Need HELP in dosing

Sue70

Sue70

Member
Hello,
My name is Sue and our cat is Pickles. She's almost 14 and has a lot of Maine Coon in her. She was diagnosed a year ago. She was originally on Novolin N. I started reading everything I could find on feline diabetes which is how I found this site. I have been "lurking" and reading many of the posts which I found very helpful. I have been testing her with a ReliOn Meter. Our vet had not heard of eliminating dry food so I wasn't sure about removing it. By April 2018 & using a U-100 syringe she was getting 13 units twice a day. We eliminated the dry food and within 2 months she was down to 1 and .5 units. In June there were a number of days when she was in the 90's and did not get a shot. Then at the end of August 2018 her numbers started increasing and so did the dose. I was never a fan of Novolin N because of the sharp drop in numbers at the 6 hour mark. I think our vet likes to try that first because it's cheaper ($25. at Sam's). In September 2018 I talked to the vet about changing to ProZinc because of the higher glucose numbers and increased insulin and he said to give it a little more time Finally, in October he agreed that Pickles may have become resistant to the Novolin and agreed to the switch. He suggested starting at 2 units. I was a little nervous about that since it was a new insulin and I started her at .8. Since we had a supply of U-100 syringes I printed out your Conversion chart and have been using that and slowly increasing the dose. She has been in the 178-300 range. We are up to 2.2 units of ProZinc as of last night when her reading was 297. This morning it was 74. We did not give her insulin. Two hours later it was 156. I gave her .2. Four hours later it was 94. At 6pm it was 191. I gave her .2. I just don't know what to give her anymore. Our vet said he trusts us to decide because we're doing so well on checking etc. Yikes! We are a multi-cat house. Everyone is now on Fancy Feast (mostly classic) twice a day. Pickles gets half FF and half ProPanel DM. She gets a Cosequin sprinkled in her food. Pickles also gets some shredded chicken after her mid-day check and around 9pm. I posted a Spreadsheet - I hope!. I spent a few hours trying to figure it out. I think I have it on but I noticed that I can't add to the spreadsheet so I probably did something wrong. Sigh! I'm sorry this is so long but I tend to get "wordy" when I'm worried. I would appreciate any input you can think of to help us with this problem. Thanks!
 
Hi and welcome to you and Pickles! Great job getting the spreadsheet set up, getting on low carb food, and home testing. You have a lot of great things in place already.

Since your spreadsheet is new, I want to just make sure that I'm reading it the way you intended it: it looks like you're testing before each shot, at +6 most days (six hours after the morning shot), and not testing during the evening cycle. Is that correct?

It does look like Pickles is showing some improvement on Prozinc, so that's good. It's too early to tell for sure, but there are hints in that direction. You did the right thing to skip the shot this morning.

What I would suggest at this point is that you try to get a test at some point in the evening cycle if you can. If there are a few hours between the evening shot and bedtime, then getting a +2 or a +3 can be helpful.

The next time you have a day off, you might consider doing a curve (testing every two hours for a full cycle). That way you can get an idea if Pickles is hitting nadir in the middle of the cycle, or if she goes low earlier or later in the cycle. While most cats are somewhere in the middle, there are exceptions. And the nadir can move, so checking from time to time is helpful.

As far as where to go from here on the dose, it's going to take a couple of days to sort that out at this point, so just keep posting as you get more information so that we keep eyes on it, and we can help sort it out.

Oh, and if you can't enter anything else on your spreadsheet, you've probably logged out of your google account. Log back in and you should be able to enter things again.
 
Djamila said:
Hi and welcome to you and Pickles! Great job getting the spreadsheet set up, getting on low carb food, and home testing. You have a lot of great things in place already.

Since your spreadsheet is new, I want to just make sure that I'm reading it the way you intended it: it looks like you're testing before each shot, at +6 most days (six hours after the morning shot), and not testing during the evening cycle. Is that correct?

It does look like Pickles is showing some improvement on Prozinc, so that's good. It's too early to tell for sure, but there are hints in that direction. You did the right thing to skip the shot this morning.

What I would suggest at this point is that you try to get a test at some point in the evening cycle if you can. If there are a few hours between the evening shot and bedtime, then getting a +2 or a +3 can be helpful.

