Kinda Newbie, Need advice in ss

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Darnell & Sprocket (GA)

Darnell & Sprocket (GA)

Member Since 2015
Hi!
Sprocket has had diabetes for 2 yrs now but he recently had 3 vet office visits, and 2 hospital stays (5 nights total). DCIN helped us alot!
Testing more, low carb wet & some dry (temp). Spreadsheet updated. Trying to post approximate food intake a day. Trying to figure out how the food effects my boys BG#'s. Eating mostly fancy feast, proplan, friskies under 5% carbs and zero carb dry with some EVO dry. Dry is temp as its all he would eat in hospital & after for short time.
Has many meds, 8 pill pockets a day, unless he spits out a pill then another pill pocket. Has marboflaxin, cyproheptadine, famotidine, ursodiol, denamarin, cerenia, besides lantus insulin. Sub q fluids daily too. Probiotic slipped in food. 2.5 units 2xday currently. In past 3 weeks his dose was all over between 3.5- 2units. His food intake was up & down but now better. So are pill pockets making a big difference on the bg? What effects bg? Calories or carbs? Etc. Its been long 3 weeks. Learning alot. Thanks.
Darnell & Sprocket
 
Hello and welcome. Sorry you had to go through some DKA episodes with your boy. :bighug: How is he feeling now? How is his appetite and weight? Are you home testing regularly for ketones?

To answer some of your questions, it's carbs that affect the blood sugar. So what you want to feed are low carb but higher calorie food if Sprocket is underweight. Which "zero carb dry" are you feeding? There is no real zero carb dry food but some are lower carbs than others. Wet food is best as you want to try to get oral fluids in him too.

Depending on what type of pill pockets, it may impact his BG. The Duck and Pea Allergy Free kind (only in the dog version, break off a piece) don't have as many carbs in them. 8 pill pockets is quite a bit. Have you tried loading each pill pocket with more than one pill? Another option is to use plain empty gel caps and load them with as many pills as you can. #5, #4 and #3 size gel caps work for cats. The smaller the number, the larger the gel cap and more you can fit in them.

I was wondering why you lowered his dose to 2.5 units. He looked much better on 3 units, and even better on 3.5. That 107 he got on 3.0 units is a nice number and no where near the danger zone. With a recent DKA, you do want to give as much insulin as you safely can. Here is a post on DKA and Ketones that is a good read. http://www.felinediabetes.com/FDMB/threads/ketones-diabetic-ketoacidosis-dka-and-blood-ketone-meters.135952/

Please read all the Sticky Notes on this forum. There is a lot of information there - and keep asking questions. We love to help. Since you are feeding dry food, make sure you read through the Sticky Note on the Start Low Go Slow Method. It's the dosing method we use for kitties getting dry food.
 
Wendy had GREAT advice. Pill pockets definitely could effect numbers. Combining pills in a hell cap was going to be my suggestion too. Can you hide the pills in food instead? Or combine pills in a gel cap and put it in his mouth with a bit of syringed in water?
 
Hi Darnell, and welcome. Like Wendy, I recommend you read as much has you can of the stickies at the top of the L&Lpage. Knowledge is power. Ask lots of questions. This can be overwhelming, but we were all new at this once and understand how it feels. Here is a post that was put together to help new members get the most benefit from this forum: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/.

What meter are you using? It helps us give you suggestions if we know whether your BGs are obtained from a vet meter or a human meter.

We're glad you found us!
 
Hi and welcome. You might want to try getting some empty gelcaps size 3 for the pills. The size 3 and 4 are cat sized. The bigger the number the smaller the capsule. What medications are you giving? Often the pills can be combined into a few gelcaps cutting back on the number you need to give since often the pills are being cut. I felt like a chemist doing that for my cats. They can be bought in bulk from Amazon. They saved my cats. I just turned the Rescue on to them and they are so happy they got them. After I give them I chase them with regular food if eating well or a spoonful of Gerbers 2nds baby food meat only which all my cats loved.

https://www.amazon.com/s/?tag=felinediabetesfdmb-20
 
FWIW, Sprocket's initiation into the diabetes "club" sounds a lot like my Gabby's. When she was diagnosed, she spent 3 days at the kitty ICU and in addition to the diabetes, she was in DKA, had hepatic lipidosis and pancreatitis. Two vets independently let me know that not all cats survive the ordeal. She did. Everyone here becomes a very skilled caregiver an most become extremely well versed in how to manage their cat's diabetes and pretty much any other illness that comes along.

