My cat never stopped peeing a lot - despite the vet's o.k.

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alsoro

Member Since 2013
Hi,

My cat is 11 years old and started drinking a lot of water for about a year ago. He was diagnosed with diabetes about 9 months ago when I finally realized he wasn't just playing a game w the sink. At first, his insulin (Lantus) was prescribed at a very low dose at first (2 units) and my vet moved it up slowly from 2 units per day to 2 units 2x a day - now to 5 units 2x per day. I never did home testing (i didn't even know you could until I read this board for a while) so all of these changes over the last 9 months were due to about 15 vet trips. My vet is also very cautious about giving too much insulin...I think he might have had a bad experience once. From what I understand from friends, 10 units is pretty high for a cat...but why is he still peeing like crazy?? He's 20 lbs (overweight, I know). He was 17 pounds for a while in the last year, but I think that was when his diabetes was really unregulated and he was losing weight due to inability to metabolize glucose properly. He has been fat for the last 5 years at least - it has been hard to control since I was in grad school part of this time, and he lived with my parents (no pets allowed where I was). They fed him whatever he wanted. Now he's with me again and I can't get him to lose weight that easily...but mostly, it seems so weird to me that he's still (possibly) unregulated on 10 units a day. My vet says that some cats always drink & pee a lot even if they have normal glucose. I give him 3/4 cup of DM hard food by Purina in divided amounts and then he gets 1/4 can of Purina DM soft food in the morning and 1/4 can at night (he likes both - so that's good at least).

Everything else with him is basically fine. He just had his full checkup. I don't know his glucose level...I have to ask the exact number bc I was just told it was "fine". At 10 units, I would HOPE it would be fine, but he pees more than I do. Should I get a 2nd opinion? What do you think about all this? He's also a lot less playful & mostly just lays around now...but this might just be age...this started changing before diabetes I think.

Thank you!
 
Re: My cat never stopped peeing a lot - despite the vet's o.

He isnt that old that he would be that lethargic at age 11 and with the peeing, it sounds like his diabetes still isnt controlled.

So I think you should start home testing. You will get a much better idea of whats going on. Once you start home testing, then stop feeding that dry food since its too high carb. Dry food spikes his blood glucose which makes the diabetes much harder to control but it isnt safe to stop feeding it until you are home testing. Also he could be a high dose cat, or have a high dose condition but would have a better idea if you were home testing...

Wendy
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Thanks so much for replying so soon. I am going to start looking into that...I have a relative in vet school also, so she should be able to help in person too hopefully. The thing that is confusing to me is that he gained 3 lbs back... so I thought that was a good sign he was finally regulated (he got pretty thin even after 4-6 months in - despite eating tons of food). Or, is that not a good sign?

The water drinking won't stop though (and people have said - he "formed a habit" but I don't believe it and that's why I came here...he does eat paper - which is a weird "habit" but drinking water is a different story)

Is the Purina DM still too high carb? He definitely likes the soft food...so it won't be a problem to get him on that entirely - probably... but I know it has to be done w/ the insulin level.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

The weight gain is good for sure! However his BG could be bouncing up and down - the highs would cause him to drink and pee a lot to clear them. And he might be in normal numbers (or low numbers) the rest of the time which would help him gain weight. Again you wont know that without home testing.

FYI- bouncing..: With a diabetic cat, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce".

Purina DM canned is fine at 3% carbs but the dry is 31%.. and you dont want carbs over 10%. But when you cut it out the BG can drop and you would have to adjust insulin, something you would only know about with home testing.

Wendy
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Thanks again... so is the goal of home testing to regulate it like humans do? One long acting shot per day + short acting insulin after meals or something? Or can he still be kept on lantus / long acting? I know the answer (in depth) is on the other board about insulin, but I just wanted a general idea. The stickies on there were a little over my head at the moment (and I work in a lab! lol... well far from diabetes).

Is there anything that can be done about this bouncing problem? I never heard of it before - it's like the body is resisting the treatment. Does it eventually stop after a while? (Maybe he's still in that phase - he hasn't been on 10 that long - about 1-2 months)

I wonder what is going on at the vet to give them this "all clear" message. I know they do the curves and all that. I'll have to call when they are open tomorrow and get more numbers / info.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Hi,
From a quick read here, it seems as if your vet didn't really have a handle on this at all and moved you up the dosing scale way too quickly.
10 units is a high dose unless your cat has a medical condition such as acromegaly or cushings.

