Izzy's Numbers

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Izzy's Buddy

Member Since 2013
Hello Everyone,

I am new to the forum, and I am hoping to get some support and advice. My Izzy was diagnosed with diabetes 1/13 after losing over half her body weight in about 2 months. We started out with low doses of Lantus two times daily and gradually built up to 4 units twice daily. I learned how to do home BG tests, and one day her numbers were very low. I ended up taking her to the emergency vet where she was put on a "sugar drip". At that time we found out that Izzy has a tumor on her mammary gland, but cannot have surgery until after her blood sugar is regulated. She was also treated for a UTI. Since then, we have reduced Izzy's dose gradually until now when she takes 2 units once daily. Two weeks ago I cut back her food to a maintenance level and since then she has been very hungry. I was doing BG tests every Saturday (although I did not find the spreadsheet to keep track of it until 3/23), but now the vet says I don't need to do them for 2-3 weeks because they will do a "fructosamine" test at that time. I will probably do the BG tests this weekend anyway for my own peace of mind because Izzy does not show any symptoms of hypoglycemia even when her numbers are low.

I am concerned because I go to a vet in a small town who only sees three diabetic cats including Izzy, and Izzy is the only underweight cat. I guess I would just like some feedback from you guys to see if I am doing all I can for Izzy. Needless to say I am very worried about her because I love her very much and am anxious to have her tumor removed.

Could someone please review my spreadsheet? Right now I feed Izzy 14 g M/D dry food at 7:00 am, give her 14 g more at 7:10 while doing her shot (2 units), and give her 1/4 tsp kitten food turkey as reward after the shot. Around 1:00 pm I give her a 9g M/D snack. At 7:00 pm I feed her another 28 g M/D. Is this the right time frame for feedings and shots? Also, when and how often should I be doing the BG tests? How long does it usually take to get a cat's BG regulated?

Sorry for such a long post. I am just so confused that I don't know where to begin with questions!
 
Good for you on mastering how to home test.

Next, learning how to use Lantus the most optimally you can. This post will get you started.

A starting dose estimate may be calculated as lean body weight in kg * 0.25.
Take the lowest of his current weight or his ideal weight
If it is in pounds, divide by 2.2
Multiply the result by 0.25
That is an estimate of where to start safely.

You want a safe dose, that can be given every 12 hours, that won't take him below 50 at the nadir (lowest point of between shots). Give the same dose, every 12 hours, as exactly as you can. How about trying 0.5 or 1.0 units every 12 hours, as he got too low to give insulin when you gave 1.5 units.

Aim to get some tests around +5 to +7 hours after his shot. This is roughly when his lowest point will be. This will be used to determine any dose adjustments, following an established protocol for felines on Lantus.

Here are the AAHA Guidelines for treating diabetes in companion animals. Print out, read, then share with the vet and discuss.

Because you are home-testing, you may want to do some reading on ideal feline nutrition at Cat Info, written by DVM Lisa Pierson. Changing to a low carb canned or raw diet may reduce the glucose levels as much as 100 points. I note he has been eating some canned, so you might try Friskies pates or Fancy Feast Classic pates which fall into the economical, low carb category.
 
Two weeks ago I cut back her food to a maintenance level and since then she has been very hungry
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Why did you cut back her food to a maintenance level? What was the reason? Was her BG regulated?

Until a cat gets regulated on insulin and/or diet, they will be very hungry and need to consume more calories, up to 50% more than a normal cat.

Yes, you can wait for the vet to do a fructosamine test. Or you can test at least twice a day and you will better data than the vet will get with that test. It will also cost you a lot less, only the cost of the test strips. The fructosamine test is only an average of the past couple of weeks.

By home testing, you are gathering real time data. You are also keeping your cat safe by not giving insulin if the BG number is too low.
 