The next time you have a day off, you might consider doing a curve (testing every two hours for a full cycle). That way you can get an idea if Pickles is hitting nadir in the middle of the cycle, or if she goes low earlier or later in the cycle. While most cats are somewhere in the middle, there are exceptions. And the nadir can move, so checking from time to time is helpful.

As far as where to go from here on the dose, it's going to take a couple of days to sort that out at this point, so just keep posting as you get more information so that we keep eyes on it, and we can help sort it out.

Oh, and if you can't enter anything else on your spreadsheet, you've probably logged out of your google account. Log back in and you should be able to enter things again.
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Djamila said:
Hi and welcome to you and Pickles! Great job getting the spreadsheet set up, getting on low carb food, and home testing. You have a lot of great things in place already.

Since your spreadsheet is new, I want to just make sure that I'm reading it the way you intended it: it looks like you're testing before each shot, at +6 most days (six hours after the morning shot), and not testing during the evening cycle. Is that correct?

It does look like Pickles is showing some improvement on Prozinc, so that's good. It's too early to tell for sure, but there are hints in that direction. You did the right thing to skip the shot this morning.

What I would suggest at this point is that you try to get a test at some point in the evening cycle if you can. If there are a few hours between the evening shot and bedtime, then getting a +2 or a +3 can be helpful.

The next time you have a day off, you might consider doing a curve (testing every two hours for a full cycle). That way you can get an idea if Pickles is hitting nadir in the middle of the cycle, or if she goes low earlier or later in the cycle. While most cats are somewhere in the middle, there are exceptions. And the nadir can move, so checking from time to time is helpful.

As far as where to go from here on the dose, it's going to take a couple of days to sort that out at this point, so just keep posting as you get more information so that we keep eyes on it, and we can help sort it out.

Oh, and if you can't enter anything else on your spreadsheet, you've probably logged out of your google account. Log back in and you should be able to enter things again.
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Thank you for responding so quickly. I hope I did the Spreadsheet right. I test Pickles at 6:00am-before breakfast; 12:00 pm-chicken snack; 6:00pm-before dinner. Every so often I do an extra. Did I put some numbers in the wrong place? The AM slot is suppose to be the 6am one, the middle numbers at +6 is the noon check, the pm slot is the 6pm check.
I’ll try to do a curve this week. Is a “full cycle” 12 or 24 hours? Thank you for your help. Please be patient with me. Computers and I have our issues!!!
 
You're doing great! You learned a lot while you were lurking! A full cycle is 12 hours, the time from one shot to the next. Keep posting here - we can help you get on top of this.
 
Great job already! I lurked when I first arrived too, and I felt it was really helpful to learn some things first. You've done great with your SS, your food switch (love that all the cats are on it), and your insulin dosing! I know it's a bit scary when your vet says you can handle the dosing on your own, but don't worry! We're here to help (and we've been doing this awhile) so we can definitely help you figure this out. I think it's great that your vet is so willing to let you take some control! Let us know what questions you have. There will be a TON at first, but that's how we all learned! :)
 
Thanks to all of you for the encouragement. Reading up on stuff is great. This site has been good for that. I’ve also learned a lot from the Forums. But I guess it’s time to get some individual help. I hate to see Pickles loosing weight. She’s always hungry and I know that’s a sign of the unregulated diabetes but it hurts to see her like this. It’s been a little over two weeks since we’ve switched to Prozinc and I’m getting a little nervous over what dose to give her now. She’s about 12.5 pounds and I started her kind of low on .8 units. We went up to 2.2 units as of Nov 10. On the morning of the 11th her number was 74! No shot then. Two hours later it was 156. I gave her .2 units. Four hours later it was 94. Six hours later it was 191. I gave her .2 units. This morning she was 306. She got .8 units. I did enter this on the spreadsheet. I’m in a real dilemma as what to do and how much to increase at a time. I don’t want to go up too much too soon. That quick drop to 74 kind of freaked me out. One good thing about the Prozinc is that Pickles seems more alert. But all this jumping up and down with the numbers is hard to figure out what is going on. Thanks for letting me vent! Definitely open to all the help and suggestions you can pass on! By the way, our vet is great! He’s very sympathetic to trying whatever will work. But just like people doctors...they can’t keep up with all the different meds etc.
 
