Need help with feedings

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Sarah and Bumbles, Aug 7, 2020.

  1. Sarah and Bumbles

    Sarah and Bumbles New Member

    Joined:
    Aug 7, 2020
    Bumbles is the sweetest 9 year old cat. She was diagnosed with diabetes mellitus in February 2020 and we've had the hardest time figuring out her insulin dose. In July she had two different incidents that required stays at the vet. Her first one was for ketones and is now ketone free but was diagnosed with pancreatitis in July. Her most recent stay starting 7/27 is because she wasn't eating and we think she had a seizure. She's was at the vet for a full week.

    She's home now but she's very underweight 6.6 pounds. I give her 2 units of Lantus 2 times a day. We feed her half a can of the Royal Canin Glycobalance wet food 2x's a day and check her BG before feedings. She's is always starving though! Do we let her free feed the Royal Canin glyobalance dry food during the day? It seems like we're torturing her with only feeding her 2x a day 12 hours apart.

    Any advice would be greatly appreciated,
    ~Sarah and Bumbles
     
    Last edited: Aug 8, 2020
  2. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    WELCOME TO FDMB! We are so glad you found us. We CAN and WILL help any cat and their person learn to navigate this difficult but MANAGEABLE disease.
    FIRST please let your kitty eat. An unregulated kitty cant metabolize food properly thats why they are so hungry yet lose weight. AND If she was hospitalized with keytones to borrow a line from another member, FOOD is like medicine. The only thing special about Glycobalance is the price. You want a WET food(can) with 10% or less in carbs.
    ALL dry food are packed with carbs. Carbohydrates feed diabetes.
    Many of us here including myself feed Fancy Feast Pates. Many use Friskies pates. There ARE other brands that have suitable amount carbs.
    Also cats are grazers we recommend two main meals with a couple of snacks in between.
    More people will speak to these issues, so hold on for more replies.
    In the mean time you may want to start here:
    New? How You Can Help Us Help You!

    Again welcome to the best darn site on this planet to help you help your extra sweet and ADORABLE Bumbles!
    jeanne
     
  3. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I see you have figured out your signature. You will want to add: Insulin used, Date of DX, food you feed, Bumbles breed...All the little particulars that ARE Bumbles..
    This signature gives our helpers an at a glance information so they dont have to search through posts. It helps us help you quicker.;)
    You will also want to start a spreadsheet. this will track Bumbles numbers to show trens in how the insulin is working for her. you can find that here:
    FDMB SPREADSHEET INSTRUCTIONS
     
  4. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

    Joined:
    Dec 21, 2019
    Yes what JT said! Diabetic cats need more food because they can’t process the nutrients efficiently and that’s why they’re always hungry and will lose weight. She’s getting less than 100 calories a day which is not enough food at all. I’d guess she should be at at least 200 calories a day. Do you know her ideal weight? If you don’t, ask the vet. A good rule of thumb is ideal weight times 20 to get the calories intake she should be getting daily. I’d add more to that because of the weight loss until she’s at her ideal weight again and ketones, which is the body telling you it’s starving. Please also remember that diabetic cats burn calories just by peeing since there’s sugar in their urine! I’d switch her to fancy feast pate or a lower carb food but not without home testing since changing foods can really lower her BG.

    the seizure concerns me as she may be getting too much insulin. Have you considered home testing? It’s the only way to make sure your cat is safe and control the insulin properly.
     
  5. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

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    Dec 21, 2019
    The other thing is that most cats do better with smaller meals throughout the day, since they’re typically grazers, and it’s easier on their pancreas. With the pancreatitis, I’d suggest feeding her more times a day. We recommend the bulk of the meals around shot times with a few more smaller meals or snacks in between.
     
  6. Sarah and Bumbles

    Sarah and Bumbles New Member

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    Aug 7, 2020
    Thank you so much for your replies!! Yes, the vet just advised us to start testing her BG - see attached.

    The vet recommended the glycobalance but we used to feed her FF pate. When you say smaller meals - like 1/4 can if wet food? We do give her the Lean Treats throughout the day.
     

