Need quick help after vet visit.

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Cordi

Cordi

Member Since 2013
I suspected my cat had diabetes after looking up and reading about diabetic neuropathy. A vet visit and a BS reading of 530 confirmed it. That was a week ago and I quickly found this forum and changed her diet to 4 varieties of Friskies that are 7% carb. She had been on dry food for 17 years. She was also started on 1 unit Lantus twice a day and a week later she is walking better and has gained half a pound. I'm thrilled.

With her symptoms being so bad and her sugar so high, I thought for sure her BS would still be a little high when I went back to the vet yesterday and that her Lantus would be increased. Nope, her sugar was 91 and this was just about 10 hours after her last dose of Lantus. The vet and I were both worried at this point that we don't know how she's going to react to insulin going forward and is in danger of going hypo. I'm an RN and I've been reading this forum a little bit so I suggested I go buy a glucometer to the vet and the vet agreed.

Basically I don't have a ton of time to research this forum to really find out the best course of action to take at this time and the vet doesn't seem totally sure either. So I'm turning to you. I've read enough to know that some meters aren't accurate with cats? Why is that? What meter should I go buy? Money is not a problem, although I don't want to spend money I don't need to spend. Right now the vet's plan is for me to check her BS before each shot and give her 0.5 units Lantus if her BS is over 120. Does this seem like a good plan? Also, the vet shaved a spot over a vein on each leg and gave me TB syringes to draw blood with. I'm good at drawing blood on people so I'm comfortable with this, however I've read that most of you use the ear? Any advice here would be helpful.
 
Hi Cordi...

Welcome to FDMB :-D

I will post on the Lantus forum so someone from there will help you.
 
Thanks Misty.

I've decided to go pick up a ReliOn meter after reading a little more here. You all seem to be using a sliding scale based on readings? Most of you are taking readings twice a day and basing dosing on readings? I haven't found a link the protocol you all use for dosing. My vet hasn't even mentioned doing that. She seems to just want to find a safe dose to give blindly twice a day and check her weekly at the office. I'm not real comfortable with that at this point. I want her well controlled to give her kidneys a chance to recover if they can, but I'm scared she's going to drop. I think based on this last week and Smudge's response just to the diet change that she might just revert and not need insulin. That's the hope anyway.
 
Most human meters are fine, but anything with "True" in the name and the Freestyle Lite meters seem to read off at low BGs. Many here use the Relion meters from Walmart (not the really cheap new one, that too has had off readings). I like the Up& Up store brand meter for Target. It's actually the WaveSense Presto (Target just repackages it), online the strips are as low as $11.50 a box at ADW (see the link on top of the page.) Strips are what can add up on cost, not the meter itself. Get one that takes the smallest amount of blood possible. Just use regular lancets, many start w/ larger gauge, but I use a 33ga and have no trouble getting a drop of blood. A drop is all you need.

NO, we don't test from the vein! Prick the ear just to the outside of the large vein you can see. It can take a little getting used to, but a cat's ears will "learn" to bleed. Ears also are less painful, my Tess actually purrs through the whole procedure. Always give a treat afterward, successful or not, and We test before giving insulin to be sure the BG is not too low to safely shoot and then try to find the nadir during the cycle so we can see how well the dose is working. That is what will determine the dose.

Just saw your last post. kitty's name is Smudge? :-D Don't use a sliding scale w/ Lantus. It is a depot insulin and needs consistency. We have a no shoot number (which will change as you have more data and become more confident) but you need to stick w/ a dose for 3 to 5 days to see the full effect of a dose. The depot needs a chance to fill or drain w/ every dose change. For newbies the no shoot number is usually 200. but I often shoot as low as 50.
 
Actually, with Lantus you do NOT use a sliding scale for dosing. Lantus dose can initially be based on weight (dose = 0.25 x ideal weight in kilograms). After the initial dose, adjustment are made based on the nadir (lowest point in the cycle) value. Generally, when you are new to managing feline diabetes, we suggest that you don't shoot if numbers are too low. On the Health board, the "post and ask for help" number is 200 whereas on the Lantus board it's 150.

Given that you're seeing lower than expected numbers, it may be wise to reduce the dose to 0.5u. This may be less than what your kitty needs but it will give you some time to gather data. In the meantime, you may want to review the starred, sticky notes on the Lantus board. They will help you to get oriented.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal version -- the “Tilly” Protocol developed by the counterpart of this group in Germany, which was also published by Kirsten Roomp & Jacqui Rand, DVM in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.
 