I would like to encourage you to start wandering around this site and the felinediabetes.com information pages and read up.
They both offer lots of pertinent information to help your cat feel better.
For diet information, http://catinfo.org/ is a must read for why you want to change your cats food to all wet....
But Please.... don't change his diet while he's on such a high dose.... The blood glucose level will drop drastically when the diet is changed
to a proper diet for a diabetic cat and you would very likely find yourself in an hypo/overdose situation which would endanger your cat's life.

That's why I ask you to read it first. And come back and ask questions.
Let some of us with experience help you make that transition.
The thing you can start right away is testing. There are many links here, and on felinediabetes.com with instructions and helpful hints
and everyone here will be happy to give you help.
You have found the best community you could ever find for helping with a diabetic cat.

I hope you will go buy a meter and strips... I hear the Relion from Walmart is fairly accurate and has cheap strips. Many people here use it.
That's a human glucometer which most of us use. The one the vet sells costs too much, the strips are costly and it isn't necessary.
You will be able to do your own curves... You won't need to pay a vet for it.

For every thing , what meter to buy, how to test, what treats to give your cat as a reward for testing, ask for help if you need it or want it.
We all love helping someone just as someone has helped us.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

alsoro said:
Thanks again... so is the goal of home testing to regulate it like humans do? One long acting shot per day + short acting insulin after meals or something? Or can he still be kept on lantus / long acting? I know the answer (in depth) is on the other board about insulin, but I just wanted a general idea. The stickies on there were a little over my head at the moment (and I work in a lab! lol... well far from diabetes).

Is there anything that can be done about this bouncing problem? I never heard of it before - it's like the body is resisting the treatment. Does it eventually stop after a while? (Maybe he's still in that phase - he hasn't been on 10 that long - about 1-2 months)

I wonder what is going on at the vet to give them this "all clear" message. I know they do the curves and all that. I'll have to call when they are open tomorrow and get more numbers / info.
Click to expand...


The dose you are giving is about the point where people begin to question insulin resistance, but before getting there, you want to be sure that you are feeding low carb wet food - you can get all the info you need including a list of foods that are under 10% carbs on the catinfo.org site.
A great deal of cats are quite carb sensitive and if you are feeding high carb or worse dry food, much of the high dose you are needing to give may be blamed on the high carbs.

Lethargic could be for many reasons and one could be a bit too much insulin or not near enough... the only way for you to know for sure is to home test. No human doctor would tell you to give your child insulin without testing the child's blood sugar first, right? So what makes your cat any less important?

Depending where you are located, if in the US, you can pick up a Relion meter, test strips and lancets, and begin testing at home. there are plenty of videos you can watch... just pricking the edge of your cats ear for a drop of blood ..... and no, it does not hurt - both of my cats often slept through the pokes. You can practice on your own fingertip if you like. Most people here can help you with tips on any troubles you may have in the beginning. Better safe than sorry.

When you get your meter and supplies, you want to be sure to pick up a container of KETOSTIX at the pharmacy because you want to test your cat's urine for ketones.

Once you are sure that you are on a good diet for your cat, and you have the hang of home testing, you will then be able to know if the dose you are at now is what is truly needed.

One BIG caution is that if you are needing to make diet changes, please DO start testing first because many cats need much less insulin or in some cases no insulin after the diet is corrected. So, get home testing first, then make any diet changes, and then you will see what's needed in the way of insulin.

Should you find that the numbers are still high, and the diet is good, you can follow the protocol here to continue with slow, steady increases until the numbers from your testing start to show some improvement.
There are tests that can be done, and we can let you know what to request from your vet later if needed.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

See my signature link on Secondary Monitoring Tools for info on urine ketone testing. Ketones develop when fat is broken down for energy. This can be a sign of diabetic ketoacidosis (DKA), an expensive, potentially fatal, complication of diabetes. Since he is currently unregulated, this could happen more easily; watch for lack of appetite and infection too, which increases the risk.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Hi, Thanks everyone. I am on walmart.com and can order everything there. However, there are different ReliOn brands - "confirm", "ultima" and "prime". Which do u use? The descriptions on the site don't entirely help - especially for a cat. (I am not concerned about the small price differences of a few dollars here or there - but I just put them here for reference.) I will order it today if you have some feedback. If the product description on the walmart site makes sense to you more than me, let me know if you can take a look. I really want to get things under control asap...I can't believe this has gone on so long and I never went outside my vet & am sort of angry about it now. Btw, I SAID to him - why don't I monitor his glucose at home like an ordinary person (my dad is diabetic) and they just said people don't need to do that for cats bc lantus is long acting enough...and that was the end of it. Even my dad (who is diabetic and a doctor - so take from that what you will) said I am making way too much of a big deal over all of this and lantus was a breakthrough and will "take care of everything"....so I am so frustrated by being blocked by supposed experts while my cat pees 10 gallons a day. Ugh - anyway, thank you all so much. Here are the walmart options:

