower dose proves to be too low it can be raised in 0.25 u increments every 3-4 days. If/when you decide to try that we can suggest a lower dose to try.
 
Kris & Teasel said:
If you go that route we'd likely suggest a drop in dose to keep her safe. If the lower dose proves to be too low it can be raised in 0.25 u increments every 3-4 days. If/when you decide to try that we can suggest a lower dose to try.
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I’ll see what the vet says tomorrow. Go from there and I’ll let you know. I bought some Weruva wet to try. But I thought I’d try a little tonight.
 
Ok still waiting to hear back from the vet. They just opened and it could be all day. Where I didn't change her units til Friday to 5 units. Does that make a difference? I know the vet had mentioned a full week for it to take notice. But I also read 3 days. I gave Molly Weruva to try last night she loved it. How much of a dose do a cut back to? if I change her food to the wet?
 
Adrienne Vanderhoning said:
Ok still waiting to hear back from the vet. They just opened and it could be all day. Where I didn't change her units til Friday to 5 units. Does that make a difference? I know the vet had mentioned a full week for it to take notice. But I also read 3 days. I gave Molly Weruva to try last night she loved it. How much of a dose do a cut back to? if I change her food to the wet?
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The 5 u dose should have done its thing by now. I'm glad Molly liked the Weruva. Which one did you try? Some are very low carb (1%) and some are high (20%). You can find them on page 58 and on on this chart: https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Re lowered dose: my thinking is a drop to 2 u should be OK. It's "educated" guesswork so getting key BG tests will be very important: every
AM and PM pre shot, at least one in the +4 to +7 on days off and one before bed every night. I suggest you work on your testing mojo intensively so you're ready to monitor properly if you try the food change.

I'll see what @MrWorfMen's Mom thinks of this. She has a lot of experience. :)
 
Kris & Teasel said:
The 5 u dose should have done its thing by now. I'm glad Molly liked the Weruva. Which one did you try? Some are very low carb (1%) and some are high (20%). You can find them on page 58 and on on this chart: https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Re lowered dose: my thinking is a drop to 2 u should be OK. It's "educated" guesswork so getting key BG tests will be very important: every
AM and PM pre shot, at least one in the +4 to +7 on days off and one before bed every night. I suggest you work on your testing mojo intensively so you're ready to monitor properly if you try the food change.

I'll see what @MrWorfMen's Mom thinks of this. She has a lot of experience. :)
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I bought the pouches. But I see they're still high in carbs. It was a tuna flavour and soupy. My husband was frustrated this morning with her numbers. I'll stop at the pet store today and look at the Weruva wet food in the can. Or maybe fancy feast? If I switch her to the new wet will she be ok? where she eats the S/O wet? Will her tummy get upset? What about the dry just cut back on that for now?
 
MrWorfMen's Mom said:
Did you get a test this morning? If so can you put the AMPS reading number on your spreadsheet. We rely on that data when making dosing decisions so anytime you get a reading, put it on your sheet as soon as it's convenient to do so.
I have no experience with urinary crystals or cystitis so I can't comment on that but I am sure Kris will chime in when she sees your response. Good to know a fructosamine test was done to make the diagnosis and not just a random BG test in the vet's office.
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Kris and Teasel tagged you in a thread on here. Not sure if you get notified? Need some help with switching out Molly's food to low card wet. Where she is at 5 units?
 
Sorry for delay. Just refreshing my memory about Molly as I've been scarce here the last couple of days! :)

Assuming there is no history of ketones or DKA in Molly's past and the high carb content of the RC SO food she has been eating, I think dropping the dose to 2u during the transition phase would be prudent. Lower carb food can have a significant effect on BG so testing as Kris has outlined is crucial and I would definitely suggest a gradual transition to avoid any sudden dramatic BG drop or any GI upset.

The carbs in the SO food are high so if you cut back on the dry SO food by a quarter every couple of days but continue with the wet SO until the dry is out of the picture totally, then start transitioning over to the low carb wet food, it should keep the change from being as dramatic as a one shot switch. That way we can track how Molly's BG is being affected and make insulin dose adjustments accordingly.
 
MrWorfMen's Mom said:
Sorry for delay. Just refreshing my memory about Molly as I've been scarce here the last couple of days! :)

Assuming there is no history of ketones or DKA in Molly's past and the high carb content of the RC SO food she has been eating, I think dropping the dose to 2u during the transition phase would be prudent. Lower carb food can have a significant effect on BG so testing as Kris has outlined is crucial and I would definitely suggest a gradual transition to avoid any sudden dramatic BG drop or any GI upset.

The carbs in the SO food are high so if you cut back on the dry SO food by a quarter every couple of days but continue with the wet SO until the dry is out of the picture totally, then start transitioning over to the low carb wet food, it should keep the change from being as dramatic as a one shot switch. That way we can track how Molly's BG is being affected and make insulin dose adjustments accordingly.
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Ok let me see if I understand. She eats about 1 cup of dry a day so cut back to a quarter a day?
Wet food S/O I feed her for breakfast , started supper feeding with the S/O. So still stay on the 5 units for now? until I transition her over to the low carb? What if my vet suggests bumping up her insulin to 6 units?
No history of ketones and not sure what DKA is?
 
