My Jake

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Jakesmama

Member Since 2014
Hi
I'm new to the board and have questions.
My fur baby Jake was diagnosed Oct 2012 and put on Lantus, 2 units twice a day. He is a big boy at 18 lbs. over time, his insulin was increased to 4.5 units 2x a day. In April he had 12 of his teeth removed due to decay. The doc and I were hoping his diabetes would revert, but instead it got worse and now he's up to 6 units 2x day.
I feed him Royal Canin wet diabetic 1/2 can 2x daily and he munches on Royal Canin diabetic dry during the day.

My question for now is,

I've seen the cat food list on this message board, mentions specific varieties of Fancy Feast and Pro Plan. My prescrip food has corn gluten meal, wheat Gluten, soy protein isolate. Are the commercial brands better?
 
Yes, brands like Fancy Feast, Friskies and others in pate style are lower in carbs than prescription or other vet foods. If you swap to a new food make sure you're home testing because his insulin needs will drop dramatically. Of course everyone here will tell you any dry food is bad, they're all high in carbs except for few high dollar ones. Dry food can also cause urinary issues.
 
Please be home testing before you make the food switch. A change from a high carb food to a low carb food can dramatically reduce the need for insulin. 6 units is kind of a high dose, and we don't want to see Jake have a hypoglycemic episode.

One question for you. Have the dose changes been based on the nadir (lowest point) in the 12 hour cycle? Or is your vet adjusting the dose based on other factors. Sometimes too much insulin looks a lot like too little.

You may find this article by vet Dr. Lisa Pierson on Feline Diabetes informative. She talks about the appropriate diet for a diabetic cat and the need to adjust the insulin dose downward immediately to compensate for the reduction in carb intake.
 
I test Jake just before he eats his evening meal. Whatever the reading is indicates his dosage. Since after surgery he was on the high 300's the diabetic specialist recommended going from 4.5 to 6 units. He's still in the mid to low 300's 6 weeks after surgery.
 
I read the recommended article. Very informative! Thank you! I think Jake may be a bit overweight, so, like me, low carb will help him drop a couple pounds. I'll let everyone know how he does.
 
Lantus doses should be adjusted by the nadir, the lowest glucose level between shots.

The only adjustments we make on pre-shot tests are:

1) if the pre-shot test is below 200 mg/dL for new folk(150 mg/dL for experienced folk with test data) to stall - wait 30 minutes without feeding to see if the glucose is rising or not and optionally give a reduced dose or skip

2) skip a shot - most common with new folk who don't have much glucose test data on how the cat responds to spcific doses.
 
So do I have to do a curve? His test is usually 8-10 hrs into his 12 hr cycle. Test first, then dinner.
 
Getting some more test data to find out when Jake reaches his lowest BG reading (nadir) would be helpful. You can do that partially with a curve, but if you can test around that +5 to +7 hour time frame, that is when most cats have their low on Lantus.

By jumping from 4.5U to 6U, you may have bypassed the appropriate dose for Jake. It's very hard to tell the difference between too much insulin and too little insulin from only a few test numbers.

We follow a modified version of the only published research study on Lantus dosing and adjustments, Tight Regulation. Dose adjustments are done in 0.25U increments, and sometimes in 0.5U increments, based on those nadirs. You might like to read the Stickies over in the Lantus Tight Regulation forum here to learn about this method of regulating your cat. Many cats even achieve remission, aka diet controlled status, using this method. It is an aggressive method of dosing so the amount of testing is important.

There is also the Start Low, Go Slow approach which makes changes slower.

If you would be willing to setup our standard format, color coded spreadsheet and enter some test data, that would be really helpful to us. Directions are here.

Are you only testing twice a day now? Before Jake eats and then gets his shot?
 
I test once, per specialist instructions. Before his evening meal. Then I feed him, wait a few minutes, give him his dose. I've wondered if I should test in the morning too.
 
Yes, testing before every insulin shot is a good idea. That way, you know how low or high the BG number is and if you should shoot or stall and not feed and retest to see if the BG number is going up or down. It's a great way to help keep your kitty safe and avoid hypoglycemia.

Lantus dosing is based on the lowest point in the 12 hour insulin cycle. That is usually around +5 to +7 hours after the shot, but ECID (every cat is different) and some cats nadir earlier and some nadir later.