Wow, I just looked at the Lantus forum you mentioned, and now I'm feeling a bit overwhelmed. This is really involved and I'm just not feeling confident in my vet. As an RN I'm really good at what I consider an art form of giving insulin to people, but with my cat I have no feel for what's appropriate. I'll give 40 units of Lantus to a person and not blink and eye sometimes, but I give 1 unit to Smudge and she goes from 530 to 91. Time to go into spreedsheet mode.

Another question. Are there syringes that have markings less than 1 unit?

Edit: I posed this before I saw you all were responding. I'm reading and absorbing what you're telling me.
 
Cordi said:
Thanks Misty.

I've decided to go pick up a ReliOn meter after reading a little more here. You all seem to be using a sliding scale based on readings? Most of you are taking readings twice a day and basing dosing on readings? I haven't found a link the protocol you all use for dosing. My vet hasn't even mentioned doing that. She seems to just want to find a safe dose to give blindly twice a day and check her weekly at the office. I'm not real comfortable with that at this point. I want her well controlled to give her kidneys a chance to recover if they can, but I'm scared she's going to drop. I think based on this last week and Smudge's response just to the diet change that she might just revert and not need insulin. That's the hope anyway.
Click to expand...
No sliding scale for Lantus; Lantus and Levemir do not work like that.

For testing, I think your changing food has made a huge improvement, and for all you know, she does not even need insulin.
Why don't you test her at shot time, then feed her, and test her every couple hours.... see how she manages on no insulin.

As for testing, people test by poking on the tip of the ear.... no need to extract blood from a vein.
There are lots of youtubes you can watch and plenty of pictures on where to test along the ear...

Testing on cat’s ear
Testing on cat’s ear Youtube
it's a start.
 
Cordi said:
Wow, I just looked at the Lantus forum you mentioned, and now I'm feeling a bit overwhelmed. This is really involved and I'm just not feeling confident in my vet. As an RN I'm really good at what I consider an art form of giving insulin to people, but with my cat I have no feel for what's appropriate. I'll give 40 units of Lantus to a person and not blink and eye sometimes, but I give 1 unit to Smudge and she goes from 530 to 91. Time to go into spreedsheet mode.

Another question. Are there syringes that have markings less than 1 unit?
Click to expand...

Yes, there are syringes with 1/2 unit markings
 
Thanks Ann...I was in a bit of rush with something, so I thought someone in LL was available. :-D
 
Cordi --

It's entirely possible that your cat may not need insulin support after a diet change or may need insulin for only a short time. However, there's no way to know that for sure. I think your plan re. going into "spreadsheet mode" will give you the information you need. Also, one thing to remember is that Lantus is a depot medication. It takes 5 - 7 days for the depot to form and for your cat to begin fully benefit. These are the instructions for setting up a spreadsheet.

FWIW, the beginning of this process is rather overwhelming, even if you have a background in medicine. (After all, this is your kitty we're talking about!) The good news, though, is that it doesn't take all that long to clear the hurdles and feel reasonably comfortable with the testing, shooting, and making dose adjustments.
 
The .5u dose is probably a good idea, if you do w/ the vets suggestion for 120 may be a little low for a no shoot number until you get to know how she reacts.

If you shoot that low only do it when you will be home to check her BG frequently. Have a hypo kit on hand, high carb food, usually the kind w/ "gravy", plenty of strips and karo syrup or honey for a quick bounce up. ECID (every cat is different) and you need to learn how Smudge reacts to the higher carb foods. For instance I can usually get Tess up w/ only a slightly higher carb food and /or a drop of honey. That will bring her up 20 points and wear off after 2 hours, but other cats need more to bring them up or they stay up longer. You learn through charting her tests.

The Lantus sub group is the most used, if you have a low number post here or over there right away and some one will walk you through the low numbers.

Also what is Smudge eating? If she is still eating dry food that can really elevate BG. If you are switching over to wet you need to be very careful as that can lower her numbers dramatically and you will need to give less insulin.

Catching up w/ the posts, :lol: :lol: yes you can get half unit syringes, they usually have them at Walmart along w/ the meter you are planning to buy.
 
Awesome. Amazing. Thank you all. I'm feeling confident now. I think most of my anxiety was coming from the disconnect from what my vet was telling me and what I was reading here.

I love Smudge so much. She's been my best friend for 17 years and I thought I was losing her, but now she's doing so great and is so frisky and happy. She LOVES the diet change. I feel bad she didn't get an optimal diet all her life, but we do the best we can and learn as we go.