Just want to be sure I am understanding ... are you saying that you were giving multiple, albeit very small, doses every few hours on the 11th? If so, and I’m not sure how Novilin is dosed, but ProZinc should be dosed twice a day. This is because it is a longer lasting insulin that typically has a 12 hour duration. The “onset” of its effect is typically about 2 or 3 hours after the shot, with its peak impact (the “nadir”) often happening about 6 hours after the injection. After that, kitty’s glucose levels will typically start to rise, until the shot “wears off” after about 12 total hours, and it’s time for another test/shoot; I.e., time to begin the next cycle. If shot more frequently than 12 hours apart, there could be overlapping nadirs messing with the kitty’s response to the dose, and it could get really challenging to figure out how a particular dose is effect the levels overall.

Or just ignore all that if I misunderstood! :)
 
Well, I think the jumping around of doses may be part of the problem. Yes, Prozinc CAN be dosed on a sliding scale, but we find it works best when a consistent dose is given AM and PM. Looking at your SS, it looks like 0.8 gave a decent blue at +4 the other day with a yellow preshot following. Why not stick with that dose for a few cycles (3-4) and get what mid cycles you can. Then we can see what kind of numbers that gives you and go from there!
 
Jenna Josie said:
Just want to be sure I am understanding ... are you saying that you were giving multiple, albeit very small, doses every few hours on the 11th? If so, and I’m not sure how Novilin is dosed, but ProZinc should be dosed twice a day. This is because it is a longer lasting insulin that typically has a 12 hour duration. The “onset” of its effect is typically about 2 or 3 hours after the shot, with its peak impact (the “nadir”) often happening about 6 hours after the injection. After that, kitty’s glucose levels will typically start to rise, until the shot “wears off” after about 12 total hours, and it’s time for another test/shoot; I.e., time to begin the next cycle. If shot more frequently than 12 hours apart, there could be overlapping nadirs messing with the kitty’s response to the dose, and it could get really challenging to figure out how a particular dose is effect the levels overall.

Or just ignore all that if I misunderstood! :)
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Thanks, Jenna Josie, for the info. The 11th was a weird, abnormal day. I do keep the shots at twice a day-twelve hours apart but I freaked out at the 74 number at 6:00am so I didn’t give her a shot. At 8:00am when she started going up so much I did a minimal dose to carry through the day. Then minimal again in the evening. Hopefully, we’re back on some kind of track now.
 
Rachel said:
Well, I think the jumping around of doses may be part of the problem. Yes, Prozinc CAN be dosed on a sliding scale, but we find it works best when a consistent dose is given AM and PM. Looking at your SS, it looks like 0.8 gave a decent blue at +4 the other day with a yellow preshot following. Why not stick with that dose for a few cycles (3-4) and get what mid cycles you can. Then we can see what kind of numbers that gives you and go from there!
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Rachel, I did wonder if I was jumping around too much with the dose. I worry if I give her too much or too little when the numbers fluctuate. I gave her 1 unit twice yesterday and already did 1 this morning. Perhaps I should stick with that for a few days and see how it works out. I have a “free” day Friday and will try to do a curve. Maybe that will show something. Thank you!
Rachel said:
Well, I think the jumping around of doses may be part of the problem. Yes, Prozinc CAN be dosed on a sliding scale, but we find it works best when a consistent dose is given AM and PM. Looking at your SS, it looks like 0.8 gave a decent blue at +4 the other day with a yellow preshot following. Why not stick with that dose for a few cycles (3-4) and get what mid cycles you can. Then we can see what kind of numbers that gives you and go from there!
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Can you add the micro-doses to your spreadsheet so that when we're looking at your data, we know what was impacted by that? If you type it in as "0.2u" for example, it should leave the cell white (which is fine) instead of turning it lime green. Just enter the dose amount at whichever hours you injected.

You were doing well with the doses (keeping them for 3-4 cycles most of the time) until she gave you that 74. And adjusting for that was the right thing to do, then followed by a few cycles where we just have to wait and see what she needs. She'll settle down again soon. I agree with Jenna though - giving microdoses like that doesn't work quite the way you think it should, so it's better not to do that at this point in your journey. In the future if she starts to rise and you want to inject, just give a regular dose and start counting your 12 hours from there. Then take a few days to work back to your regular shot time. If your work schedule doesn't allow you to do that, then it's usually better to just skip for that cycle and start over at the next regular time.

There is a way to use Prozinc with microdosing, but it requires that you are testing a LOT and since at this point you're only doing one mid-cycle test, it's not really safe.
 
