I am new and overwhelmed. PLEASE ADVISE.

Hello, thank you so much for reading this. Going to try to keep this short and concise for you guys.

So, my 7 year old MN, 8-10lb cat Kuma was diagnosed 8/20/20 with a BG of 500 by his Pennsylvania vet. He had polyuria, polydipsia, polyphagia, some lethargy and a bit underweight. He did not begin insulin treatment until 9/4/20 due to me having to relocate from Pennsylvania to Florida in that two week timespan. During this time Kuma was staying with my mother in which she was giving him Friskies Wet Classic Pate Salmon Dinner BID or TID.

Went to Florida vet on 9/4/20 Kuma had tx done with a BG of 494. No ketones, no glucosuria, no bacteria, no high bun or muscle atrophy etc. She gave me a vial of Prozinc, U-40 syringes and advised I feed Kuma RX diet 1/3 of a cup Royal Canin Glycobalance DRY food BID and give 2 units of Prozinc BID at 12 hour intervals. I feed and treat between 6am-7am/6pm-7pm.

Now, I want to say that although the Florida vet has some empathetic qualities, I dislike her overall because I feel like she is relatively old school and won't be open-minded to my suggestions and/or irritated at my questions. She can be a bit rude. She advised that I do not do any home testing of Kuma's BG. I was stressing to her that I can do it and want to do it as I understand the importance of knowing his levels but she was not receptive to it at all, advising that I bring him in for a fructosamine test in 4-6 weeks. That already makes me feel like she isn't very supportive nor confident in at least maintaining Kuma's health as a partnership. I may not be a veterinary professional but ultimately, I have to have some kind of autonomy and education in order to take care of him properly. And I have to be able to feel like I can talk to her and I just do not at this time.

Also, she did not truly explain to me why I must feed the dry food Glycobalance just that "it will help regulate his blood sugar levels. It's a prescription diet, it will help." Yes, but how? How can high carb dry food (at 23%?) help a diabetic cat in the first place? She just did not explain the benefit in depth enough for me to believe it fully. I bought it anyway just to be safer than not.

I followed the vet's regimen for two weeks to a T. No scheduled small snacks or anything. Yet I still noticed Kuma's PU/PD and some more weight loss. This is when I began introducing small snacks throughout the day, it would be a quarter of friskies wet pate or small pieces of raw chicken breast every 4 hours or so.

Needless to say, I bought the AlphaTrack 2 Glucometer from Chewy. I took Kuma's BG today in which it was 582mg/dl 7:07am. Now, I am considering cutting back on snacks but I don't want him to lose weight. Worried.

So here are my immediate questions and *concerns*:

I want to test throughout the day, but at what times? I use Prozinc 2 units BID. I plan to keep a diary.

Regarding diet, has anyone used Royal Canin Glycobalance and did it work in maintaining BG levels in the long run?

Does raw food or a wet food diet show promise in decreasing high BG levels overtime?

Anything else I should know? Please tell me what I am doing wrong/right. What do you think of the vet I have now? What would you do? I am considering changing vets after Kuma's fructosamine test with this current one.

*My main concern are costs. I just relocated with my fiance from PA to FL. In this relocation I had to quit my job as I was not able to transfer. Currently looking now and have interviews set up but I do not want to be very dependent on my fiance. I am still picking off of my savings.*

*My PA vet mentioned getting an abdominal ultrasound to ensure there is no tumor pressing on the pancreas as that would make regulation difficult. This is not an immediate concern right now
due to my finances. In my area, ultrasounds can range from 600-1000$. I am trying to do what I can with what I have.*

Thank you very much. I appreciate all the help.

 

We have fl members here who might be able to help you find a new vet cause you need one!
that said
WELCOME TO FDMB!
Y ou and Kuma have an up hill battle to climb we will help you get to the top!
first you MAY just want to start here:

New? How You Can Help Us Help You!

We are dedicated to helping any and all who finds us so you and Kuma HAVE landed in a safe plcae!

WELCOME TO OUR FAMILY
jeanne

 

you can use this as your diary!
FDMB SPREADSHEET INSTRUCTIONS

 

I am very appreciative! I am in South Miami, in the Coral Gables area. I will definitely take a peek at those documents but can you provide an opinion to my post when you have time? I thank you very much again!