ReliOn Prime Blood Glucose Test Strips, 50ct (do I need more?) - $9
ReliOn Prime Blood Glucose Monitoring System, Blue - $16 (lower star rating than the "Confirm")

ReliOn Confirm Blood Glucose Meter, Blue - $15
ReliOn Confirm Micro Blood Glucose Test Strips, 50ct - $20

ReliOn Ultima Blood Glucose Monitor - $15
ReliOn Ultima Strip 50ct - $20

ReliOn Ketone Test Strips
ReliOn 30G Ultra Thin Lancets

I read the first link BJM, so here's some info too... I think some of this is good (?) or is it ?
The 5 Ps
Purring - is the cat exhibiting customary signs of contentment or happiness? - yes, he always purs
Playing - will the cat play and interact with others? - he hasn't been playful in about 4-5 years...since he started getting fat. He used to chase things but now he just looks at me when i bring a toy or throw a ball like "i dont think so"
Preening - is the cat maintaining its fur and cleanliness? - yes, he does this all day
Peeing - occurs, and is a normal volume? - way too much...even sticks to the bottom of the litter box
Poohing - fecal material is formed and passable? - this is fine

Last thing - why can't cats take glucophage or januvia? Or, can they - and this is another thing I don't know? Or is that too late anyway since he's on insulin now?
 

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Re: My cat never stopped peeing a lot - despite the vet's o.

I use the ReliOn Prime and love it--cheap strips, too 50/$9. I would buy the meter and 4 boxes of strips to start with AND a few boxes of lancets - maybe 28 gauge for starters AND a tube of triple antibiotic w/pain relief creme. I will be back in a bit to help you
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Walmart is the only store where, if you actually ran out of strips, you can go in and buy them. Other stores do not sell them. There is a website that does, though--but for now, just get the meter, strips, ointment and lancets from Walmart. (ReliOn meter, ReliOn strips, any brand of ointment--make sure it has "pain relief" and any brand of lancets that are say, 28 gauge for starters)..you COULD also buy lancets that are 30 or 31 gauge (higher the gauge, the thinner the needle). We suggest the thicker needle for people who are just starting out home-testing. The meter will probably come with a "lancet device"--but most of us freehand.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Personally I have two meters since I have two diabetic cats...I have both the Bayer Contour and the Relion Micro...really love the Relion Micro as it takes just a speck of blood and the strips are realitively cheap...I get the smallest amount at 20 for $9 since the cat I use it for has been in remission for over 2 years thus I don't check him that much so don't need a lot of strips hanging around. However, my other diabetic is a DCIN sponsored girl and they supply her testing supplies and she came with the Bayer Contour... both are excellent meters just the strips for the Contour are more expensive than the Relion. But recently I ran out of the strips for the Contour and started using the Relion and the numbers are virtually the same. Haven't used the Relion Prime as it is a fairly new meter but if it works as well as the other Relion meters any of the 3 would be a great choice.

Mel, Maxwell, Autumn & The Fur Gang
 
Re: My cat never stopped peeing a lot - despite the vet's o.

MommaOfMuse said:
Personally I have two meters since I have two diabetic cats..
Click to expand...
I also have two meters. When Gobby was first dx'd, I bought a TrueResult and the strips for it are about $25/50 and the RiteAid is 5 minutes away if I needed more strips. Then I started hearing that the TrueResult reads much lower when the BG numbers are higher, say about 150 & up., So I brought the TrueResult to the vet's office at Gobby's next vet visit--it was about an 80 point when tested against the vet's with the same drop of blood. So then I bought the ReliOn and had that tested with the vet's meter--only about a 30 point difference. Although, when Gobby's numbers are in the 50s-70s, the two meters read about the same. Basically the TrueResult comes in handy when his BG is low. BTW, if you use two meters and your cat is low, use the same drop of blood to compare the meters....
 