Sue70 said:
Rachel, I did wonder if I was jumping around too much with the dose. I worry if I give her too much or too little when the numbers fluctuate. I gave her 1 unit twice yesterday and already did 1 this morning. Perhaps I should stick with that for a few days and see how it works out. I have a “free” day Friday and will try to do a curve. Maybe that will show something. Thank you!
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Rachel, I went through my spreadsheet again. You're right about the jumping around there. I don't want to go up too fast and have a repeat of the "74". I had given her breakfast and her shot of 1 unit before I your message. I like your advice about shooting at .8 for a few days so I will start that tomorrow morning. Thank you!
 
Djamila said:
Can you add the micro-doses to your spreadsheet so that when we're looking at your data, we know what was impacted by that? If you type it in as "0.2u" for example, it should leave the cell white (which is fine) instead of turning it lime green. Just enter the dose amount at whichever hours you injected.

You were doing well with the doses (keeping them for 3-4 cycles most of the time) until she gave you that 74. And adjusting for that was the right thing to do, then followed by a few cycles where we just have to wait and see what she needs. She'll settle down again soon. I agree with Jenna though - giving microdoses like that doesn't work quite the way you think it should, so it's better not to do that at this point in your journey. In the future if she starts to rise and you want to inject, just give a regular dose and start counting your 12 hours from there. Then take a few days to work back to your regular shot time. If your work schedule doesn't allow you to do that, then it's usually better to just skip for that cycle and start over at the next regular time.

There is a way to use Prozinc with microdosing, but it requires that you are testing a LOT and since at this point you're only doing one mid-cycle test, it's not really safe.
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Djamila, I added the micro-doses to the spreadsheet and also made a couple corrections. I'm using U100 syringes and the Conversion Chart for the U40. I accidentally put a couple wrong numbers in the spreadsheet. That was the only time I ever micro dosed and was hesitant to do it. Hopefully, never again! I'm taking Jenna's advice and starting tomorrow morning will give Pickles .8 units for a few days and see how she reacts. I tested Pickles a couple more times today and will try and do a complete curve on Friday. Looking at the spreadsheet---I'm assuming that Blue is great; Yellow is okay etc.? Thank you all for your guidance.
 
The colors go roughly like this:
Lime green = too low
Dark green = the best for most cats (normal, non-diabetic is 50-120, with most numbers between 50-80)
Blue = pretty good
Yellow = too high
Pink, red, and black = way too high

:)
 
Just finished a day of doing a curve on Pickles. She is the most wonderful, calm cat. Half way through the day when she saw me getting the lancet and meter ready she got on the table and waited! What a girl!!
Ok-the plan was to give her 0.8 for a few days. On Nov 14 she dropped low in the afternoon and only went up to 127 at dinner time. I was worried about it dropping too much overnight so I gave her 0.2. The 15th & 16th were all 0.8. Her numbers always seem to go up throughout the night. After finishing the curve today (Nov 16) I’m thinking her dose needs to be raised. Should I go to 1.0 or higher?
 
Isn't it great to have a calm, cooperative kitty?! Teasel is like that and it makes it all so much easier for me. :)

I suggest you go to 1.0 u today if you're home to monitor. What happened in the 14th might not happen today. They can be especially unpredictable at the beginning of their FD journey.

Would you mind setting up your signature for us? It's the light grey text you see under our posts. We read that capsule info to get a sense of what the situation is before we advise. Here's how:
  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
 
Kris & Teasel said:
Isn't it great to have a calm, cooperative kitty?! Teasel is like that and it makes it all so much easier for me. :)

I suggest you go to 1.0 u today if you're home to monitor. What happened in the 14th might not happen today. They can be especially unpredictable at the beginning of their FD journey.

Would you mind setting up your signature for us? It's the light grey text you see under our posts. We read that capsule info to get a sense of what the situation is before we advise. Here's how:
  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
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Thank you, Kris. I think I did the Signature correct. I couldn’t quite figure it out before.
 
We (Pickles, me & hubby) are entering strange territory now and need some advice. We’re been slowly raising her Prozinc. I really like the spreadsheet because I can see patterns. One thing I noticed is that her glucose level rises more throughout the night. Is this normal? The last 4.5 days she’s been on 1.8. Last night (5th) I gave her 2.0 for the PM and was going to continue with that number. But this morning she was at 152 and I went hesitant to give her 2.0 so I gave her 1.8. Her mid day & dinner checks were 95 & 77 with no PM shot. The last evening check was 172. I’m assuming she will be high in the morning since she didn’t have a shot last night. So-o, do we stay at 1.8...2.0...?? What to do if the levels go lower again like today? Are we on the right track with what we’re doing?
 
