Low carb food and glucose checks

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Susan Shropshire

Susan Shropshire

Member Since 2021
Does anyone have information on how food affects the glucose checks? If Leo eats food with less than 1% carbs will it affect the glucose check for a certain period of time?

Sometimes he wakes me up around 4-6am and is hungry. I get up and feed him wet food, and then I test his numbers around 8:30 am before his injection. If he ate at 6am will that skew the numbers to make them higher at his AMPS?

This morning, I checked his levels at 6:30 before feeding him, and then he ate. It was 272. Then before his injection I tested him (that was 2 hours later) and it was 322. I know that isn't a big difference and really in the 20% +/- we can have on testing. That is what made me wonder if it makes a difference.
 
We just recommend no food 2 hrs before PS time. By that point any low carb food should be mostly out of their system, and it also helps you get consistent data for your shoot/no shoot decisions. However, we also try not to feed after nadir because the insulin is wearing off - so BG is starting to rise anyway, and then you give it an extra boost with food. So.if.yoi can swing that, that's ideal. Some cats just aren't that cooperative, or may need that food due to other issues.

Every cat reacts differently to food, and often differently each day lol it's possible you may find a pattern over time (for example, most days he may get a 50-point bump from food by +1, but by +2 the insulin has already onset and he's lower than PS...then some days that may not happen).
 
FrostD said:
We just recommend no food 2 hrs before PS time. By that point any low carb food should be mostly out of their system, and it also helps you get consistent data for your shoot/no shoot decisions. However, we also try not to feed after nadir because the insulin is wearing off - so BG is starting to rise anyway, and then you give it an extra boost with food. So.if.yoi can swing that, that's ideal. Some cats just aren't that cooperative, or may need that food due to other issues.

Every cat reacts differently to food, and often differently each day lol it's possible you may find a pattern over time (for example, most days he may get a 50-point bump from food by +1, but by +2 the insulin has already onset and he's lower than PS...then some days that may not happen).
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Thank you. I usually feed him in the AM at the time of his injection. I leave the food out for a bit because he is a slow eater but he eats the majority at the beginning. Then I feed him in the middle of the day and then at night when he gets his PM injection. He gets freeze dried chicken treats when I test his blood sugar through the day. I did see a bump tonight. He was at 250 then +2 he was 363. He did eat quite a bit but it was less than 1% carb wet food. He ate it up until about an hour before I did the test. I'll try to watch when I feed him and remember not to feed him within 2 hours of when I want to test his sugar levels.
 
Susan Shropshire said:
Thank you. I usually feed him in the AM at the time of his injection. I leave the food out for a bit because he is a slow eater but he eats the majority at the beginning. Then I feed him in the middle of the day and then at night when he gets his PM injection. He gets freeze dried chicken treats when I test his blood sugar through the day. I did see a bump tonight. He was at 250 then +2 he was 363. He did eat quite a bit but it was less than 1% carb wet food. He ate it up until about an hour before I did the test. I'll try to watch when I feed him and remember not to feed him within 2 hours of when I want to test his sugar levels.
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Just curious, what food are you feeding? Are you using one of the food lists linked on this site, or going off the can? I only ask because less than 1% is a little unusual. Is it just the tiki cat? Which one?

As an FYI you were increasing a little too much, too quickly. Below 5U we increase in 0.25U units. Above 5U is 0.5U increases. Im not quite sure what the recommendation is so going to tag @Christie & Maverick and @tiffmaxee to see what they think. It doesn't seem like you missed a good dose but it's hard to know with whole unit increases.

Edit: a lot of us use the 5-slot autofeeders and have them rotate to empty slot 2 hrs before PS.
 
FrostD said:
Just curious, what food are you feeding? Are you using one of the food lists linked on this site, or going off the can? I only ask because less than 1% is a little unusual. Is it just the tiki cat? Which one?

As an FYI you were increasing a little too much, too quickly. Below 5U we increase in 0.25U units. Above 5U is 0.5U increases. Im not quite sure what the recommendation is so going to tag @Christie & Maverick and @tiffmaxee to see what they think. It doesn't seem like you missed a good dose but it's hard to know with whole unit increases.
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He eats Purina Organic Chicken & Carrot. I called purina and they said it is .9% carbs. https://www.chewy.com/purina-beyond-high-protein-organic/dp/279315 He has food allergies so we are limited as to what he can have and what he will eat.

He may have snuck a couple of bites of the other cats food that was fancy feast tuna flaked and its 1.5% carbs but it was only a small amount.

I have been going by the "tight regulation"
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
 
Susan Shropshire said:
He eats Purina Organic Chicken & Carrot. I called purina and they said it is .9% carbs. https://www.chewy.com/purina-beyond-high-protein-organic/dp/279315 He has food allergies so we are limited as to what he can have and what he will eat.

He may have snuck a couple of bites of the other cats food that was fancy feast tuna flaked and its 1.5% carbs but it was only a small amount.

I have been going by the "tight regulation"
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
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Ok just wanted to check! Sometimes people go off the can/guaranteed analyses and that's not quite the right way to do it.