If you can "hide" some of the pills in a piece of chicken or cheese, that will help to offset some of the pill pockets.

With a cat that is recovering from DKA, calories are important. DKA is the result of an infection/inflammation + not enough calories + not enough insulin. As a result, it's important to maximize the amount of insulin you're giving and making sure your cat is getting at minimum this usual amount of calories -- up to 1.5 times the usual amount is even better.

Please let us know how we can help. The members here are very generous with their time and information. If you have questions, please don't hesitate to ask.

@tiffmaxee - Elise: the list of meds is in Darnell's initial post (marboflaxin, cyproheptadine, famotidine, ursodiol, denamarin, cerenia, squids and a probiotic).

 
Wendy&Neko said:
Hello and welcome. Sorry you had to go through some DKA episodes with your boy. :bighug: How is he feeling now? How is his appetite and weight? Are you home testing regularly for ketones?

He is feeling better. More social, playing some. His appetite is on cyproheptadine. I cut the half dose to a quarter 2x a day & today no cypro i am. His appetite is just ok this morning. He may still need quarter dose 2xa day for few more days. His weight is 14.4 with my friends scale at home. He used to be 18 2 yrs ago. I have ketone strips that I use when i see him pee. Some were trace after hospital and now negative.



To answer some of your questions, it's carbs that affect the blood sugar. So what you want to feed are low carb but higher calorie food if Sprocket is underweight. Which "zero carb dry" are you feeding? There is no real zero carb dry food but some are lower carbs than others. Wet food is best as you want to try to get oral fluids in him too.

Depending on what type of pill pockets, it may impact his BG. The Duck and Pea Allergy Free kind (only in the dog version, break off a piece) don't have as many carbs in them. 8 pill pockets is quite a bit. Have you tried loading each pill pocket with more than one pill? Another option is to use plain empty gel caps and load them with as many pills as you can. #5, #4 and #3 size gel caps work for cats. The smaller the number, the larger the gel cap and more you can fit in the better

Zero carb dry from Young Again. Pill pockets are the cat chicken flavor. The pills are big. I can't get more than one in each. We went to 2.5 units from 2 units. Before this happened I was feeding (without realizing) higher carb wet food when he had 3 units daily. He had alot of gravies and crumbled treats on top. All that is gone now. Trying under 5%carbs now. Thanks for your advice. I will look at these. Its making more sense this time for me.


I was wondering why you lowered his dose to 2.5 units. He looked much better on 3 units, and even better on 3.5. That 107 he got on 3.0 units is a nice number and no where near the danger zone. With a recent DKA, you do want to give as much insulin as you safely can. Here is a post on DKA and Ketones that is a good read. http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/
http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/
Please read all the Sticky Notes on this forum. There is a lot of information there - and keep asking questions. We love to help. Since you are feeding dry food, make sure you read through the Sticky Note on the Start Low Go Slow Method. It's the dosing method we use for kitties getting dry food.
Click to expand...
 
JanetNJ said:
Wendy had GREAT advice. Pill pockets definitely could effect numbers. Combining pills in a hell cap was going to be my suggestion too. Can you hide the pills in food instead? Or combine pills in a gel cap and put it in his mouth with a bit of syringed in water?
Click to expand...

The pills are large. One to a pill pocket. He is not well on syringed pill with water. He is 2 weeks left with all meds. Any longer I will look into compounding into liquid or sugar free treat. .
Thanks
 
Tricia Cinco(GA) & Harvey said:
Hi Darnell, and welcome. Like Wendy, I recommend you read as much has you can of the stickies at the top of the L&Lpage. Knowledge is power. Ask lots of questions. This can be overwhelming, but we were all new at this once and understand how it feels. Here is a post that was put together to help new members get the most benefit from this forum: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/.

What meter are you using? It helps us give you suggestions if we know whether your BGs are obtained from a vet meter or a human meter.