I think I would keep with the 1.8u for a little longer. I would also recommend testing at different times if you can. Not all cats nadir at +6, so scattering the tests around can give you a better idea of what's going on. My cat reaches nadir at +6 some days, and +3ish on other days, so moving the testing times around can be helpful, especially when you're getting greens like you are these days.
 
Djamila said:
I think I would keep with the 1.8u for a little longer. I would also recommend testing at different times if you can. Not all cats nadir at +6, so scattering the tests around can give you a better idea of what's going on. My cat reaches nadir at +6 some days, and +3ish on other days, so moving the testing times around can be helpful, especially when you're getting greens like you are these days.
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Thank you for replying so quickly! I checked my email this morning before shooting. Yes, I think you’re right about the 1.8. I was surprised to see Pickles glucose reading at 188. I really thought it would have been much higher. We will also start testing at different times of the day. Thanks for the advice!!
 
Hello! I have a couple questions. 1. Do I continue posting under this thread like I am or do I start a new thread with each question etc? 2. I REALLY like doing the spreadsheet. It makes more sense then just keeping it all in a notebook. Pickles numbers have been pretty good lately. I’ve got her at 2.0 twice a day. Here’s my dilemma-our vet said not to shoot when her reading is 100 and lower. But what do I do when her evening number is 110 like it was on 12/12/18? I ended up giving her a little less but was that the right thing to do? I was afraid to give her the usual dose because I didn’t want her level to drop too much overnight. Yet, the next morning it was in the 200’s. 3. Any suggestions on how to get Pickles to start putting some weight on? She’s down to 11 lbs from 16. Thanks for any advice. You all are my support group!
 
You're doing really well! :)

Re thread: keep this one if you like and start a new one once you begin a new page (usually after about 100 posts).

Re whether/how much to shoot: she's very moderate in her responses and your dosing choices have worked out really well - including when she was at 110 at PS. You're accumulating a good body of data to refer to if/when she surprises you with a lower PS. I think that you can give insulin if she's near 100. The 1 u dose worked fine at 110. If she was lower, say 80 to 100, you could try 0.5 u. It's really guesswork and experimentation.

Re weight: are you letting her have several meals a day of her regular low carb food? Once she's better controlled for a longer period of time she should put on some weight. I wouldn't restrict food for now but split it into many small meals.
 
Hey there! Wow Pickles is doing so well! You have a SS most people here would give their eyeteeth for! :) Yes, as Kris said, I think Pickles would be fine with a dose in the 100 range. You could try stalling but my guess is that it wouldn't do much for Pickles...she tends to stay in fairly flat ranges which is good.

As for food, how much do you feed right now? Does she eat well or does she just kind of pick at her food? There are higher calorie foods that you could probably try if she needs to put on some weight, but I've never tried any of those (my chunky cats don't need any extra calories!!).
 
Hi Kris & Rachel! Thanks very much for your comments & advice. It’s pretty much what I was thinking for the lower number decrease of insulin. It helps to have confirmation on my thoughts. I feed Pickles 4 times a day. She doesn’t seem so overly hungry then. Her appetite is very good! About the weight...I was investigating Blue Buffalo Wilderness cans. The carbs (3) don’t seem too bad & the calorie count is a little higher. The chicken & duck ones seem the best. We’re on the 3rd day of it for her noontime feed and she really likes it. I’m hoping a few extra calories might help. I found a pet scale for a good price & am planning on weighing her once a week. :) Sue
 
Have you asked your vet how much she should weigh? My cat was chubby when he was diagnosed and over time and a healthier diet, he lost a few pounds. I thought he was too skinny, but the vet said it was his ideal weight. It just took me awhile to get used to his new svelte figure ;):cat:
 
Good point, Djamila. Pickles was kind of chubby to start with. I think I over worry because we once had a cat who lost a huge amount of weight due to cancer and ended up dying. The last time (end of Oct) when we had Pickles in at the vet, he just said she would hopefully put on some weight when she stabilized. He didn’t sound too concerned. Maybe I need to chill out a bit. Thanks! ;):)
 
It does sound like he agrees that she needs to gain a bit though. She's getting great numbers right now, so you may try some higher calorie food as Rachel suggested if she doesn't start gaining soon.
 