Since I got Izzy, she has been overweight. Based on the vet's recommendation in 2011 because of her weight and her frequent diarrhea, I put her on a low calorie, high fiber diet. She still did not lose weight. From November 2012 to early December she dropped from 12 lbs to just over 5 lbs. At that point we found out she had diabetes. The vet recommended that she switch to M/D, a high protein dry food at a high amount to help her gain weight quickly. Two weeks ago she reached her target weight of 8 lbs and the vet recommended that she be cut back to the maintenance amount of food for 8 lbs. This was a drop from 70 g daily to 60 g daily. Then last week it was increased to 65 g daily to add a snack between meals. No, her blood sugar was not regulated at that point. Should I bump her back up to 70 g?
 
Thank you for the advice, BJM. I will read the guidelines this evening. If I make dietary or dose changes do I need to consult with my vet first? Or is this okay to do on my own?
 
Dose changes made by following the protocol appropriately can be done by the caretaker.

Check the food list at Cat Info. There are 3 lower-carb dry foods, if she won't eat canned: Wellness Core original, Innova Evo Cat & Kitten, and Young Again 0 Carb (internet order only). We encourage canned or raw diets as the moisture content is more appropriate. Cats tend not to drink as much water as they need when on a dry diet, leading to renal issues.
 
Yes, obesity is a contributing factor in diabetes. It can also cause insulin resistence. It's good that you have been able to get your cat to her ideal weight.

How many calories in the 60 grams of food you are feeding? You said the Hills' m/d dry.

We recommend a ultra low carb diet for diabetic cats. Many cats are successful on this low carb diet, many even going into remission. For more info, I recommend you go to Dr. Lisa Pierson's site, catinfo.org, and read about diet for any cat. She also has a good article on Feline Diabetes.

We use this chart to find low-carb wet foods that are <10% calories from carbs. http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf The Hill's M/d dry you are using is about 14-16% carbs and that is higher than we like to see being fed to a diabetic cat.

Would your cat eat wet/canned food?
 
If I make dietary or dose changes do I need to consult with my vet first
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Yes, it is always good to keep that good relationship with your vet.

If you make diet changes, especially to a lower carb food, the BG numbers will drop. You will need to be doing more home testing. At least before every pre-shot to keep your cat safe, not going too low and encountering a hypoglycemic situation.

We can help you with dose changes but in order to do that, you will need to do more home testing. Once a week is not enough.
We have a proven protocol we use for dose changes when using Lantus or Levimir, from a vet published journal.

If finances are a concern, as they are for many people here, we have recommendations on how to save some money. Just ask.
 
At 65 g per day, she is getting 260 kcal per day. How many calories should she be getting while we are trying to get her BG stable? She would definitely eat wet food. I am going to read through the AAHA diabetes management guidelines and the info on feline nutrition. Then I will talk to my vet about switching her to wet food and doing two doses per day instead of one. If I change anything, I will do the pre-shot tests and post them on her spreadsheet.

Thank you for the help and support so far. I will be back here to check in tomorrow.
 
Sounds like a plan. Let us know what you decide to do.

I'm not positive on the number of calories but have seen a calculation that does lbs * 15 calories +70 .

For your cat at 8 pounds times 15 = 120 + 70 = 190
190 + 50% more would be 285. It's all an approximation on the food measurements and number of calories in the amount of food. The 65 grams of food might be enough for now. But if she loses weight, a few ounces a week, it's time to increase the food intake.
 
Hi Izzy and Izzy's Buddy! :YMHUG:

Izzy's Buddy said:
I put her on a low calorie, high fiber diet. She still did not lose weight. From November 2012 to early December she dropped from 12 lbs to just over 5 lbs. At that point we found out she had diabetes.
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That right there is a red flag to me. "High fiber" usually means "high carb" and was probably a contributing factor to her diabetes. For cats to lose weight, they don't need fiber since they're obligate carnivores. I had a cat with weight issues after surviving a bout of hepatic lipidosis. I put him on the Hill's weight management diet and the only thing that helped him lose weight is when I fed him a minuscule amount that was half the serving size recommended on the bag. On the catinfo.org website linked above, she has an entire page about feline obesity that you may find extremely helpful. I wish I'd known about it at the time, but hindsight is always 20/20.
 
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