 

Welcome! You already seem so confident in what you are doing and the choices you are making for Kuma - well done!!!

I'm based in the UK so can't help with vets but I just wanted to say if you're not happy with your vet - move on!! I did and I feel so much better for it. Kyra and I (and my husband and other 2 cats) are still finding our way through all of this but having a positive vet makes such a difference. Our old vet had Kyra in once every 2 weeks for BG tests (consult fee everytime) and was trying to get me to pay for Fructose tests every 3 weeks (about £100 a go), despite us home testing a whole bunch... It will do you the world of good to switch, when I did I even sent a lengthy email, spreadsheet attached, telling them what I expected from them as our new vet.

Now some proper helpful people will be along soon to help you with your questions

 

I have N O use for this food. Theres NOTHING special about it but the price.
We recommend a LOW arb can (wet food) such as Fancy Feast Pate they are all under 10% carbs. If you have a dry food junkie (like my Trouble was) theres are BETTER low carb options such as Dr Eleys OR Young Again. I'm sure other members will chime in on this!

This is a high dose to be starting on but we see this all the time again that is for our veterans to address

 

Our spreadsheet can be your diary AND once you see it you will see how and when to test. This ALL can be mangge when you do find employment

Already addressed
dry food is PACKED with carbs. its like throwing gasoline onto a fire.

ABSOLUTELY Immediate as well as long term!

You have the right frame of mind to be handling this disease I WISH I could say for your vet. If it were me I'd leave that practice.

There are ways and means to cut corners bit at first? It can get expensive. Looking for a new vet can get expensive. There are things like Care Credit. They help greatly. Also if things get really bad money wise you can ask at DCIN (Lets cross that bridge when IF you get to it.

This si something I cant address. There are many member here with multiple issues. You will have that experience to lean on.

Again welcome to the best site on this planets to learn everything you need to know about feline diabetes and beyond.
j.

 

Hi there. Welcome to yourself and Kuma.

Not a lot.

Look for a new one.

I think it's a good plan to trust your instincts on this one. As you correctly observe, a collaborative approach and a progressive attitude are key qualities to look for in one's vet. In the forum FAQ section there is a topic covering suggested questions to ask when interviewing a new vet.

That smacks of a standard pitch from a pet food company rep.

You'll find great information about feline nutrition at this vet-authored site:

catinfo.org - Feline Diabetes Page

I've linked you to the page with key information about safely managing diet changes for cats receiving insulin but it's very much worth your while reading the whole site.

I see Jeanne has given you some initial links to get you started. Here's another helpful link explaining a little more about using the spreadsheet:

Understanding the Spreadsheet Grid

In terms of costs, when you are regularly home testing then there will be no need for fructosamine tests or vet-run glucose curves, you can do the latter easily at home and the data you gather will be more accurate because the blood glucose (BG) readings won't be influenced by vet/travel stress.

I see that you're starting to test with an Alphatrak. It's a very good meter (I have one myself) but the test strips are a bit pricey. Most members here use human glucometers (with an appropriate, cat-specific BG reference range) to monitor their cats because strips are cheaper. Also all the dosing guides here are written with reference to human meter numbers. If you do decide to change to a human meter, the Relion Prime from Walmart has the cheapest strips and is a popular choice among US members. Walmart also do lancets (29-gauge or lower) and urine ketone test strips.

WRT insulin and syringes, I'm in the UK so can't help with that but hopefully other US members who use Prozinc will be able to give you some tips on cost of these items. There's an active Prozinc support group here at FDMB. Here's a link:

https://felinediabetes.com/FDMB/forums/prozinc-pzi.24/

Check out the yellow information 'sticky' posts at the top of the board to learn more about how Prozinc works and also dosing methods for this insulin.

I hope some of the above will help to get you going.


Mogs
.

 

Hey there, feel free to look back in my post history, but our vet had us on this diet as well. We have two diabetic cats in the house, and they were both fed this for some time. Our first diabetic cat, Boo has been on this food for the last 6 months, and by all accounts has been looking better than he has since he was diagnosed about 3 years ago. We are planning on switching him to a lower carb diet as well as soon as we get his sister regulated better and we can switch our focus to him. With a 6 month pregnant wife, and myself working two jobs, we have a lot going on!