We're glad you found us!
Click to expand...


Thank you!! My human meter is relion confirm. Got it after his hospital stay. I put alot of comments in that section too.
 
My list of medications is above. Its lengthy. Most of meds are big so one per pill pocket. If I realized it would put his numbers up so much I would have compounded a few into liquid or some sugarfree treat. He is so fussy since he became diabetic. He won't eat baby food, I have tried many times. He would only eat the dry in hospital so I gave him a mix of zero carb from young again& evo dry. He is eating almost all wet now. Thank you.


tiffmaxee said:
Hi and welcome. You might want to try getting some empty gelcaps size 3 for the pills. The size 3 and 4 are cat sized. The bigger the number the smaller the capsule. What medications are you giving? Often the pills can be combined into a few gelcaps cutting back on the number you need to give since often the pills are being cut. I felt like a chemist doing that for my cats. They can be bought in bulk from Amazon. They saved my cats. I just turned the Rescue on to them and they are so happy they got them. After I give them I chase them with regular food if eating well or a spoonful of Gerbers 2nds baby food meat only which all my cats loved.

https://www.amazon.com/s/ref=nb_sb_ss_i_4_18?url=search-alias=aps&field-keywords=gel capsules size 3&sprefix=Gel capsules size ,aps,241&crid=TQYZAKNRSSM5&rh=i:aps,k:gel capsules size 3
Click to expand...
 
Sienne and Gabby (GA) said:
FWIW, Sprocket's initiation into the diabetes "club" sounds a lot like my Gabby's. When she was diagnosed, she spent 3 days at the kitty ICU and in addition to the diabetes, she was in DKA, had hepatic lipidosis and pancreatitis. Two vets independently let me know that not all cats survive the ordeal. She did. Everyone here becomes a very skilled caregiver an most become extremely well versed in how to manage their cat's diabetes and pretty much any other illness that comes along.

If you can "hide" some of the pills in a piece of chicken or cheese, that will help to offset some of the pill pockets.

Hi. What does FWIW stand for? Sprocket has been diabetic 2 years now but I just realized the food I have been given him recently was not good. High carbs. This is his 3rd time in hospital. 1st with diagnosis with ketones & enlarged liver. 2nd was reaction to vaccines. 3rd is now. Ketones, dka, mild hepatic lipidosis, cholangiohepatitis. A new vet thinks he may have had a bout of pancreatitis even though it didn't look like it on ultrasound. I have tried to put in meat, cheese & butter with no luck.


With a cat that is recovering from DKA, calories are important. DKA is the result of an infection/inflammation + not enough calories + not enough insulin. As a result, it's important to maximize the amount of insulin you're giving and making sure your cat is getting at minimum this usual amount of calories -- up to 1.5 times the usual amount is even better.

Calories. Big issue. Lost one vet to disagreement on this. She wanted me to give 220 cal a day but he is still not out of woods. If not then just put him to 3 units now. So that was my problem. I wrote to get not happy, had to rewrite so it didn't sound so bad. In my eyes, this is irresponsible advice. New vet with more experience in same office. Hope it works out. He is on that antibiotic and it made him very nauseous without famotidine which I added after 2nd hospital stay this month. Currently he is about 300- 450 calories. I put it in comments on the spreadsheet. Is that enough? Lower he acts more quiet, and higher he is more social. He was 18 lbs in 2015 so he already lost alot of weight over 2 yrs. So I am not worried for him to lose any weight. I am amazed how the vets are so in disagreement of his care. We are trying to learn how to maintain him in best way. Advice is appreciated. Hard to understand all this. Thanks

Please let us know how we can help. The members here are very generous with their time and information. If you have questions, please don't hesitate to ask.

@tiffmaxee - Elise: the list of meds is in Darnell's initial post (marboflaxin, cyproheptadine, famotidine, ursodiol, denamarin, cerenia, squids and a probiotic).
Click to expand...
 
Here's hoping the meds won't be needed soon. I don't like syringing water either. The baby food was lapped up to chase the gelcaps. Many of the meds you mention can be combined. And powdered to fit into the small Just something to keep in mind if ever needed I never was successful with liquids. If ever you needling term meds many can be compounded into treats too. A friend of mine swears by Pill Pals for large dogs that she uses to coat everything. Don't know the ingredients though.
 