A few points of clarification:
You were still seeing some yellows, even though not at a typical nadir time so the recommendation would have been 0.25U increases.

You held the 4U for quite awhile, you could have increased by 0.25U every 3 days/6 cycles there as well since nadirs were 200-300.
 
FrostD said:
Ok just wanted to check! Sometimes people go off the can/guaranteed analyses and that's not quite the right way to do it.

A few points of clarification:
You were still seeing some yellows, even though not at a typical nadir time so the recommendation would have been 0.25U increases.

You held the 4U for quite awhile, you could have increased by 0.25U every 3 days/6 cycles there as well since nadirs were 200-300.
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I usually try to call the company that makes the food to find out the carb % and ingredients, since sometimes its vague. Like liver could be liver that is the same as the main ingredient (ie chicken, chicken liver) but not always.

I had actually held the 4 units per my vet. I am just not happy with how he treats the numbers. They have been fine with it being in the mid 300's for the majority of the day. Then Leo got pancreatitis and his tryglycerides are really high so the numbers are too high.

I think I have decided to go with the Low and Slow instead of the tight regulation. I did go to 4.5 and stay there for 4 days before going to 5. Do you think I should go back and do 4.25? or do 4.75 (those .25 units are really hard). From this point on I will keep a dose for 7-10 days before changing and then change in .25 units instead of .5. It does sometimes seem for a day or two after a dose increase his numbers seem to get a little higher.
 
Susan Shropshire said:
I usually try to call the company that makes the food to find out the carb % and ingredients, since sometimes its vague. Like liver could be liver that is the same as the main ingredient (ie chicken, chicken liver) but not always.

I had actually held the 4 units per my vet. I am just not happy with how he treats the numbers. They have been fine with it being in the mid 300's for the majority of the day. Then Leo got pancreatitis and his tryglycerides are really high so the numbers are too high.

I think I have decided to go with the Low and Slow instead of the tight regulation. I did go to 4.5 and stay there for 4 days before going to 5. Do you think I should go back and do 4.25? or do 4.75 (those .25 units are really hard). From this point on I will keep a dose for 7-10 days before changing and then change in .25 units instead of .5. It does sometimes seem for a day or two after a dose increase his numbers seem to get a little higher.
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@FrostD

@Sienne and Gabby (GA)

@Wendy&Neko

@tiffmaxee

Thanks ladies
 
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I don't think I would backtrack and decrease the dose at this point, but wait for the others.

My two cents...if you are able to test often enough, I'd suggest sticking with TR until you get to mostly blues, or even blues and some greens. It will get you to a good dose more quickly and have him hopefully feeling better. The pancreatitis plus not enough insulin is risky in terms of ketones/DKA, and pancreatitis often ends up being chronic.

He's on a fairly high dose, once you get to 6U we recommend testing for IAA and acromegaly. Since you're already at 5U and numbers are high, I'd consider discussing that with your vet and scheduling and appointment for the labs if you can swing it. You'd increase by 0.5U now.
 
FrostD said:
I don't think I would backtrack and decrease the dose at this point, but wait for the others.

My two cents...if you are able to test often enough, I'd suggest sticking with TR until you get to mostly blues, or even blues and some greens. It will get you to a good dose more quickly and have him hopefully feeling better. The pancreatitis plus not enough insulin is risky in terms of ketones/DKA, and pancreatitis often ends up being chronic.

He's on a fairly high dose, once you get to 6U we recommend testing for IAA and acromegaly. Since you're already at 5U and numbers are high, I'd consider discussing that with your vet and scheduling and appointment for the labs if you can swing it. You'd increase by 0.5U now.
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Thank you! my vet had been telling me to wait 7-10 days before making a change due to his body adjusting. I’ve also heard 5-7 days. He does tend to have higher levels after an increase for at least a day or so. I’m afraid of going to high too fast. I have had two “yellow” readings over the last 2 days so
Hopefully we are starting to get there.
I had asked the vet about Agromalaly (however it’s spelled) and there were some things he looked at that he said made him think that wasn’t the case. I also read about IAA and it said it’s hard to know for sure if they are on Lantus since it’s a human insulin their body will make antibodies to it. That was on a vet website.
We did have a 2 day period not too long back where he was in the upper 100s at his PM shot. I only did a 1/2 dose that night and the next morning it was in the low 200s. We did a slightly reduced dose but then the #s went back up. I wish I knew what caused the low #s! I haven’t been able to replicate it.
I’m going to work on his feeding times to see if that makes a difference. He is on a low carb food and was when those low #s happened.
My vet had told me he was happy with his #s since his clinical signs were good but I disagree. He really doesn’t have any signs that I see but the #s don’t lie. I’m hoping since we did have those low #s once it’s just that we haven’t hit the right dose.
I know there are some others on the forum that are on higher doses as well. Do most of those have other issues that have caused the dose to be higher?
 
My cat was on Lantus and both IAA and acromegaly came back positive. I scheduled the visit when we got to 6U but by the time the blood was drawn I was up to 13U or something.

I'm not sure I can say "most cats" at this dose, but I would say many cats, yes. Some cats are just high dose cats with no known underlying issues.