So we will drop to 0.5 Lantus BID, keep a spreedsheet of readings for a week, and go from there. I think it's very wise to drop the dose because at the beginning of this she was absolutely ravenous and ate like she was starving, which she was. Now she seems much more indifferent to food. I highly suspect she will soon need no insulin. Thank you all.
 
Hello and welcome to the board!

Its a steep learning curve at first but perhaps we can make it a little easier. There are 3 key things to know

1.Food is key to regulating or even remission for your cat. Cats unlike humans frequently go into remission with a lower carb food so your friskies food may already be helping Smudge!

2. A good insulin is important - Lantus is great. I do agree that the 0.5 dose will help as 1 unit may have been too much. Lantus is a depot insulin and it takes a few days to build to the optimum level in the cats system and before you see its impact. The key is consistency and you typically hold the starting dose for a week unless the cat drops below 50. The protocol Sienne provided gives more details on this but if you do the spreadsheet we can advise on dose as well as your vet. Let me know if you need help with the spreadsheet.
BTW syringes with 1/2 unit markings: For U-100 syringes (Lantus, Levemir), get 3/10 cc, half-unit marked, short needle, 30-31 gauge ie Relion 3/10cc 30 & 31 gauge short, BD Ultra fine 3/10cc short, Terumo Thinpro Insulin Syringe 31G 3/10cc, Kroger 0.3cc 8mm, 31 gauge.

3. Home testing - this is critical to keep your cat safe as you have seen. As a newbie we dont advise you shoot under 200 until you have data to know how Smudge will respond.
The Relion models are good - the Confirm and Micro are best for newbies as they need less blood than the Prime. We test the ears - heres some more tips: https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub.

I usually recommend 4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Keep us updated!
Wendy
 
One of the complicating factors in me figuring out what was going on, is that Smudge stopped grooming herself. I thought it was just old age, but I found that one of her toenails had grown around and stuck in her paw. I thought that was the cause of her gait problem. I started keeping her nails trim for her and thought I was doing good. She started walking better for awhile but then it got worse all of a sudden, that's when I figured out it was diabetic neuropathy.

Anyway, I just looked over at her and I see her grooming! I'm so glad for her. I know she must be feeling so much better. She is taking pride in herself. Yay Smudge :)
 
Thats great news. Let us know when you get the meter and we can go from there!

Also you could try methylcobalamin for the neuropathy - you can get the pills in any health food store just make sure they dont have sugars or xylitol in them because thats toxic to cats. Or you can buy the zobaline cat version. Takes 4-6 weeks to work and helps more if the cat is regulated.

Wendy
 
I got the ReliOn Confirm from Wal-mart and ordered some Zobaline from Amazon. Thanks for that suggestion. Smudge's AMPS was 167 and I'll check her at 6+. All seems to be going well. After reading other people's stories I'm just glad both my cats love the wet food and don't seem to miss the dry at all. I did put a bowl of dry on top of the fridge for my 3 year old since he can be a little more finicky, but he barely touches it and likes the wet just fine. Thanks again for all the intro info. It really helped.

One question with ear pricks. I used the lancet by itself this morning, but I felt like I went too deep. Next time I'm going to try the spring loaded pen thing. Do you all like those, or do you just use the lancet alone?

Smudge SS
 
Hi! 'Spring thing' - yep, I use the spring thing. I just can't make myself poke freehand. I've used it since the beginning so KT nor Dakota know any different. It works wonderful for us!

BIG HUGS to ALL of you!
 
Did you give insulin at 167? we dont normally advise newbies shoot under 200 so I hope you got some mid cycle tests?

Also I cant access your SS - can you "share" it ?

Wendy
 
I did shoot at 167. I felt comfortable with it. 6+ was 79 and PSPM was 81 so we're holding it again tonight. Things couldn't be going better. The SS should be public now too.
 
When you say held you mean skip right? Also can you put your SS into you actual signature so we can find it easily?


I am now wondering if 0.5 is also too high, you really (at least at first) want a dose you can give twice a day.

Let me know
Thanks

Wendy
 
I got the signature set up. I agree with you Wendy. My intuition is telling me 0.5 will end up being too much and we are too new to be predictable. I suspect just the diet change will be all she needs in the long run. Maybe she has gluten induced IBS and by fixing that we will fix the blood sugar.