For example, my Wink nadired around +3 to +4. That was because the duration of the Lantus was more than 12 hours for him so the previous shot and the current shot were overlapping and bringing that BG number down early in the cycle.

You need to test in the middle of the cycle to find out when your Jake gets his low. That low is what the protocol uses to adjust the insulin dose for Lantus.
 
Thank you, I will test him around 3pm and see what he reads. I will also test tomorrow am pre-shot. Good thing he's a tolerant cat! dancing_cat
 
3:30 I tested Jake and he was at 298. He usually tests at 325 around 6pm. I'm giving him his first low carb dinner around then, so I'll feed him, wait until his night shot and test again.
 
It is less likely to provoke a GI upset if you switch food gradually - about 20-25% different food per dayn Some cats get nauseated, vomit, have diarrhea, of become inappetant with fast food changes.

Plus, this will shift the glucose a bit slower so you have enough time to adjust the insulin, and less risk of going hypo.
 
We have a nifty spreadsheet grid to store your test numbers in a shareable Google Drive file
Instructions are here.

Once you get your spreadsheet set up or when you look at someone else's signature link, this'll make more sense!

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
All meters sold in the US must read within + or - 20% of what a lab would get.

And, all human meters read approximately 30-40% lower than pet-specific meters. We do not adjust the readings from human meters; we ask you to note in you signature what meter you are using.

We have reference values for human meters, so that is not an issue in most cases. Many of us in the US like the WalMart ReliOn Confirm, Confirm Micro, or Prime meters. If you're not a fan of WalMart, you can to our shopping partner Americal Diabetes Wholesale and purchase the Arkray Glucocard 01 or 01 Mini which are the unbranded version of the Confirm models made by Arkray USA.

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Jake tested this morning at 346 after coaxing him from under the bed. He isn't feeling well and hasn't eaten his breakfast. Just sleeping. Haven't given him his shot yet.
 
Retested Jake before giving shot. He was at 349. Didn't eat all of his breakfast, seems to be running a fever. His ears are very warm. Gave him his usual 6 units.
Right now he's eating a little more. Hasn't thrown up or anything.
 
Tested at 4:30, read 211. Has eaten no dry food for at least 20 hrs. Will test again before bedtime insulin shot.
 
As far as the spreadsheet goes, I have a Mac, and can't download excel spreadsheets. Does anyone have a Mac compatible version?
 
We don't download the spreadsheet. The spreadsheet is stored out on Google, so you need a google account setup. Once you have that done, just follow the instructions in the SS setup and link to your signature. You do all the updating directly from your google drive.
 
Jake has been on Fancy Feast/Friskies pâté meals for three days. His sugars are not going down. Still on 6 units 2x a day. He's been diabetic for a little over 2.5 yrs, and on prescription food for that long. Not giving him dry food. Is it going to take a bit longer before I see a reduction in his sugars?
 
Well I don't know what's going on. Jakes sugars have gone from mid to high 300's to low to mid 400's!! Been feeding him Friskies pâté and fancy Feast pate. I think my cat is backwards!! He's on 6 units of Lantus twice a day. Sugars not going down!
 
I test Jake right before I feed him, and he gets his shot 12 hrs apart. If I feed him at 8am, he's tested just before. Then I test again around 5pm, then feed him. He does get a small meal between tests. His last shot will be around 7-8pm.
 
I've been giving Jake 3 small cans of Fancy Feast a day, testing before I feed him in the morning and once at 6 hrs after morning shot. His evening shot is 12 hrs after morning shot. It's been a couple weeks since I started, but a few days without dry food. He's been diabetic since Oct 2012. I tested him this morning and his BG was 415!! Second time this week he's been that high. He's on 6 units 2x day of Lantus. He is always hungry. Not sure why his sugars are stil high. He usually tests in the 300's which still isn't good. What am I doing wrong?
 
Maybe you're doing everything right and something else is happening. It would really, really help if you used Google Drive so you could store his test numbers on our grid system (a spreadsheet, but no math).

If you started at too high of a dose, that may trigger compensatory hormones to release stored glycogen which converts to glucose.
If there is any infection, that can keep glucose levels elevated.
There are some medical conditions which make a cat need much higher than usual doses - steroids for IBD, for example.