If your vet is referring to physical signs of acromegaly, many cats do not show those until it's later stages. My cat showed none of them, and by the time the results came back his face shape did start changing to the classic "acro look".

IAA usually resolves on its own in about a year; the key is knowing your cat has IAA changes how you decrease doses when the IAA starts to break.

With acro, the dosing strategy does also change a bit.
 
FrostD said:
My cat was on Lantus and both IAA and acromegaly came back positive. I scheduled the visit when we got to 6U but by the time the blood was drawn I was up to 13U or something.

I'm not sure I can say "most cats" at this dose, but I would say many cats, yes. Some cats are just high dose cats with no known underlying issues.

If your vet is referring to physical signs of acromegaly, many cats do not show those until it's later stages. My cat showed none of them, and by the time the results came back his face shape did start changing to the classic "acro look".

IAA usually resolves on its own in about a year; the key is knowing your cat has IAA changes how you decrease doses when the IAA starts to break.

With acro, the dosing strategy does also change a bit.
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Thank you for all the info! The vet said something about since he saw a downturn in the numbers something in that made him think he didn't have acromegaly.?? I don't actually know why he thought that though.
I have seen a slightly lower number today. I am currently at 5 units. I do see that when I increase his dose for a day or so his numbers go up so I am hoping that the numbers are coming a little lower now. I am also watching a little closer how much he eats and when to see if there is any correlation. He seemed like he didn't feel good this morning and didn't really want to eat at first. I gave him cerenia and then he ate and seemed to feel a little better. I always worry about his pancreatitis flaring up again.

With the acromegaly. Did you choose to do any treatments? I noticed that you switched to levemir, was that because of the acromegaly? How is your kitty doing now? It seems he is in remission? I don't know much about acromegaly.
With the IAA, you say that it usually resolves on its own over time? Are their treatments or dose increasing the dose finally overcome it?

Thank you for all your help. I feel that the vet I had wasn't doing the best for me and Leo. They have actually be happy with the numbers. In an email they actually said they thought his numbers looked great! I had already started thinking it was time to find a new vet and they took a position out of state so that helped make that decision.

Question..... I would love your opinion. I am looking at two different vets. One has been a vet for quite some time. He started out at the clinic working as teenager. Then he decided to go to vet school and opened several clinics in Atlanta. Then the owner of the clinic where he started decided to retire and he sold his practices in Atlanta and purchased the one where he started. He has since sold out to a corporation but still works there. He has several cats of his own and runs a rescue on the side. The second is a newer vet. She is at the clinic where I have been going. I have seen her a couple of times when my vet was out and she seems really good. She caught Leo's food allergy when the more experienced vet said it was stomatitis. We did the blood work, removed his allergens and his mouth has almost completely cleared. The other vet had told me our best case senario was to just keep it from getting worse but eventually would lead to teeth removal. I am thinking of the going with the new vet since she might be more up to date on the newer treatments and findings. I am really torn. I thought since she is at my current clinic I could do an appointment with her to get a feel for how she is and then if I don't find I am happy I can move to the other clinic.
 
As for the acro - there are a few different treatments depending really on finances. I chose a more "experimental" route (meaning not a lot of officially published scientific studies, but a lot of success here on the forum) with cabergoline. It's a pill compounded in liquid that I give every other day.

I switched to Levemir because it's usually better at such high doses (tends to keep them a little flatter, doesn't sting).

There is no treatment for IAA, the best you can do (anecdotally) is keep them in green range as much as possible... otherwise the antibodies tend to take hold and run the numbers up again.

As for the vet...I personally would schedule a virtual consult with each, and see what they think you should do going forward from a "whole picture" standpoint. For me personally, the vet who is most patient, thorough, would like to see lower numbers, and doesn't just write off IAA/acro altogether would be who I go with. It's ok if they take a "let's wait a month or two and see" approach, but I don't like your current/old vet just writing it off altogether (FYI, with acro the tumor "pulses out" different amounts of the IGF at different times, so yes it is totally normal to see breaks in the numbers, or numbers climbing)
 
FrostD said:
As for the acro - there are a few different treatments depending really on finances. I chose a more "experimental" route (meaning not a lot of officially published scientific studies, but a lot of success here on the forum) with cabergoline. It's a pill compounded in liquid that I give every other day.

I switched to Levemir because it's usually better at such high doses (tends to keep them a little flatter, doesn't sting).

There is no treatment for IAA, the best you can do (anecdotally) is keep them in green range as much as possible... otherwise the antibodies tend to take hold and run the numbers up again.

As for the vet...I personally would schedule a virtual consult with each, and see what they think you should do going forward from a "whole picture" standpoint. For me personally, the vet who is most patient, thorough, would like to see lower numbers, and doesn't just write off IAA/acro altogether would be who I go with. It's ok if they take a "let's wait a month or two and see" approach, but I don't like your current/old vet just writing it off altogether (FYI, with acro the tumor "pulses out" different amounts of the IGF at different times, so yes it is totally normal to see breaks in the numbers, or numbers climbing)
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Thank you so much for all the info. I’m feeling hopefully seeing the first green numbers ever!
 
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