I also wonder since he is steady in 300s, & low 400s with 2.5 units 2xday. If once his pill pockets stop in 2 weeks his numbers will come down to 200s??
Concerned to go up to 3 units for 2 weeks then possibly back down to 2.5 for losing pill pockets of 7- 9 a day.
Suggestions???
 
You might get the dog pill pockets in duck flavor, which are larger than the cat ones, but lower in carbs. You can break off what you need for each pill, and even with that many meds, one bag should last you a long time. It is certainly possible that, when the higher carb pill pockets are out of the picture, he will need less insulin. For right now, though, giving him enough insulin is key to preventing ketones.

It's not unusual to get conflicting advice from different vets. They all have different levels of experience, just like in most other professions. Finding a vet that is truly knowledgeable about FD is rare, unless they are specializing in it. I took my cats to UCDavis, which has the #1 rated veterinary teaching hospital in the country, and I found out that vet students there get 5 hours of training on diabetes - in BOTH cats and dogs!! No wonder most vets know so little about it! The best most of us can hope for is to find a vet that is willing to work with you and to learn. Many of us print out the Tight Regulation protocol and other info from here and share it with our vets.

FWIW = For what it's worth. In the post I linked for you yesterday there is a link to our slang dictionary, which will help you understand some of the terms and expressions we use around here. But never hesitate to ask if you don't understand something. There is a LOT to absorb at first, and we all felt totally overwhelmed, too.

Is there a day soon when you would be able to run a curve (testing every two hours for one twelve hour cycle)? That will help us see if he needs an increase (which several of us think he does). Are you using syringes with 1/2 unit markings? We recommend dose changes of .25 units at a time, as for a cat that is a lot, and it's much harder to measure .25 or .75 with a 1 unit marked syringe. Relion makes one that is relatively inexpensive.

I'm glad you're using a human meter now, as our protocols are written for human meters, and most of us use them. Much easier on the wallet!

 
Darnell said:
I also wonder since he is steady in 300s, & low 400s with 2.5 units 2xday. If once his pill pockets stop in 2 weeks his numbers will come down to 200s??
Concerned to go up to 3 units for 2 weeks then possibly back down to 2.5 for losing pill pockets of 7- 9 a day.
Suggestions???
Click to expand...
I would still increase, and increase to 3 units. You need to get Sprocket to a good insulin dose, and 2.5 units isn't doing it. I would proceed with a few more tests, maybe like a curve today, then increase if you see nothing below 300. If people are following Tight Regulation and seeing nothing below 300 or for kitties that are recently out of DKA and seeing high numbers, we would increase by 0.5 units. It's better to get him in good numbers sooner. It looks like he's not getting enough insulin. And you have to worry about glucose toxicity setting in, where kitty gets used to higher numbers. You can always reduce in a couple of weeks, if you find that stopping the pill pockets makes that much of a difference.
 
@tiffmaxee - I would not use those pill pockets/pill pals. They contain propylene glycol which the FDA has indicated is not safe for cats. From the link you provided, propylene glycol is only in the 7.4oz bag and not the 3.2 oz. Why the ingredients would be different makes me rather suspicious.
 
Sienne and Gabby (GA) said:
@tiffmaxee - I would not use those pill pockets/pill pals. They contain propylene glycol which the FDA has indicated is not safe for cats. From the link you provided, propylene glycol is only in the 7.4oz bag and not the 3.2 oz. Why the ingredients would be different makes me rather suspicious.
Click to expand...
Thanks for that info. I will tell my friend who has been using them for a very long time.
 
Interesting. I am ordering the dog green pea n duck that had less sugar in pill pockets today from Chewy. If he needs more than these pills then I will compound into sugar free treat or liquid.
Unfortunately, I can't do a curve during the week cause I still need someone to hold him. I am getting a bg when someone comes to help with fluids this week. His ear is starting to look rough. His other ear he wont let me use much cause he gets gunk in it but I have ear meds for it but it makes that ear tender.
Poor guy. Feel bad.
 
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