As a nurse I'm no stranger to insulin, and I actually consider giving insulin to be an art form, not a science. I already think I have a good feel for how she's doing. Every patient is different, and I can read a patient fairly quickly off just a few numbers.

I work 3 days a week, 12 hour shifts, in the middle of the week. That means I still have tomorrow all day at home with her to watch her and see how she is doing. I weigh how she presents to me when I observe her as much as I weigh the numbers. So far all I can say is she is doing amazing. Gaining weight, grooming, happy, practically frisky for an old lady. A 180 turn around from 2 weeks ago. One of the main factors in my thinking she will need less insulin going forward is that her appetite has normalized. She was ravenous. I have no problem giving insulin to a patient who is eating, but a patient with a finicky appetite isn't getting a shot from me.

Starting Tuesday night, I'm going to be gone 13+ hours a night, and I won't be risking her going low. I'll see what her numbers are, but if she continues to be green and blue, I'll either skip doses or give .1 (at work we say hold, but I'll start saying skipped here). I might also see if my boyfriend can watch her or come check on her. Although I won't trust his judgement as much as I trust my own :)
 
You might want to go down to .25 and see how Smudge does on that while you can test tomorrow.

Here's what .25 looks like
025unit-1.jpg


Smudge may very well be one of those very lucky kitties who can become a diet controlled diabetic just from the diet change! We've had several members lately who once they changed over to the low carb diets on Dr. Pierson's Food Chart have been able to go OTJ (off the juice)

Keep it to the foods that are under 10% carb (Column C on the chart)

It looks like Smudge is going to be a great candidate for being a quickly controlled kitty! If her numbers stay in the normal range (50-130) for 2 weeks without any insulin, we have a party!!
 
I'm just really surprised that even though her initial BS at the vet was so high and her neuropathy is SO VERY bad that her BS is so easy to control now. It probably has to do with her age. I work in geriatrics and I know small changes with the elderly have large effects. Her gait was really really bad, slipping and sliding on the wood floor. Now it's just bad. She is wobbly, but on her toes, not her honches. She is also pretty lazy and not wanting to walk to far. I'm trying to encourage her to exercise but I'm not going to be crazy about it. Hoping the B12 pills help more.
 
163 AMPS after skipping dose last night. I decided to reduce dose again. I'm calling it 0.25 but it was just a hair over 0. She is just so consistent and doing so well. She is a lucky girl. And this little scare is going to ensure that her little brother will have a much better diet the rest of his life. I can't wait to get the vitamin pills for her neuropathy. My little bears are just such happy healthy lucky little guys :)
 
Sienne and Gabby said:
...Lantus dose can initially be based on weight (dose = 0.25 x ideal weight in kilograms). ...
Click to expand...

Small edit here, as I've been reminded by Dr Pierson on one of my other posts
- you use the lower of current weight if underweight OR the ideal weight if normal or overweight.
 
Lets see how 0.25 does. As mentioned before, Lantus is a depot insulin so it takes a few days to adjust in the cats system before you see an impact of a dose change. The current numbers may be an impact of the 0.5IU from a day ago. That is also why you want to be consistent with dose.. a sliding scale doesnt work since you dont see the dose change impact for a few days.

So I would advise you stick to the same 0.25IU dose for at least 3-5 days (read the protocol link Sienne gave above and excerpt pasted below) unless Smudge drops below 50 in which case its another dose decrease.

Lastly can you start getting a before bed test say 2-3 hours after PMPS? many cats drop low at night and that test will tell you which way he is going.

keep us updated!

Wendy

General" Guidelines:
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 (blue green) before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 (yellow) increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 (pink red black) increase the dose by 0.5 unit.

Reducing the dose:
If kitty drops below 50 reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose. Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...
 
Hi Wendy,

I just stopped by to update. Things are going great. It looks like her sugar is pretty stable with a skinny 1 unit. And clinically she is a different cat. She's gaining weight and grooming and playing. Every day it seems she is doing something new that I haven't seen her do in a long time. This morning I caught her scratching the scratch post. She still walks funny, but she's getting stronger and stronger and doesn't fall or have to take breaks anymore. And of course, any input is welcome.
 
thats great she is feeling better.
Do you think you could get a few mid cycle tests a few times a week ? Say 5-7 hours after morning shot and 2-3 hours after evening?

It would be good to know how low she is going during the day (or night) because if she is going under 50 you would decrease her. Its likely, if not now, that she will start to do that as her pancreas heals - blues are healing numbers. Also if she stays in the 50-130 range for a week you would also want to decrease by 0.25 units.