The great thing about this forum is that pretty much all suggestions here are cost friendly. There will be some expenses to be sure, but there are a lot of cost friendly alternatives. We use the ReliOn Prime from Wal-Mart and the test strips are less expensive, I believe.

You will be overwhelmed for sure, but the one thing that this group has taught me is patience, this is a marathon, not a sprint. With our first diabetic cat, it took years to feel like we were seeing any improvements, and that was without this group. I can't imagine how much better, quicker, he would have gotten had I found this group. Keep plugging away, celebrate the small victories, and don't get discouraged!

 

Thanks Mogs!

 

Truly love the dryness of this answer!!

 

I am so very thankful for everyone's responses. I feel a bit more confident now and not as lost. I tried consulting my PA vet about my FL vet's choices but she won't return my messages. She probably doesn't want to get entangled in this or offer an conflicting opinion which I understand. Yet another red flag of this FL vet was when she advised I feed Kuma 1/3 of a cup of the dry food. She thought he was quite underweight. That amount is already so small to begin with in addition to her thinking he was underweight.....It just didn't make the most sense to me? -ugh, whatever, man-

Anyways, I'm very glad some of you said what I suspected of the rx food. I feel like before I proceed with any testing or dietary choices I should research as much as I can to be better prepared with a dietary plan and proper feeding schedule. Just easier said than done. In your opinion, do you think I should just stop the RX food now or just continue until his fructosamine test? What about snacks? I know ultimately I will have to try some things in order to find what better fits my cat, but just would like opinions for me to brew over.

I do thank you all.

 

If you DO decide to take away that dry food do it SLOWLY. A little lees of it every time you put it down. Example: When I took away Troubles dry food (and he WAS an addict) his numbers dropped 100 points overnight. Had we not been testing he couldnt have gone hypo. So removal is slowly and testing essential!

The snacks are easy. ANY freeze dried meat is perfect. 0 carbs! Many here swear by Purebites minnows or chicken. There are others
LOL you are sure to get more responses about treats.

 

Because Kuma is now on insulin you need to hang fire on changing the carb load of his food until you've begun home testing his BG levels, reason being that the current insulin dose may need to be reduced. If you read through the catinfo.org link above, the author covers how to safely manage the process of reducing dietary carb load.

@Panic -

Elizabeth, any chance when you have a moment that you could you give Kuma's Person a few basic pointers on best times to test and to feed during a Prozinc cycle, please?


Mogs
.

 

You might want to post a new thread something like this
? Lookin for a vet in South Miami ,Coral Gable area
You might get more eyes on it

 

Hello there! LOVE your username haha!

So IS Kuma underweight? A cat should on average get 20 calories per lb of ideal weight. An unregulated diabetic needs twice that amount. An underweight unregulated diabetic needs even more, as much as he wants. Don't restrict food from an underweight cat.

Some rules about food. Free feeding is best, though doesn't always work depending on the household/cat's eating habits. When testing, we keep food up for 2 hours prior to shot-time to provide us with a "fasting number". We also try to keep food in the first half of the cycle, before Kuma's nadir. We won't know what his nadir is until you start testing, but on Prozinc it's usually 5-7 hours after insulin. A good rule of thumb to start is small meals at +2, +4, and +6 hours after insulin. This INCLUDES the PM cycle, kitties need food at night. However, when my girl was severely underweight and unregulated, I let her eat at her scheduled meal times, AND any other time she asked. After nadir you normally want to refrain from feeding because it will "burn up" the insulin faster and won't last the full 12 hours. I would give zero carb treats after nadir if she was still hungry.

Cost sounds like an issue, so cancel the fructosamine, return the Alphatrak and get a ReliOn Prime meter from Walmart. $9 for the meter, $18 for 100 strips. You can also buy the lancets there for $1-2 for 100. Fructosamines, glucose curves, and the Alphatrak are going to eat you alive with costs.

 

As for the food - once you start testing you can reduce the dose by 30-50% and start introducing the low-carb wet food safely. 2 units is a high starting dose so he may benefit from it anyway. You can also pick up some Ketostix from Walmart/any pharmacy and check for ketones during the transition.

