Introduction: Looking for feedback on SS

Hello all, my name is Kim, mom of sugar kitty Gus.

Just a little (but long) introductory post, looking for some feedback.

Background:
We are fairly new to diabetes. Diagnosed on July 20, 2021. He was prescribed 1 unit 2x/day of Lantus (now 2 units - see below for more info). We home test (human meter). No signs of Ketones but still testing once a week.

He’s a ‘healthy’ 16lbs - he’s a big structured, muscular boy - not just chubb. He’s on a low carb FF Pate and gets freeze dried treats and I just started boiling chicken breast for him as a snack in between meals as he is still extra hungry. It should be noted that I feed him whenever he asks, but I’ve noticed I get constant higher (probably food influenced) numbers throughout the day where we should be seeing onset and nadirs, so I thought boiled chicken might help keep that down a bit. He still gets 3-4 cans of wet per day - he’s most hungry in the morning hours. To be honest, his feeding schedule is irregular.. I’m working on this but not sure when the best times are for him.

I had a recent conversation with my vet about his numbers and other related notables and he told me to increase his dose to 2 units on Oct 8. I’ll ask politely to not get a slap on the wrist for following his orders I am aware that here, it is recommended to only increase by .25/.5u. This doesn't mean I won't take suggestions or feedback, I’m just trying to work with my vet and his plan for Gus. I will not increase any higher than .25 or .5 units if the need to increase is needed in the future - I would fight that - I have a really great relationship with my vet with lots of knowledge - particularly with cats. His RVT is my oldest friend (they are a travelling vet team).

Reason for post:
I’ve been following this forum (and FB sister) since Gus was diagnosed. I truly love how dedicated the mods and admins are… they (you) have a wealth of knowledge that I can appreciate and trust in.

I’m hoping that someone (or two or three..or more) with experience might have a look at Gus’ spreadsheet and give me some feedback on how you think he’s doing and any suggestions to help get him regulated. My mission is to gather as much info as I can for my next Vet chat or for my own good.

I just did a curve today to see how the new dose is doing - this should be helpful, hopefully.

Please let me know if I’m missing any important info above or if my spreadsheet isn’t available in my signature, this is my first post here.

 

Hi and welcome to the forum!
Well done hometesting, having the SS and the signature set up, and testing for ketones! Very helpful.
Looking at the SS, Gus seemed to be doing very well during the first couple of weeks on 1 unit when you had the libre attached.
Then the numbers were not as good. Did you do anything different during this time?

A few of things I would do to help Gus

• Try and always get tests in during the pm cycle. It is just as important as the am cycle. Try for a before bed test in every night. If that test is lower than the PMPS test, I would set the alarm and test again to see it has not dropped too low. It will also give us valuable data.
• Have a look at the two dosing methods we have DOSING METHODS here and choose one of them. You will do much better if you are following a method. Holding the dose too long can make it harder to bring down the BGs as glucose toxicity can play a part. I would only increase the dose 0.25 units when needed.
• I would look at trying to get set feeding times for Gus and stick to them each cycle. For example feed the main meals at shot time then +2, +4 and +6 each cycle. It is better to feed during the first half of the cycles when the insulin is strongest. If you think he will not last until the next dose (for food) maybe offer some food at +8. Also adding some warm water, if he will accept it, to the food will keep him fuller longer.
• look at maybe getting an automatic timed feeder to help you with the feeding schedule.

Before I increased the dose I would get some of those pm cycle tests done as cats often drop lower at night, and we could be missing something.
Keep asking questions, we are happy to help and again welcome to you and Gus.

 

I'm going to tag a few people. I think the 2U may be too high...we generally don't go back down in dose, but I wonder if the big increase missed a good dose. But I'm not experienced enough to say for sure. What happened when the libre started and after? Numbers went a little wonky

@Wendy&Neko @tiffmaxee @Bandit's Mom
@Bron and Sheba (GA)

Edit: removed some stuff since Bron just barely beat me to it lol

 

Thank you for tagging FrostD/Melissa

I was a little hesitant to up the dose by 1 full unit.. I honestly asked my vet about increasing to 1.5 but he saw the numbers and said 2u... but I'm afraid that the perfect dose could have been missed also.