Wendy
 
Is she getting any methylcobalamin for the "walking funny"? Sounds like she could have diabetic neuropathy, nerve damage from the too high glucose levels. The methyl form of B-12 can help heal this, as it crosses the nerve barrier.
 
29!! eep!! Arent you glad you got mid cycle tests in now?

Ok so two things

1. Please keep an eye on her today to ensure she goes back up. Next time you see a number under 50 please give 1 tsp of high carb wet food ( or low carb mixed with 1 drop syrup) and test again in 30 minutes. And come here for help. You will want to keep giving this and testing every 30 minutes until you get two tests in a row that are rising when you stop the syrup/HC. Heres how to treat low numbers: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

2. Keep the 0.5 dose now for a few days unless she drops under 50 again in which case you drop to 0.25 . If she does need a lower dose, we need to reduce her dose gradually so as not to overwhelm her pancreas by dropping too quick.

Wendy
 
Wendy, can you take a look at Smudge's spreedsheet? I don't have a lot of numbers but most of the numbers she has are just a smidge over normal. I'm also skipping a lot of doses and if I do shoot it's a tiny amount. I'm calling it 0.1. I'm giving just a hair over 0 with just the smallest bit of daylight between the plunger and zero. My plan is to just give her that little drop if she goes over 140, but to pretty much skip other than that. It's the weekend so I'll try to get some more numbers as I can.

It's so funny though. Now all the positive changes I'm seeing in behavior are coming from her little brother. He's always been so protective of her. When she was weak and stumbling to get to the food bowl at dinner time, he'd turn around and go back and sniff her to make sure she was OK. Now, he's playing with her and gently circling and swatting her. She HATES it! She's always been an antisocial kind of girl. Hence her name. But it's so fun to see her be her crouchy angry self again swatting him back.
 
What meter are you using?

We could do an OTJ trial now although she is a little high sometimes. So

- no insulin and measuring a couple of times a day to see what she does - especially before and an hour after food. If she can sustain 50-130 (depends on meter let me know) for 14 days then she is officially in remission.
- Meanwhile you want to work to sustain and help her pancreas out so give lots of mini meals instead of a couple big ones.
- absolutely no high carb treats or dry food.
- You could also try and feed the lower carb friskies flavours to see if she comes down more.. which flavours are you using now?

Its great that they are "playing" now - he can tell she is feeling better!!

If the OTJ trial doesnt work you may need to learn to shoot low. But lets try the suggestions I gave above first/

Wendy
 
Wendy&Tiggy said:
What meter are you using?

We could do an OTJ trial now although she is a little high sometimes. So

- no insulin and measuring a couple of times a day to see what she does - especially before and an hour after food. If she can sustain 50-130 (depends on meter let me know) for 14 days then she is officially in remission.
- Meanwhile you want to work to sustain and help her pancreas out so give lots of mini meals instead of a couple big ones.
- absolutely no high carb treats or dry food.
- You could also try and feed the lower carb friskies flavours to see if she comes down more.. which flavours are you using now?

Its great that they are "playing" now - he can tell she is feeling better!!

If the OTJ trial doesnt work you may need to learn to shoot low. But lets try the suggestions I gave above first/

Wendy
Click to expand...

I'm using the ReliOn Confirm.

Just read your post. During my work week the kitties get feed twice a day at 8:00am and 5:30pm and I take Smudges pre-shot number just before putting it out. On the weekends I'll take her sugar at 6:00am and 7:00pm, but when I have food out varies. I'll usually try to always have some food out. It's not a perfect 12/12, but it's the best my schedule allows. Today I took her sugar at 8:00am and it was 125, the food bowl was empty and I filled it up and didn't shoot. Then I went to bed (shift worker). I got up at 6:00pm and the bowl was empty and they were hungry so I filled it again. I didn't check her sugar until about 8:00pm. It was about 1.5-2hrs after eating when I got her PM number and it was 173 so I gave her just a hair over zero with just a little daylight between the plunger and zero.

I see how I should have gotten a pre-feed number now, and then seen how she does after eating. I'll still get some numbers tonight to see how she goes, then tomorrow night I'll be sure to get a pre-feed number. What do you think about her being 173 2hrs after eating? I'm thinking it's too high still. I guess she probably runs around 130 before meals but spikes up to 170+ after eating.