Cut the dose back to 2u as soon as you start reducing the dry food amount.
Feed 3/4 cup of dry and continue with the wet SO but give her a bit more of the wet food to make up for the calories you have removed by reducing the dry food allotment.
Maintain that for 2 days. This will allow you to hone your testing skills and allow monitoring to see how the reduction in carbs is affecting Molly.
Then reduce the dry to 1/2 cup daily for a couple of days, again adding in more SO wet to make up for the calories in the 1/4 cup of dry you've taken away.
Repeat until the dry is out of the picture and all Molly is eating is the SO wet.
Then we'll get you to start reducing the amount of SO wet food and replacing it with the Low carb wet food. By this time, I'm sure you will be a testing pro!;)

As for your vet, what you do to keep Molly safe at home is totally up to you. 5 units is a lot of insulin for the majority of cats and as you switch to lower carb content in her food, the amount of insulin Molly needs will also drop. It's even possible that the 5u dose is already too high because too much insulin can look just like too little. If you tell the vet you are taking the dry food away which will lower the carbs Molly is currently getting, the vet should understand why you won't be increasing Molly's insulin dose at this time.

If there has been no history of ketones then Molly has not had DKA which is diabetic ketoacidosis which is great!
 
MrWorfMen's Mom said:
Cut the dose back to 2u as soon as you start reducing the dry food amount.
Feed 3/4 cup of dry and continue with the wet SO but give her a bit more of the wet food to make up for the calories you have removed by reducing the dry food allotment.
Maintain that for 2 days. This will allow you to hone your testing skills and allow monitoring to see how the reduction in carbs is affecting Molly.
Then reduce the dry to 1/2 cup daily for a couple of days, again adding in more SO wet to make up for the calories in the 1/4 cup of dry you've taken away.
Repeat until the dry is out of the picture and all Molly is eating is the SO wet.
Then we'll get you to start reducing the amount of SO wet food and replacing it with the Low carb wet food. By this time, I'm sure you will be a testing pro!;)

As for your vet, what you do to keep Molly safe at home is totally up to you. 5 units is a lot of insulin for the majority of cats and as you switch to lower carb content in her food, the amount of insulin Molly needs will also drop. It's even possible that the 5u dose is already too high because too much insulin can look just like too little. If you tell the vet you are taking the dry food away which will lower the carbs Molly is currently getting, the vet should understand why you won't be increasing Molly's insulin dose at this time.

If there has been no history of ketones then Molly has not had DKA which is diabetic ketoacidosis which is great!
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Ok, I see the past few days she hasn't been eating as much dry, not sure why. I'm just worried I won't be able to get her off the dry. Mix the low carb with water once I have her on that?
I find sometimes when I prick her ear, not enough blood comes out. I massage it but nothing, then I have to prick her ear again.
My vet doesn't want me to change her food. Where she had crystals before, but like I told Kris that was 5 years ago now.
 
Adrienne Vanderhoning said:
Yes, I'm printing it off lol. But I'm still scared
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Adrienne Vanderhoning said:
Ok, I see the past few days she hasn't been eating as much dry, not sure why. I'm just worried I won't be able to get her off the dry. Mix the low carb with water once I have her on that?
I find sometimes when I prick her ear, not enough blood comes out. I massage it but nothing, then I have to prick her ear again.
My vet doesn't want me to change her food. Where she had crystals before, but like I told Kris that was 5 years ago now.
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Did you try warming her ear first? Did I tell you about the "rice sock" that many of us use? Take an old, clean sock, put about 1/4 cup of dry uncooked rice in the toe, tie it off and warm it in the microwave until it's *safely* hot (ie., you can comfortably handle it). Put it over her ear for 15 to 30 seconds before you try to test.

Being scared is normal. The remedy is to work on overcoming any of the testing issues, both hers and yours, so you're prepared to monitor as much as needed. Aside from that, Linda gave you a good plan for the food change - very slow and careful. You can post here any time for help. It's like many things - scary before you begin, a lot less so once you're doing it.
 
Another thing to get going: start adding a little bit of warm water to each of Molly's wet food meals. Start with a teaspoon or two. As time goes on you can increase that amount to whatever she'll tolerate. It's one of the best things you can do to keep her well hydrated and her bladder flushed. I do that for Teasel. His meals are like soup.
 
This thread is really long now so I suggest you start another one on this same forum. Give it a new title - something like "Help For Molly".
 
Kris & Teasel said:
Did you try warming her ear first? Did I tell you about the "rice sock" that many of us use? Take an old, clean sock, put about 1/4 cup of dry uncooked rice in the toe, tie it off and warm it in the microwave until it's *safely* hot (ie., you can comfortably handle it). Put it over her ear for 15 to 30 seconds before you try to test.

Being scared is normal. The remedy is to work on overcoming any of the testing issues, both hers and yours, so you're prepared to monitor as much as needed. Aside from that, Linda gave you a good plan for the food change - very slow and careful. You can post here any time for help. It's like many things - scary before you begin, a lot less so once you're doing it.
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Yes, I'm going to start her on the plan right away. She has gained weight she looks good again. So playful lol

I do heat up a sock with rice every time now. But she doesn't like that poke!
 
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