Need to make changes for Miles

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Svrunicorn

Member Since 2013
Hi, I'm Shelly and my sugarbaby is Miles. He's 7 and was diagnosed a couple years ago, He is considerably overweight even with very careful portion control @ 18lbs. unfortunately I only found the forum last night due to being desperate (his insulin has gone up again and is almost 200 for a vial now even though it lasts 3 months, and evidently have a sh*%#Y vet :evil: . He put miles on Royal Canin diabetic dry food and has us giving him 5units of Lantis twice a day. Every time he goes in for a curve the doc says he's doing great where he is, the problem is that he will start twitching quite often and the vet says to give him cheese. After reading here I am getting rid of the vet and making some serious changes. I started testing his blood last night when he was twitching (@ 3am) and the meter said Lo. I gave him some Karo to lick off his gums and a little of our other cats food and watched him. I tested him snack +1 and he was at 54 then +2 he was at 87 at breakfast time (8am) he was back down to 57 so I did not give him his insulin I tested him again at food +1.5= 86, +4=77 , dinner time (8pm= 54) so no shot, kids let him out so I haven't been able to test him after dinner. Going to move both fur-babies to wet food and keep close eye on miles blood sugar. I had started testing him after dx but dr. was confusing me about where his blood should be. I have a Reli-on micro tester. Any advise would be helpful. confused_cat
 
Hello, Shelly

Welcome! You did good by Miles. He was probably having hypos caused by too much insulin when he was twitching. Quite possibly you saved his life by feeding & testing him. Good instinct to dump the vet & not give insulin at those BGs. I have no experience with Lantus, but know a bit later other members will come on & provide advice plus links for you.

In your place, I'd stop the insulin for now, change his diet to low carb wet food, test him & see what he needs you to do. Since you write that he twitched on several occasions that might mean that you'll need to start at the beginning - there could be other causes for twitching than hypos but my best guess is hypos. Others may disagree. I hope that Miles no longer needs any insulin or shortly won't! My experience is with ProZinc & Levemir. Thanks to the awesome members of this board, both my sugar babies are now in remission which is what I wish for Miles.

Where are you located?

Best wishes,
Sophie
 
Thank G*d you decided to test! Keep it up -always test before shots, and when possible, halfway between shots.

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Given the twitching you have seen, do NOT give insulin at the next shot unless he tests at over 200 mg/dL. Lantus has a cummulative effect and we need to drain out some of that for safety. When he next tests over 200 mg/dL, he has earned a dose reduction. Without lots of recorded tests, I would drop it at least one unit if no other changes are made. We have a research tested protocol for using Lantus in cats which can greatly reduce the dose (and cost!) of insulin, and in some cases, get the cat to a diet-controlled state.

We recommend low carb, canned or raw, over the counter food for cats, per Vet written Cat Info. We suggest staying below 10% calories from carbohydrates (not weight). Friskies pates (in the US) are in this range and inexpensive. Change food slowly to avoid GI upsets, about 20-25% change per day.

Note 1: glucose levels may drop 100 mg/dL when changing carb levels. This may result in as much as 2 to 2.5 unit decrease in insulin or more, so if you make changes, you MUST be home testing.

Note 2: glucose levels may be 100 to 180 mg/dL increased when at the vet, so in office tests are often unreliable indicators of how well the diabetes is being controlled. You can do a curve at home for much less cost, too.
 
Hello and welcome to the board!

Can you confirm if you have changed his food yet or is he still on dry?

Lets start fresh. I would will want to start with a beginning dose of Lantus which is 2IU based on his weight given every 12 hours according to our protocol : http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

It would also be good if you can do 4 tests a day for now to get a good picture of how the dose is working.

- 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.

Plus a spreadsheet would be good so we can help advise on how he is doing and for you to see trends etc - let us know if you need help with it - http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy
 
He is currently in transition. This morning was the first time I added wet. I reduced the dry and added some wet. He will eat it but our civ. Kristy wouldn't touch her food with the wet mixed in. she's going to be hard to transition, I'll have her mommy work on her (I'm gramma to her). He hasn't had a shot for the last three meals due to low numbers (in the 50's)
Shelly
 
The dry and wet foods don't have to mixed together; they may be on separate plates.

And in a pinch, there are some dry foods which may be used for transitioning or super-resistant kitties.
- Evo Cat and Kitten dry at pet supply stores
- Stella and Chewies freeze-dried (meant to be rehydrated)
- Young Again 0 Carb (internet sales only and actually about 5% calories from carbs)
 
Hi Shelly and sugardude Miles and welcome!

Echoing the other people here that agree you probably saved Miles life with your home testing and karo syrup to bring the numbers up.

Here are some transitioning tips for your stubborn dry food addict. I used just about all of these, getting my sugardude and dry food addict Wink off of dry food and on to low carb wet food.

If Miles is testing in the 50's, before each shot, that is normal BG (blood glucose) range. I would not give any insulin either. Let's see how the diet change goes and see how his BG's trend now that he is off the insulin and his depot is draining. He may need to go back on insulin, he may not need to go back on insulin. Let's see how things shake out over the next week or so.
 
Those numbers sound great As BJ said, as long as he is 50-130 he does not need insulin - and we advise newbies not to shoot under 200.

Keep with the transition - if he is going into remission then that will help immensely!

Wendy
 
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