Re: My cat never stopped peeing a lot - despite the vet's o.

You definitely want to start with a larger gauge lancet...
that's one of the obstacles in testing for so many in getting a blood sample. So you want a lower number... like 26 or 28....
the 30 /31 gauge are best for humans.

And I love my lancing device. I could never freehand. Shadow would attack me if I did it that way.
She knows what's coming when she hears the click and it's fast. Much faster than I would be if I freehanded.
I have an Accu-chek Softclix Plus.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

That's funny Rhianna! You better stick with the lancing device--I would too if Gobbles scitz'd on me. With Gobbles, he is literally like a rag doll. Just lays on my lap and doesn't even squirm! He's always been a laid back cat though. He's basically like a lump of play dough!
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Before Maui was diagnosed with diabetes, she was an obsessive water drinker. She would drink out of my glass, even the condensation off the glass, she would lay by the water bowl and drain it. She licked ice, basically anything wet that she could drink she did.

Maui also ate dry food only and had major skin issues - itchy, flaky, fur falling out.

After being diagnosed with diabetes, finding this board, learning to home test, giving her insulin twice a day (BID) AND changing her food from dry to low carb wet - I used Fancy Feast Classics, her drinking slowed down, to where today, she rarely drinks from the water bowl. Now, I do add about 1 can of water to 1 can of food, so I know she is getting plenty in her food and no longer needs to drink.

I am glad that you are open to home testing. We can't begin to tell you just how vital it is to the well being of your cat.

I am also sorry to say that your vet's approach honestly, is dangerous. He has you on 10 units of insulin a day without home testing and he got you there by raising you 2 units at a time.

We use the start low, go slow approach - meaning. start at a low dose - such as 1 unit or less and slowly, with home testing adjust the dose as needed, in 1/4 to 1/2 increments. NEVER 2 units at a time. The reason is, you may just skip over the ideal dose.

My recommendation is this:

1) reduce the dose immediately to 1 unit

2) start home testing ASAP

3) ONLY when you are doing 1 and 2, remove the dry food completely AND stop feeding the DM canned, it is higher in carbs than needed. You can feed Fancy Feast and Friskies - which is essentially the same products for a lot less than the cost of DM and get the low carb varieties - anything that is classic in fancy feast and pate in Friskies. If you refer to the chart linked above, you want to get foods that are under 10% carbs. Ideally 2-5%.

4) purchase ketostix to test for ketones in urine

Once you get set up, with home testing, we can take it from there. And if we don't see improvement after all this, then you can always get him testing for insulin resistance - IAA, cushings, ACRO, etc.

But my guess is, you will see improvement when you follow steps 1-3.

Tell us where you are located, we may have members that can help.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

alsoro said:
The 5 Ps
Purring - is the cat exhibiting customary signs of contentment or happiness? - yes, he always purs
Playing - will the cat play and interact with others? - he hasn't been playful in about 4-5 years...since he started getting fat. He used to chase things but now he just looks at me when i bring a toy or throw a ball like "i dont think so"
Preening - is the cat maintaining its fur and cleanliness? - yes, he does this all day
Peeing - occurs, and is a normal volume? - way too much...even sticks to the bottom of the litter box
Poohing - fecal material is formed and passable? - this is fine
Click to expand...

If you use a non-clumping litter, it may be easier to clean out. Or you could put in more litter so the urine cannot soak to the bottom. Or syou might pray the pan with an oven oil baking spray to release the litter more easily, saturated or not. Some folks use litterbox that has a grill and non-absorbable litter. The urine drains through and you just scoop at the fecal products. I believe the Smart Box is one of those. As you get closer to control, the urine output should reduce, as will the thirst.

alsoro said:
Last thing - why can't cats take glucophage or januvia? Or, can they - and this is another thing I don't know? Or is that too late anyway since he's on insulin now?
Click to expand...

The reason those aren't helpful is that they push the pancrease to keep working when what it needs is to rest and (we hope) heal. Insulin injections take the place of insufficient insulin from the pancreas and remove the feedback triggers to keep pumping it. That lets the pancrease rest. Doing this, you have a shot at diet-controlled remission.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

The fact that your kitty has gained weight while still peeing a lot / unregulated -- you should really look into getting the IGF-1 test for Acromegaly done. At the same time, test for IAA (the same lab runs the test for an additional ~$14 -- it costs more to ship the blood sample -- so get both tests done at one time)

If you do decide to try a dose reduction, monitor carefully for KETONES as a condition called Diabetic Ketoacidosis can attack quickly requiring hospitalization / ER / 24 hour care.