I’m trying some higher calorie food at noontime. But I’m still trying to keep the carbs down. She’s getting Blue Buffalo Willdernes right now. The chicken is 3 carbs and 132 calories. The duck is 3 carbs and 128 calories. Does anyone have any other suggestions for higher calorie food?
 
Those are actually pretty good for calories. If you look on this list, you'll find calories listed in the far right columns, so you can scroll through and see what else might work: https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

The problem is that a lot of higher calorie foods are also really high in fat - so they could be used to help put on some weight, but I wouldn't consider them a long term option.
 
Yes!! This is the list that I have been looking at. :) What I’m thinking of doing now is giving Pickles the Blue Buffalo twice a day for a couple weeks and shredded chicken the other two times and see if she starts to gain a little. I’ll check out some of the other brands, too. I don’t want her going back to her old weight—just a few more pounds. We’ll figure out a way to work around the other cats. At noontime we take Pickles in the kitchen and close the pocket door. The other kitties don’t need a noontime snack...or additional weight! So far they don’t seem to mind the closed door.
 
I don’t think things are looking too good right now. Pickles numbers are not bad but up until 2 days ago she had a huge appetite and would eat anything you gave her. Yesterday she ate some but not a lot. This morning she ate just a little bit. I cut her shot in half. We’re going to wait until this afternoon to see if she eats at noon and then go to the vet and check things out. I’m wondering if something else might be going on. :(
 
Sue70 said:
I don’t think things are looking too good right now. Pickles numbers are not bad but up until 2 days ago she had a huge appetite and would eat anything you gave her. Yesterday she ate some but not a lot. This morning she ate just a little bit. I cut her shot in half. We’re going to wait until this afternoon to see if she eats at noon and then go to the vet and check things out. I’m wondering if something else might be going on. :(
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Has she ever had pancreatitis? It's very common in diabetic cats and can present as lack of appetite, lethargy, signs of pain ("meatloafing" position), sometimes vomiting and diarrhea. There's a quick yes/no test the vet can do in office or a pricey blood test that gives actual readings of levels of various pancreas related things. Neither is foolproof and vets will often treat "as if". Treatment is for symptoms and can include antinausea meds (Cerenia is often the go to), pain meds, maybe subQ fluids and appetite stimulant meds if treating nausea alone doesn't work.
 
Kris, I have just been reading up on all the “possibles” to ask the vet & pancreatitis is at the top of the list. Thank you for responding to my post so fast. I’m pretty upset right now. If necessary, we’ll insist on a total blood work up to rule out anything else. I’m hoping for a fixable outcome since Pickles numbers have been so good lately.
 
That does sound like possible pancreatitis. Or ketones, but given the low numbers you're seeing, I'd think pancreatitis is more likely. Unfortunately lots of our kitties have it.

As Kris said, there are two tests. Neither one is particularly accurate, although the lab/expensive test is more accurate than the quick yes/no test. Basically if it's positive, it's a true test. If it's negative, they could still have pancreatitis, and it's just not showing in the test. They do have to be fasting for the lab test to have the best chance of accuracy, and some vets don't realize that.

If it is pancreatitis, don't let your vet talk you into steroids. At least not yet. There may come a time when it's worth trying, but certainly not for a first bout of p-titis.
 
Djamila, what would other options rather than steroids be? I want to be loaded with information when we go to the vet. I wondered about ketones and that is also on my list. I’ve never checked for that. Other things on my list are thyroid and kidneys. Also, I don’t know if this would make a difference, but for the past few days I’ve been feeding her Blue Buffalo Willderness Chicken pate for the extra calories once or twice a day. I’ve got that on her Spreadsheet.
 
You should have ketone test strips at home for any diabetic cat, so grab some of those at the pharmacy and get in the habit. They are less common in cats with good numbers, but can appear anywhere. Is this a new food? It could be that the transition was too quick and she's pushing back. Maybe try offering some of her previous food and see if she'll eat that. A rapid food change can cause tummy upset, so it could be as simple as that, and not any of these more serious things.