When I was testing, I noticed that he didn't drop when he should be, rather went up... You'll notice i did a weird +1 test on Oct 14, thinking that maybe he was dropping lower then his body is used to and was having small bounces ... I'm not even sure if that is a thing in the first hour with Lantus but I wanted to make sure. Also not sure if bouncing is within such close range numbers or if it's usually only really low then really high (not like Gus' 10-15 or 196-272).

 

I don’t think you have gone past the best dose. You stayed on 1unit for 2 months after you stopped using the libre, but didn’t do a lot of testing and could easily have missed some lower numbers.
I don’t know what happened between when you stopped using the libre and when you started hometesting but there is quite a difference in the numbers.
Did you change the food at all?

 

I replied but it seems my message need moderators approval? Let me retry sending

 

*Trying to post this again*

Thanks for the warm welcome, Bron
I know, I was a little disappointed in the change in numbers from the Libre - both my vet and myself were shocked that he had regulated so quickly.

I took it upon myself (didn't discuss with the vet) to change his diet during this time.

On the Libre his "new" diet was 2x 2.25oz meals/day (at insulin time every 12 hours), 1/4 dry (snack at +8) - this met his total kcals for the day. I had been feeding him Performatrin Ultra (Pet Valu Canada holistic brand) wet and dry. I was told that the Performatrin Ultra wet and dry was too high in carbs when joining the FB group, which I agree 100% on the dry food (first ingredient made me sick when I saw potato, that changed at some point and I never noticed) wet had some carrots and veggies etc... that isn't great either!

This was my effort to see if maybe we could go into remission with a low carb food change. I'm guessing the fact that he didn't eat much throughout the cycle is why they were lowers and in a good range. Makes me wonder it this is something I should go back to, but I'm not sure that Gus would be able to hold off for the 12 hours these days - he's always been a good eater but a little extra lately.

Example would be on September 4/5 he was refusing food throughout the day (but eating at insulin time) and his number came down mid cylce - he had some litter troubles from the food switch that I think he associated with the new food.

I will start getting more bed time tests in tomorrow (I'll give Gus Gus' little ears a break tonight from todays curve). I'm a bit of a nighthawk (especially on the weekends) so this won't be hard.

Thanks for the link on the dosing methods, I will have a look asap! I'm in a bit of a rock and a hard place with dosing.. I truly am torn between listening to my vet and just going ahead and getting the help here. I do have a good relationship with my vet, so having an open conversation about anything new I learn here is not out of the question.

For feeding, I will give that a try and stick to it. It's somewhat what is happening now give or take a half hour. I feed a larger meal at test time, then he wants food (smaller, 1/4 FF cans, snacks) at +2, +4 and +6, then he takes a long nap - then at +9 he gets a little something to tide him over otherwise he will tear up my couch and drive me bananas until he gets PMPS shot/meal. I'm also waking up 3 hours before AMPS to give him a snack as there were 2 mornings that he had vomitted and I felt it was from hunger ... so he now gets a small snack at that time, hasn't happened since. I have been adding a bit of water to the meals, but maybe I'll see just how much he'll tolerate.

Sorry, long response. Thanks for your help!

 

(I'm cutting out the food portion from my post while it gets an approval from the mods... not sure what I've done or said wrong - hopefully this will post fine)

I was a little disappointed in the change in numbers from the Libre - both my vet and myself were shocked that he had regulated so quickly.

I took it upon myself (didn't discuss with the vet) to change his diet during this time.

On the Libre his "new" diet was 2x 2.25oz meals/day (at insulin time every 12 hours), 1/4 dry (snack at +8) - this met his total kcals for the day. I had been feeding him Performatrin Ultra (Pet Valu Canada holistic brand) wet and dry. I was told that the Performatrin Ultra wet and dry was too high in carbs when joining the FB group, which I agree 100% on the dry food (first ingredient made me sick when I saw potato, that changed at some point and I never noticed) wet had some carrots and veggies etc... that isn't great either!