 

Panic is right on all counts. Get the ReliOn it’s a great reliable meter and you’ll save a ton on the strips which is where your money will be burning fast since you should be testing about 4 times a day at least. Once you start testing, get your kitty off of dry food. It’s the worse for diabetic cats. Most of us feed FF pate which is less than 10% carbs and perfectly good and fine for them. Here’s a chart with pretty much all pet foods amour there and their carb content. You want to be under 10%

and yes, more food! A good rule of thumb for daily calorie intake is 20 times ideal weight, as Panic said. So if he should be 10 pounds, he should be getting 200 calories a day at least. More if he needs to gain. Diabetic cats lose weight because they can’t process the nutrients in food well so they eat but are still constantly hungry and lose weight. They also burn calories just by peeing since there’s sugar in their urine.

btw, most of us here don’t consult our vet regarding the diabetes anymore. By home testing, you’ll be in control and you’ll figure out, with our help at first, when to change doses. You don’t need their input or permission. It’s very freeing when you realize you know more than they do ha!

 

Coral Gables is a very expensive area. I went to college in Miami. I’d look for a vet a bit out of the area. Not super far but you should be able to find one further south. When I lived there, my vet was in the Miami Shores area. An ultrasound shouldn’t be more than $450 and that’s here in Los Angeles! But if there are no symptoms, you’re right it’s not an urgent matter. Keep it in mind though if he starts to vomit, feel nauseated and not want to eat. Then you’ll need one.

 

Ok, so I did some testing today, it was not very consistent as you can see but I wanted to get into the swing of things right away.
11:03am - 375mg/dl
6:26pm - 624mg/dl
6:45pm - 558mg/dl

This was all before any meals/snacks. I gave insulin at 7p today. I was thinking about testing around 9p or 10p. Thank you to those who mentioned the glucometer ReliOn, but one question: how do you interpret a cat's reading from a human glucometer?

In regards to that Alphatrack, are the readings from 6:26 and 6:45 trustworthy?? Can someone explain the major difference if so?
Also, Kuma is not underweight at this time. He weighs about 10-11lbs. Spine is not palpable and ribs are not very visible/palpable (probably due to my snacks over the past couple of weeks).

I feel like I have to hit the ground running so I can get an understanding of Kuma's levels, but at the same time, I don't want to turn him into a pin cushion. Not to mention, I have to learn to incorporate so many things at once I feel, intervals in which to test/nadir etc. choosing snacks, making a decision about the horrid RX food, choosing the right glucometer, the spreadsheet. All of it I want to digest and understand right away but I know it takes time. I just do not want him to suffer for it in the long run.

A bit overwhelmed again but I know this is a process. I will be reading some of the replies to this thread over again so I can get things into perspective.

 

You're picking up things a lot quicker than most people so don't feel stressed! You won't learn it overnight, there's too much info. Diabetes is a complicated disease. Get the framework down first, then we'll start filling it in.

Get a test in at +2 (2 hours post-shot, which would be 9pm). We don't give exact times because everyone here is in a different timezone, we base them off how much time has passed since the shot (+1 is one hour after, +2 is 2 hours after, etc). A +2 is always handy to get at every cycle because if there's a noticeable dip that's an indication to be aware, the cycle will be active. Or if it goes up/doesn't move it's probably going to be a fairly chill one. Generally.

Meters are allowed up to a 20% variance, so the 624 and 558 are the same number essentially. Keep that in mind.

Human meters run lower than pet meters, but it's not a problem because we adjust accordingly. The info you find here, unless specifically stated, is based on human meter numbers. There's no comparison between the two, just remember that the human meters are a little lower, but when they get down to numbers under 100 (where it's important) they are pretty accurate of each other. I think an Alphatrak's non-diabetic numbers are 80-150 and human meters are 50-120.

When you can, I would make a spreadsheet from the instructions Jeanne linked above (or if it's too much, we can have a mod create one for you. One less thing for you to stress about). We use these as our guides when helping others understand BG and dosing. We also share them with our vets.

 

You will get more eyes and advice when you start one of these:
FDMB SPREADSHEET INSTRUCTIONS

 

oh did I do that already? lol

ETA: and I cant for the LIFE of me remember where that pesky info is for signatures ..dang I've been on since 4 am I MAY need a nap!

 

It’s here:

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Make sure your signature is up-to-date.

• On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
  • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add any other text, such as
  • Caregiver & kitty's name (optional)
  • DX: Date
  • Name of Insulin
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Thank you!

 

Thank you Ale. She might not be ready to do this right now but I wanted it handy and I'll be darned BRAIN FART!