I came to this board in 2007 with Norton at 13U BID and eating dry food. When we changed to low carb canned food, he only needed 8U BID. He did test positive for Acromegaly.

Acromegaly is a pituitary tumor that spits out "Insulin-like Growth Factor", which causes the kitty to eat and grow, and need extra insulin.

The pituitary tumor can cause head-aches, so a pain reliever like Gabapentin is very helpful.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Hi - thanks again - to just answer some of what everyone posted: really, the litter is fine.... I just use a lot and had to throw one out bc it didn't have enough litter and the pee was stuck to the bottom...so now I use more. I was considering the litter that lets the urine pass through but the thought of any pee escaping was just much worse than replacing the litter as often as I do (seriously to my nose there is nothing worse than cat pee - and this litter masks it entirely even though it does clump).

I didnt know DM was higher in carb than Fancy feast! Wow - good marketing at work. I'll ask about Acromegaly (ive never heard of that)... I always have to figure out the right way to ask about a syndrome though - one must never refer to reading about it on the internet or it's a definite "no"...

I don't think its safe to take him down from 10 to 2 out of the blue , is it? Shouldn't it be tapered? Well, either way I have to wait for the delivery of the glucose testing supplies - and I'll use the auto-click lance per your recommendations. I think I would have a hard time poking him w/ a needle. I think those let you take the needles out so you can still lance manually if you really want...though they are small.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Here are the numbers...this is upsetting somewhat bc he's still obviously diabetic (to give some context to this, my parents watched him when I had to travel extensively for work, and my mom took him to the vet 10 times and paid all the bills - so I can't be upset w/ her - it's just upsetting that he is so clearly diabetic and nobody has done some obvious things like getting him off the carbs!! I said that to the vet, but he said even off the hard food, he could still have some problems due to insulin resistance, he suspects.)

Fructosamine - December 2012 - 366 (on 5 units bid)
Jan 24 – blood sugar 344 (about 3 hrs after insulin at 5 units)

Blood curve when he went from 4 to 5 units in Dec: lowest of the curve = 175. Highest of the cuve: 426

Weight:
Nov 15 lbs (he was down from a peak of 20 due to diet food but also to poorly controlled diabetes - initially he was just on 2 units in the am)
Dec 17 lbs
Jan 18 lbs

Recommendation is to give him wet food only with 17 lb calorie ideal... vet thinks NO need for dry food bc his glucose is still so high - but shift over slowly & watch him. Also, the vet was saying cats metabolize the insulin so fast that by the 4th or 5th hr, his blood sugar is back up - and although you could give insulin 3 or 4 times per day, it is not practical for most people. He also said some cats get insulin resistant. He encouraged me to do the self testing i read about here if I felt okay & could come in to learn how if I wanted.

My takeaway here: If the lowest of the curve was 175, this is not good. I cannot believe he basically is walking around with a 340 blood sugar all the time! I need to get him off dry food, see what his glucose is when dry food starts going down (self test), and administer a new insulin dose - no faster than 1 month at a time, or maybe 3 weeks (he suggested it's not a good idea to change his insulin faster than that).
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Your takeway is good, but start testing first and then get him off dry, and then work on the dose. If you get a spreadsheet set up here we can watch your numbers and help advise on when to change dose and by how much,

It's great you have your vets support. It's a good idea to have your vet show you the testing as many new members can have problems with it at first. Maybe he can do one ear to show you and then you can try doing the other ear with his supervision.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Oh ok - yeah, I should have a baseline - the meter should be here next week I think. There isn't a walmart close to me really. If I can't do it with the videos, Ill try to go in the vets office with him...in the meantime, i am going to just cut back a little of the dry bc i am giving him too much to get to 17 lbs anyway. He goes crazy when he's hungry though...I think I need some help with that actually. Are there any tips for this that work. The vet did say it's always better to be thin if u are diabetic especially - since it helps with insulin resistance too - but his hunger behavior knows no bounds. He will start by sitting on my laptop and progress to screeching and shredding paper - and he actually bit me recently (because all the blogs for people with fat cats say to ignore their "protest behavior"....well he doesn't like being ignored...)
 