    Attached Files:

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  7. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    At the moment I would let her, have at least half a can. But hold on for more replies . ;)

    Good for you getting the spread sheet started . It will be very helpful if you add this info to it. So GLAD you are home testing ! It really is the only way to keep Bumbles safe. :D
     
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  8. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

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    Dec 21, 2019
    I happen to have the glycobalance here because I used to feed Minnie that. It was also vet recommended :arghh: It’s only 61 calories per can. What do you think or guess her ideal weight would be? 10 pounds? If it’s 10, then she should be getting at least 200 calories maybe more to gain weight back. If it’s 12, 240. That’s more than 3 cans a day. I’d give her 4 right now to put some weight back. Minnie is 16 pounds and she gets 300 calories which translates to about 4 cans of FF a day. The calorie count is on the back of each can and different flavors have different calorie content so you have to do the math based on what you’re feeding her. So, for Minnie I give her 1 can and a half around shot time. 1/2 a can then I test her then another 1/2 about 30 minutes laster and the last 1/2 about 2 hours after the shot. Then she gets another 1/2 a can at +6 and a small snack at about +8. Then I repeat the am routine at night and leave 1/2 a can out overnight.

    btw, you don’t need a pet meter to home test. Most of us use human meters. I have Walmart’s Relion, which I really like, it’s very reliable and had the most affordable test strips.

    what’s the carb content in the lean treats?
     
  9. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    YES to what Jeanne and Ale have said! Let her have lots of food in small increments. The weight won't come back until she's on the correct dose (can take some time to figure out what she needs but don't rush it) but until then let her have what she wants! My girl was down to 4 lbs and was eating upwards of 4-5 cans per day! Almost ate me out of house and home LOL but they'll slow down once they get their blood sugar in check.
     
  10. Dusty & Roe

    Dusty & Roe Member

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    Apr 28, 2020
    Sara I just have to say what Beautiful markings Bumbles has so different . There are so many better food choices out there that are actually human grade . Pet food labels are getting trickier to say the least . Then if you want the better food you pay a much higher price it’s almost a whole learning process just picking out a can food lol
     
  11. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Sara,

    I echo Roes' comments about Bumbles' beautiful markings. :)

    I agree that because she's underweight and ketone prone it's especially important that she gets enough grub.

    Based on what's currently in your signature would my understanding be correct that you're not checking Bumbles' BG levels at home at the moment? If you're not yet doing so, it could help you to regulate her BG better and that would help her to regain weight.

    If you have any information on where her BG is running at the moment (e.g. most recent vet curve or fructosamine test) it would help us to get a better picture of Bumbles' current status and perhaps make more suggestions on what might help.

    NB: If you are home testing then the only time that you need to withhold food from Bumbles is for the two hours prior to her preshot blood glucose test to make sure it is not influenced by food.


    Mogs
    .
     
  12. Sarah and Bumbles

    Sarah and Bumbles New Member

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    Aug 7, 2020
    Hi Mogs - thank you for all the info and the kind words about Bumbles! Her ideal weight is 9-10 pounds. We will definitely start feeding her more, and will only withhold food 2 hours before the BG test. The Lean Treats are only 3 calories each. I haven’t filled out the BG spreadsheet but will do that today. I’ve attached the log we’ve been keeping in the meantime.

    Our vet instructed us to check Bumbles BG two times a day. If the BG is normal (between 70-160) 1) feed 2) wait two hours 3) give two units of insulin. If her BG is high 1) give insulin immediately 2) feed.

    ~ Sarah
     

    Attached Files:

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  13. Sarah and Bumbles

    Sarah and Bumbles New Member

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    Aug 7, 2020
    Hi Roe - I’ll definitely start researching other cat food brands! Thank you for kind words about Bumbles. She’s the sweetest!!
     