I feed her the 5oz cans Friskies Classic Pate variety pack which has Mariner's Catch, Turkey & Giblets Dinner, Salmon Dinner, and Liver & Chicken Dinner. If the bowl gets low and I'm home, I'll add in one of the tiny cans of Fancy Feast: Tender Liver and Chicken or Ocean Whitefish. Smudge eats nothing else. Roro has a bowl of the old dry food on top of the refrigerator that I only have to refill for him once or twice a week. He's 20lb of muscle and needs the little extra. He's my gentle giant.

Thank you for your help.
 
Wendy&Tiggy said:
173 is a bit high. You could try just feeding the fancy feast classic pâtés for now, the friskies are a little higher carb.. See this sheet .. http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf
You want column c (%calories from carbs) under10% but you might want to try 5-8 for now. I think the liver and chicken is 9% so maybe hold off on it? Anyway check the sheet and see.
Click to expand...

Yeah, the Fancy Feast are ideal but so expensive and so inconvenient in those tiny cans. With Roro in the mix and how much he can eat, and he loves wet food, I can't just do the Fancy Feast. The reason I throw the chicken and liver in there is because I'm afraid to give too much of the fish based varieties for fear of mercury. I guess in the short run mercury isn't an issue. In order to get her into remission maybe we can do some things short term.

This is all very eye opening for me in a way. When I give insulin to people I have to deal with the fact that people are going to eat what they want to eat. They are either sick and don't want to eat at all, unpredictably, or they are eating food their family brings in or otherwise not following their diet. Not to mention the fact that diabetic people are advised to eat a high-carb, low-fat diet. Don't even get me started on the stupidity of that. I'm also not used to ever checking mid cycle numbers with people. We check pre-shot/pre-meal and that's it.

So what's the goal here? If she is <130 pre-shot, but >50 mid-cycle, that's ideal? And with a 173 reading after eating we already know she's not ready for OTJ, right?
 
Well maybe try the lower carb friskies, or cook some chicken and mix it in. The goal is to support the pancreas to help it heal for the next few weeks.

You want her to sit in the 50-130range without insulin. 173 is pretty close and I am hoping a few minor changes will bring her down. You can certainly shoot low instead but it's important to get more tests then to ensure she doesn't drop too low ie http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Tonite can you get a test in a few hours to make sure she doesn't drop too low?
 
Wendy&Tiggy said:
Well maybe try the lower carb friskies, or cook some chicken and mix it in. The goal is to support the pancreas to help it heal for the next few weeks.

You want her to sit in the 50-130range without insulin. 173 is pretty close and I am hoping a few minor changes will bring her down. You can certainly shoot low instead but it's important to get more tests then to ensure she doesn't drop too low ie http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Tonite can you get a test in a few hours to make sure she doesn't drop too low?
Click to expand...

I can test every few hours tonight. So you're thinking if I feed her very very low carb in the short term she can heal and be OTJ. Then maybe a few months down the line she can tolerate the 9% varieties? Although, you're right, if Fancy Feast is the cure, then just do the cure and stop medicating, even if that's what she needs to eat forever.
 
It's up to you.. Either

1. Stop insulin now and see what happens with different feeding schedule and lower carb food
Or
2. Continue the small dose but shoot at lower numbers and get more tests in. So say shoot at anything over 150, get midcycle test and see how low that takes her, and if it's ok, then reduce the no shoot number to 125 ... The mantra is shoot low to stay low. Read the primer I gave you above

Wendy
 
It's been awhile but here is an update. I just kept feeding smudge the Friskies Classic Pate and stopped the insulin. Whenever I spot check her, her BS is between the 50s-110s. Also, the weird walk is finally all gone. So for Smudge it took a little over a month for her to become diet controlled and 3 months for her gait to return to normal.

Thank you for this site :)
 
Thank you for the update on Smudge! Sounds like some great progress has been made. Congratulations!

Yes, the diabetic neuropathy can take time to heal and see your cat walking more normally. My Wink still walks with a bit of a waddle and feet splayed out to the sides, but a least he isn't walking down on his hocks anymore.
 
:mrgreen: :mrgreen: :mrgreen: CONGRATULATIONS!! :mrgreen: :mrgreen: :mrgreen:

Tips to stay OTJ

We say a cat is in remission if the cat can maintain BG levels for 14 days between 40-120 with most of that spent under 100. However, please keep in mind that once a diabetic always a diabetic.

1. Never feed dry - not even treats. If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission.
3. Measure blood once a week, indefinitely. You want to catch a relapse quickly.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check.
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quick!

If he does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any.
 
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