Re: My cat never stopped peeing a lot - despite the vet's o.

"My takeaway here: If the lowest of the curve was 175, this is not good. I cannot believe he basically is walking around with a 340 blood sugar all the time"]

My cat walks around with 400+ BG's. Somedays, he sleeps a lot (like all cats do!!!), but this morning, at 471, he was playful and alert!!! You're in good hands here. Take a look at Gobbles' SS and you'll see your kitty's numbers are not unheard of. Hang in there :mrgreen:
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Do NOT drop the dose immediately, unless you have your ER phone number handy.

There are no indications that the dose you are giving is too high, so a lower dose will do nothing but cause harm to your cat.

As already posted by Phoebe, weight gain and continued excess urination, with difficulty regulating are all indicators of insulin resistance.

I have always used the lancet device for testing because it's consistent every click, so the cats know what to expect. Free hand is never exactly the same... some times deeper than others, so the cats never know if it will hurt this time or not.

With insulin resistance, the longer you hold a dose, the better 'grip' the resistance retains, so it's best to hold for 6 cycles / 3 days at most, and your home testing numbers will let you know how the dose is doing.

With some insulins, they are not as long lasting, but insulins like Lantus and Levemir are long enough and you would not ever need to dose more often than every 12hours with them, but many owners of cats with insulin resistance will use an additional insulin, fast acting, to help bring down the very high numbers.... you will here of people mention using R. Just like humans, basal and bolus insulins are often needed. Once you are home testing and have an idea how your cat's numbers are curving, you'll know if you need to consider adding the other insulin or not.
 
Re: My cat never stopped peeing a lot - despite the vet's o.

Hello there!

My cat Sneakers has acromelegy and is currently at 21u BID- which is a LOT but she didn't test for IAA, which is thankful.

A few things- I don't think I caught your cats name (or your :-D )??-

Dosage DO NOT drop to 1u. As he is getting 10u currently that is an insane idea as it could invite ketones and that could lead to DKA which is around $4-5,000 to treat. Yes, this is worst case scenario and it involves him not eating and having an infection but it has happened and we hear about it after the fact. Slowly drop it by 2u just like you increased it (5 days on the same dose) and keep an eye out on those ketones just to make sure they don't pop up an ugly head. This far into high dose your cat has become accustomed to enormous levels of insulin and cutting it off to a trickle is not the greatest idea in the world. You should see (hopefully) his numbers improving as you go lower and his food is improving. Do not change automatically to wet, transition it as you are testing. My cat lived on low levels of ketones for months- trace to little- so I had to be very careful and make sure she ate well and prayed for no UT infection or anything else that fd cats can get.

He will be hungry. Until he is regulated or even semi regulated he will be STARVING. His body cannot process the proper nutrients it needs so it tells him to eat EVERYTHING he can in hopes that it will get enough to survive. So feed him a lot. Sneakers was eating almost 20 ounces a DAY at her starving and that went on for months. Today she eats 6-8 ounces, sometimes less.

This is where you can use the lower cost foods because he will go through it like crazy. Generic/petsmart Fancy feast (most pates are low carb %), Walmart Special kitty (4 types under 8%- chunky chicken and tuna, super supper, mixed grill, tuna- last 3 come in the 13oz cans for $.70/can). Lowest end but they have all the nutrients needed and leave the high end/high priced stuff until he stops vacuuming everything in and still goes to look for your food for desert. One cat on the acro board still goes after raw noodles sometimes. And he's regulated.

Relion meters- all good. and they have the cheapest strips out there which means you can buy a lot of them and feel like the bank isn't quite broken. And, using the SHOP link above, you can get them cheaper through ADW- under the brand name Arkray. They usually have a buy 4 get one free deal going on and if you auto-ship your order you get a % off which usually takes care of the s/h charges. You just decide if you want them monthly, 45 days (what I have), every two months, and so on. By the time I open the last box the next order is being shipped to me, no worries. That way you don't have to visit wally world so often unless you just want some reserves (since you don't live all that close to one). ADW is also good for syringes- AND they have a needle snipper for the syringes so you can throw them in the trash instead of putting them in a container and figuring out how to trash them. Getting that my next order.

There is a test for acromelegy and IAA. It costs about $80 for both tests and the mailer plus whatever your vet charges to do the office visit and draw the blood and spin it. Both are worth while tests to do and you can get the testing information in the acro/IAA/cushings page.
 
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