  14. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

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    Dec 21, 2019
    You should not wait 2 hours after you test to shoot because by then her BG has changed. What we do here and recommend that others do is test, feed and shoot. It should all happen within minutes of each other. I suggest you read up on the two dosing protocols we use here and pick one. I would never shoot a regular dose at 70. To me, that would be a token dose or no dose because that’s a pretty low number. Anything under 50 is considered a hypo and 70 is pretty close to that. What most of us do is above 200 at preshot, we give a regular dose, between 150-200 you can either stall for 20 minutes and retest to see if numbers are going up still without food or give a token dose. Under 150 most of us will skip the dose. Every cat is different and you need to test to get enough data to know what your cat nadir is, lowest point in any one cycle. I’d try to test midday at a few different times to get an idea of when she goes lowest. Like +6, then on another day +5 and maybe +4. We increase or decrease the regular dose by the nadir, not the preshot numbers. Please review this link about Lantus dosing methods:

    http://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

    TR is a bit more aggressive than SLGS. With TR you’d only decrease the dose if she goes lower than 50 and with SLGS that threshold is 90. I really don’t understand why your vet would have you wait 2 hours to shoot without retesting. I’m tagging a few other members who may be able to guess what that is... @Red & Rover (GA) @Bron and Sheba (GA) @Panic @Nan & Amber (GA)
     
  15. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Sounds like a case of not knowing what they're talking about to me. :rolleyes: Not even NPH has you waiting two hours to shoot!
    I agree with Ale, waiting two hours to shoot is ridiculous. Lantus typically doesn't kick in for 2 hours after injection. You should be testing/feeding/shooting within 15 minutes (unless you're stalling).
     
  16. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

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    Dec 21, 2019
    Thanks! I was wondering if I was missing anything :smuggrin:
     
  17. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

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    Dec 21, 2019
    The other issue I see with what the vet said about waiting is that it throws off your 12 hour interval in between shots and most insulins need consistency. Which one are you using again?
     
  18. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    In terms of dosing protocols, that's a new one on me. :confused:

    Aleluia has given you a quick overview above of how Lantus should be dosed. Lantus is a long-acting insulin. With each dose you fill up a little 'tank' of insulin in the kitty's body (the insuiln 'depot'). The idea is to consistently dose every 12 hours, testing before giving insulin to make sure it's safe to do so, and also testing in the hours between to see how low the BG is going when the insulin is most active. Because of the depot nature of Lantus, it needs to be dosed consistently. As Aleluia advises above, the mid-cycle tests are important because Lantus dosing decisions are based primarily on the nadir BG. The preshot test primarily tells you whether it's safe to administer the next dose. The mid-cycle tests help you determine whether the dose is too high, too low, or just right. :)

    I see that you are using an Alphatrak meter. If members replying to your posts don't open your spreadsheet they won't see this information. When you have a minute it would be great if you could add this information to your signature, Sarah, so that members can see at a glance that you're using a pet meter. :)

    Most members here use human meters to test their cat's BG levels. Human meters use a different reference range to pet meters (they read slightly lower). The hypo threshold of 50 quoted by @Aleluia Grugru & Minnie above is correct for human meter users but it is TOO LOW FOR ALPHATRAK. You will need to use a higher value with your glucometer. I've only recently returned to FDMB after a somewhat protracted sabbatical so I'm not confident to cite a reference range for you to use (I used the range given to me by my vet). If you ask for help with this on the Lantus and Levemir Support Group's subforum I'm sure the experienced members there will be able to give you more information on the reference range to use with your Alphatrak.


    Mogs
    .
     
  19. Sarah and Bumbles

    Sarah and Bumbles New Member

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    Aug 7, 2020
    Hi Ale - I thought it didn't sound right either because it throws the injection schedule off - I thought we were supposed to giver her shots every 12 hours. Thanks for the advise, I'll check out the Lantus dosing methods in the link you provided. I just started testing at midday and today at +6 she was at 643 (AlphaTRAK2)! Would that concern you?
     
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  20. Sarah and Bumbles

    Sarah and Bumbles New Member

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    Aug 7, 2020
    Thanks, Mogs! Added the pet meter to my signature. I just started mid-day testing today and will update the spreadsheet tonight. I'll check out the Lantus and Levemir Support Group's subforum.
     
  21. Sarah and Bumbles

    Sarah and Bumbles New Member

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    Aug 7, 2020
    I agree - which is why I started searching around for more info and luckily found this forum <3. We use Lantus for Bumbles.
     
  22. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

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    Dec 21, 2019
    I see that now in your signature. Thanks for setting that up!!
     
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