Removing dry food usually drops the glucose, sometimes as much as 100 mg/dL. When I changed my GA Spitzer to low carb canned, his dose of 3 units dropped to 1 unit.
 
He started out on 2u 2x a day. Over the past 18 mo his dose increased. Then I discovered he needed 12 teeth removed, and after the surgery this April, his bg's have gone up instead of down. He isn't on any other meds, has no other health issues. Should I try giving him less insulin? I'm afraid to, I don't want his BG to get any higher!

I've tried to get the spreadsheet, but I'm having trouble finding it. I downloaded Google Drive.
 
When too much insulin is given, compensatory hormones release glycogen for conversion into glucose. This raises the levels. When/if you exhaust those reseves, you may see a sudden drop or even a hypoglycemic event, which is why it is so important to test around the expected nadir or +5 to +7 hours post-shot.

For the Google Drive - work with it on the web, not with the downloaded app. Got to the web page, make sure you are logged in, then follow the instructions in the previous link on creating a spreadsheet (download the template to your PC, do not do anything except immediately upload it into Google Drive. Print the additional instructions out, if needed.
 
OMG!! I just tested Jake at his 6 hr mark, and he tested at 53!!!!!
He went from 415 to 53 in one day!! Gave him a tiny bit of dry to bring his sugars back up a little.
 
hope he's ok.

With the spreadsheet, you just click on the cells and type in whatever. If you like, have a look at mine as an example. I only started using it less than a week ago, so maybe look at some others too.

x
 
He's ok. I just tested, he's up to 165. It's 5:15pm. Two hrs till shot time.
I need to know what the cells mean, except the date one of course. What info goes where?
 
well done on the spreadsheet, if I can do it anyone can!!

He's getting pretty low numbers, if you shoot below 200 I'd test him at least every couple of hours. I don't want you to go through what I went through last night when Angel had a hypo (luckily a mild one, but still so worrying).

hugs x
 
I gave him 3u last nite, he tested this morning at 219. Fed him and then gave 3u 20 min later. Will test around 1pm. 3u is half what he was taking. :-D
By the way, these are U. S. numbers. I noticed you're in the U. K.
 
Because we are in many different time zones and because interpretation and taking action depend on when a test is with respect to the shot, it really helps if you report them in terms of
AMPS - morning (AM) pre-shot
PMPS - evening (PM) pre-shot
+# - any test # hours after shot
Ex
+3 - a test 3 hours after the shot
+7 - a test 7 hours after the shot.

A note: the nadir, or lowest glucose level between shots, moves around. It can be helpful to test different days at slightly different times to help clarify your cat's specific tendancies.
Ex
+6 Monday
+7 Tuesday
+5.5 Wednesday
And so on.
 
hi Cory,

How's Jake doing today? I gave you US numbers coz I didn't want to confuse you, what's going on is enough to take in without being given numbers that don't make any sense.
Well, just going to call the vet and see how my boy is doing

x
 
Although I am new to this diabetic cat care, I am a retired nurse and was involved in diabetic teaching at one point in my career. With my cat Stewey, I found that despite whatever type of food I was administering...I required significant regimentation. Aloughing her to graze (even on dibectic dry) kept her blood sugars in flux. Her numbers were all over the place. By keeping her on scheduled feeding times, giving the same portion of food each feeding...brought her blood sugar numbers into a consistent range. This regimentation saw her coat become healthier, her energy levels rise and her personality come back to normal. Perhaps, once a week, I may see an elevated sugar. Before regimenting her feeding times and amounts, her sugars were steadily rising and her insulin was up to 4 units twice daily. She now receives 1 unit twice daily and is doing well. She does not have any other health issuse at present which does enfluance her response. I also only feed her wet food. The dry food is just that...dry. And the carbohydrate level of the diabetic dry is still too high. Most of the dry contains very little animal base protien as well. Give it some thought. A new regime may help Jake in the long run. Good luck, Jane and stewey
 
Jake is doing well on wet food only. He tested a little high this morning, but I'm wondering if the Friskies food had anything to do with it. He's been eating Fancy Feast. I didn't get to test his nadir today because he's sleeping under the bed. He was full of vinegar this morning, trying to climb up onto my dresser. If he comes out soon, I'll test him, otherwise i'll wait for his pm test.
 
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