This was my effort to see if maybe we could go into remission with a low carb food change. I'm guessing the fact that he didn't eat much throughout the cycle is why they were lowers and in a good range. Makes me wonder it this is something I should go back to, but I'm not sure that Gus would be able to hold off for the 12 hours these days - he's always been a good eater but a little extra lately.

Example would be on September 4/5 he was refusing food throughout the day (but eating at insulin time) and his number came down mid cylce - he had some litter troubles from the food switch that I think he associated with the new food.

 

Hi Kim
You don’t need moderator approval to post anything so I don’t know what happened there.
In regards to the food…..have you taken all the dry food away now and only feeding a low carb wet diet?
I would not go back to only feeding at shot time. It is much better for the pancreas to get smaller meals more often and I’m sure Gus would be much happier too!
Gus will get hungry until his numbers become more normal. This is because the nutrients can’t be utilised properly until he is getting enough insulin…..this will happen. It just takes time.
I would try sticking to feeding him (as much as possible) in the first half of the cycle. Add some warm water if he will let you to the food to help fill him up. Don’t feed for the 2 hours preshot so the BG isn’t food influenced.
Try and get at least 1 test in every cycle, at different t times if you can, so we can see what is happening. Test more often if you have the opportunity.
Get those night time tests in as well so we can see what is happening.
And read the two dosing methods. The tight regulation will give you faster results, but you need to be only feeding a wet diet and need to test at least 4 times a day.
Bron

 

Yes, he is only eating wet (FF) now. I have Dr. Elsey’s chicken on hand just incase .. but I rarely give it to him.. like 4 kibbles once a week (maybe not even every week) … for whatever reason if he doesn’t eat his wet, if I put 4 kibbles beside his dish he eats it. My civvie is an old girl that’s a bit set in her ways and loves her crunchies… She is mostly on wet now also but sometimes her head goes up and she’ll only eat dry.

(From original response that didn’t send)
For feeding, Your suggestion is somewhat what is happening now give or take a half hour. I feed a larger meal at test time, then he wants food (smaller, 1/4 FF cans, snacks) at +2, +4 and +6, then he takes a long nap - then at +9 he gets a little something to tide him over otherwise he will tear up my couch and drive me bananas until he gets PMPS shot/meal. I'm also waking up 3 hours before AMPS to give him a snack as there were 2 mornings that he had vomitted and I felt it was from hunger ... so he now gets a small snack at that time, hasn't happened since. I have been adding a bit of water to the meals, but maybe I'll see just how much he'll tolerate.

I started feeding multiple times a day, when I learned that they don’t use their food wisely, I stopped every 12 hours and started multiple smaller meals to be easier on the pancreas.

I’m going to look into the 2 dosing methods tomorrow for sure (it’s getting late here)

I will also try to make a habit of getting at least 4 tests a day at different times (including PS)

I was going to try posting the rest of the original post … but we’ve basically covered it here again, so no need.

Thank you for your help! I will be back should I respond here or start a new thread?

 

Sounds as if you are doing everything right.
A small snack at +9 is ok, especially if he vomits from an empty tummy later on. My Sheba used to do that and I found a small snack solved the problem..
To save you having to get up during the night, have you thought about an automatic timed feeder? I found one invaluable for overnight snacks and when I was away during the day.
Go to bed if it’s late……You need your sleep.
You can continue with this thread for the time being. Just change the subject line to reflect your questions. If you can get a few days tests in the pm cycle and a few more in the am cycle we will be able to see what is happening.
Sleep well
Bron

 

I think an automatic timed feeder will be my next investment

I may not be doing everything right, but I’m trying my hardest and learning as much as possible and you’re helping with this. Thanks again!

Goodnight

 

Waving from Ontario.
Welcome.

 

Ontario too, hi! Thanks for the welcome!