And yes, if it's pancreatitis the treatment is the symptoms - you can't really cure it. You just make them comfortable and wait it out. If that turns out to be the problem, we can definitely help. The biggest thing I would say is insist on the pain meds. A lot of vets will give everything else (anti-nausea, appetitie stimulant, sub-q fluids), but try to tell the owner that the cat isn't showing pain. Cats don't show pain, so that's just dumb. Pancreatitis is known to be painful, so insist on some bupe and give it until appetite returns. Here is some reading: http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

However, I would again go with the simplest option and think about the food transition. It may not be anything more than that.
 
Thank you, Djamila. This is all excellent advice. I will definitely get the ketones strips. I will also read the site you gave me. I cannot begin to tell you how much I appreciate all of you!

Yes, the food (Blue Buffalo Willderness)was a new one. I’vet been giving it to her at noon for the past week. It has more calories. Trying to get more weight on her. She got Fancy Feast & DM for the other 2 meals and shredded chicken at night. However...the last 2 days I gave her BBW in the morning and at noon and FF/DM at dinner & chicken at night. Maybe the BBW is too rich?

We will be going to the vet this afternoon and I will let you know the outcome.
 
We’re back from the vet. Pickles had a temp of 103. He said normal is around 101. They did a total blood work up plus a thyroid panel. We should have the results tomorrow. Doc gave Pickles an antibiotic shot plus a B12 shot. We came home with Veraflox (antibiotic) & Mirataz (cream gets rubbed on ear) for weight loss problems. She was down to 9.5 lbs. The Doc said her numbers look good and he thinks something else is going on. Got my fingers crossed that it’s something fixable. Pickles ate some after we got home. Normal dinner time is 6pm. We’ll see if she eats then so I can give her a shot.
By the way, our vet thinks we’re doing of wonderful job with the checking and insulin. I told him it’s due to our great online support group!
 
Hope everyone had a good Holiday. I haven’t posted lately because I needed to process things. Pickles got her bloodwork results on Friday and we saw the Vet on Monday. All her blood results are good except...her kidney numbers were higher than normal. The old term is renal failure. The new term is chronic kidney disease. If caught in the early stages and getting the proper foods etc a cat could possibly go years longer. It’s a toss up. I spent the weekend researching the net for info. I found a site that had a lot of good info-felinecrf.org. Diabetes can also bring on kidney problems. The symptoms are similar to diabetes-exsessive thirst, urination, weight loss. The Vet said to let her eat whenever she’s hungry to try and put on some weight. She gets Nutri-Cal to stimulate her appetite.He suggested ordering the prescription kidney food. According to the website, you want a food that is low protein & low phosphorus. Most of those foods have a high carb count. I checked the catinfo.com site to search for foods that wouldn’t counteract the 2 diseases and I think some Blue Wilderness and Wellness brands are about the best. I will order the prescription food but mix it with some Fancy Feast. The Blue & Wellness have more calories and will work good for extra feedings.

On top of all this, Pickles glucose numbers are actually really good. I don’t understand what is going on. She hasn’t had any shots today. Her lowest number seems to be at noontime. Since she’s been on antibiotics I’ve had to lower her insulin quite a bit. I’m sorry this is so wordy. I guess I just need some reassurance as to whether we’re on the right track with the insulin and food.
 
I'm so sorry to hear that Pickles is in CKD, Sue! I don't have any experience with it other than what I've read on here sometimes. Do you know what stage Pickles is in? I believe that earlier stages of CKD you want to do higher protein and low phosphorus. It's only in the later stages you want to think about lower protein. I know Tanya's Site (https://www.felinecrf.org/) has some really great info. Did the vet suggest anything else for treatment? It sounds like it may be very early stages, which is great.

You might want to post out on Main too and use a subject like like "New Diagnosis of CKD Questions" and use the question mark icon. That will help get some eyes on it from other folks who have CKD kitties. We have several around I know so that way you can get some more reassurance and help.

As for the BG numbers, they look great! You'll want to keep an eye on things as you start new foods to see how that affects her. Hopefully it won't cause any problems, but it's good to keep an eye on things. :)
 
Thank you, Rachel. It was a bit of a shock. I did my bit of crying and then hit the internet. Yes, Tanya’s site has the most information in an easy to read platform. The Vet feels it’s in the early stages. Her phosphorus is 8.1 (normal range is 2.7-7.3); creatinine is 2.2 (normal range 0.6-2.1). The Vet really didn’t suggest anything else except to make sure she eats and to get the prescription food. She gets a small gob of Nutri-Cal a couple times a day.
One thing I read on Tanya’s site was that if blood work is done when the cat has an infection it might show higher numbers in the kidney part. Doc wants Pickles back in the beginning of Feb. and he will draw blood for a kidney check again. I’m hoping it might show normal...but we’ll see.
Thanks for the suggestion about posting on the Main board. I didn’t think of that. I’ll do that tomorrow. It’s been a long few days. I really appreciate all of you! :)
 
There are many members who have CKD diabetic kitties. They can help you with food selection, etc. It's very hard to get a shock like this. :bighug::bighug::bighug:
 
It was certainly unexpected. Just when we seem to be getting the diabetes under better control—BAM! Rachel suggested posting on the Main Board. I was going to do that earlier this morning but found someone had just posted about the same thing! I’ve been reading those responses and will probably post later today with more questions. This site has been so helpful! It reminds me that we are not alone with our fur-babies problems. :)
 
Sue70 said:
It was certainly unexpected. Just when we seem to be getting the diabetes under better control—BAM! Rachel suggested posting on the Main Board. I was going to do that earlier this morning but found someone had just posted about the same thing! I’ve been reading those responses and will probably post later today with more questions. This site has been so helpful! It reminds me that we are not alone with our fur-babies problems. :)
Click to expand...
I know that @JanetNJ has CKD experience.
 
Sue70 said:
Thank you, Rachel. It was a bit of a shock. I did my bit of crying and then hit the internet. Yes, Tanya’s site has the most information in an easy to read platform. The Vet feels it’s in the early stages. Her phosphorus is 8.1 (normal range is 2.7-7.3); creatinine is 2.2 (normal range 0.6-2.1). The Vet really didn’t suggest anything else except to make sure she eats and to get the prescription food. She gets a small gob of Nutri-Cal a couple times a day.
One thing I read on Tanya’s site was that if blood work is done when the cat has an infection it might show higher numbers in the kidney part. Doc wants Pickles back in the beginning of Feb. and he will draw blood for a kidney check again. I’m hoping it might show normal...but we’ll see.
Thanks for the suggestion about posting on the Main board. I didn’t think of that. I’ll do that tomorrow. It’s been a long few days. I really appreciate all of you! :)
Click to expand...
There's a very good Facebook page for ckd cats called Cats with Chronic Renal Failure. They helped me when my cat was diagnosed with ckd.

The creatnine is high but only stage 2. The phosphorus is quite high. You want to try to get that under 5. It can make them feel poorly and advance the ckd quicker. Switch the food to something low carb low phosphorus such as Tiki Cat (I like the after dark line). You may find diet alone isn't enough to lower the phosphorus the way you want... In that case you'll want to add a phosphorous binder such as aluminum hydroxide to the food. Fancy feast is very high in phosphorus so you will want to get her off that.

You don't want her on the kidney perscription food. (At least not until she's stage 4) It's low in protien which can lead to muscle wasting and very high in carbs.
 
It looks like Pickles may be heading into diet controlled diabetes (remission), so I beg you not to feed the prescription kidney food. As others have said, there are options that are good for both diabetics and CKD kitties. A diet controlled diabetic cat is rather fragile as far as carbs are concerned, and despite what vets (and the food company reps that sell to them) will tell you, the prescription food is not necessary at this point.
 
This has been a busy day! Thank you, Janet, Djamila, Kris & Rachel for responding to my earlier post.
First-I cancelled the order for the prescription kidney food. Thank you for that! I was actually on two thoughts about getting it because of the high carbs. I don’t know why Pickles BG numbers are suddenly so good but I hope it lasts for a while!
Second- I shopped around and found some Tiki food at a Petco. The numbers for that brand are good! I want to try some to make sure Pickles will eat it before I order any. I like the food chart on catinfo.org
Third-I’m looking for the aluminum hydroxide. The pet stores didn’t know what I was talking about. I found some on Amazon. The one I was looking at is called Phos-Bind, 200 gram power for dogs & cats. Is this what you are referring to?
Janet, I googled Cats with Chronic Renal Failure but a specific site by that name did not show up. I have been on Tanya’s Page and that gave me a lot of good info.
Well, it’s 4:00 and I can finally sit down with a cup of coffee and a cat in my lap. By the way, we are a multi-cat house!
:bighug::cat:+
 
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