New, Concerned FD Mom

[Ashley H & Gizmo]

Gizmo has been on Lantus (2u/2x a day) for about 6 days. He's also nearing the end of the his Convenia injection for UTI. While he certainly seems to be feeling better and acting much more like his usual self (yay!), he's becoming less tolerant of testing and injections, particularly in the morning.

He's also been vomiting more...I spoke with the vet yesterday, and she lowered his dose to 1u twice a day. However, last night when we successfully tested, his glucose level was 75 (prior to this his lowest was 189). I didn't administer his injection, for fear of dropping him too low, waited about an hour and retested. He was more agitated about the second test, but it was still only 99. We did not give insulin last night.

This morning, we woke once again to the lovely sounds of a cat puking. Once he was settled I tested his BG...First reading came back with an error, so we had to go in for another try and he was not having it (actually started grumbling at me). Of course, his angst increases BG and the reading was 444 (close to what it was when the vet diagnosed him).

He hasn't received any insulin in over 24 hrs, at this point (did not give is AM shot today). I would like to retest his levels to make sure they're truly that high before giving him anything. I'm sure my partner is sick of talking about cat diabetes and me being super stressed, but I just feel kind of helpless and don't know what to do...

Since diagnosis, ~1 week ago, we haven't been 110% convinced he's diabetic. He's a big kitty (neck to butt as long as my human 5'7" torso) and has always weighed close to what he does now (16.4). He's been put on diets by vets before and then taken off, within 6 months, when he loses weight because he's then "too thin" for his size.

Could his OG symptoms have been due to his urinary tract issues (increased water consumption/urination/urinating outside the box) rather than diabetes? Should I get a second opinion? Is it normal for BG to change that dramatically in a couple of days?

 

[Kris & Teasel]

Gizmo has been on Lantus (2u/2x a day) for about 6 days. He's also nearing the end of the his Convenia injection for UTI. While he certainly seems to be feeling better and acting much more like his usual self (yay!), he's becoming less tolerant of testing and injections, particularly in the morning.

He's also been vomiting more...I spoke with the vet yesterday, and she lowered his dose to 1u twice a day. However, last night when we successfully tested, his glucose level was 75 (prior to this his lowest was 189). I didn't administer his injection, for fear of dropping him too low, waited about an hour and retested. He was more agitated about the second test, but it was still only 99. We did not give insulin last night.

This morning, we woke once again to the lovely sounds of a cat puking. Once he was settled I tested his BG...First reading came back with an error, so we had to go in for another try and he was not having it (actually started grumbling at me). Of course, his angst increases BG and the reading was 444 (close to what it was when the vet diagnosed him).

He hasn't received any insulin in over 24 hrs, at this point (did not give is AM shot today). I would like to retest his levels to make sure they're truly that high before giving him anything. I'm sure my partner is sick of talking about cat diabetes and me being super stressed, but I just feel kind of helpless and don't know what to do...

Since diagnosis, ~1 week ago, we haven't been 110% convinced he's diabetic. He's a big kitty (neck to butt as long as my human 5'7" torso) and has always weighed close to what he does now (16.4). He's been put on diets by vets before and then taken off, within 6 months, when he loses weight because he's then "too thin" for his size.

Could his OG symptoms have been due to his urinary tract issues (increased water consumption/urination/urinating outside the box) rather than diabetes? Should I get a second opinion? Is it normal for BG to change that dramatically in a couple of days?

Good instincts in withholding insulin. What insulin was prescribed? It's possible that even 1 unit is too high a dose or that some other factor raised his BG and he isn't truly diabetic. What food does he eat - kibble or canned? If he's a borderline diabetic he might be one who can be diet controlled.

How about getting a testing routine going for a couple of days but no insulin. Test AM and PM before feeding and one or two other times between those two tests. You need a baseline set of numbers to see what he does without insulin. If his BG is high-ish post here for advice. We'll likely recommend a food switch first if he eats kibble or gravy style wet foods.

If you want to track the BGs in an orderly fashion I recommend you use the FDMB spreadsheet:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

[Ashley H & Gizmo]

I created a spreadsheet in Excel, mostly to track BGs and other info for myself and to share with our vet.

We've been testing at least once a day since starting Lantus/Glargine, 2 units last Friday, and recently began doing tests twice a day (AM and PM). However, in recent days I've only be able to get the PM test if we get one at all. He's scheduled for his first curve next week, which we'll be doing at home and I just hope it goes well!

He's currently on dry kibble - Iams Healthy Adult - and has zero interest in canned food, because he's never had it. He did have some tuna water last night, like the vet recommended when we spoke about lowering his dose since he is eating less than I would consider normal. (He's all about the treats he gets post test/shot and will nibble his food in the evening, but is much more likely to eat from my hand.)

Retested him, just now, and it had increased a bit more to 453. I gave him the 1 unit, and will retest again this evening for sure...even if it makes him hate me!

 

[Kris & Teasel]

I created a spreadsheet in Excel, mostly to track BGs and other info for myself and to share with our vet.

We've been testing at least once a day since starting Lantus/Glargine, 2 units last Friday, and recently began doing tests twice a day (AM and PM). However, in recent days I've only be able to get the PM test if we get one at all. He's scheduled for his first curve next week, which we'll be doing at home and I just hope it goes well!

He's currently on dry kibble - Iams Healthy Adult - and has zero interest in canned food, because he's never had it. He did have some tuna water last night, like the vet recommended when we spoke about lowering his dose since he is eating less than I would consider normal. (He's all about the treats he gets post test/shot and will nibble his food in the evening, but is much more likely to eat from my hand.)

Retested him, just now, and it had increased a bit more to 453. I gave him the 1 unit, and will retest again this evening for sure...even if it makes him hate me!

I'm sorry for missing that link to your SS - senior moment! It tells me that 2 u is too high a dose and that he's bouncing in response to the lows yesterday. It's possible he might have been very low mid cycle. His good dose range at this point in time might be between 1 and 2 u, 1 u or less than 1 u. The only way to know is with a structured testing routine. This is what that looks like:

• test every AM/PM before feeding and giving insulin (no food for at least 2 hours before)
• at least one test around mid day and/or just before bed
• other tests scattered at different times to fill in gaps on the SS.

You say he's becoming less tolerant of testing/injecting. Unfortunately, you'll have to find ways to desensitize him. Freeze dried meat treats are good for this (Orijen brand or Pure Bites are two examples). There are lower carb kibbles you can try too: Young Again Mature Zero is available online from their website and Dr. Elsey's, the litter company, has recently come out with "Clean Protein" low carb wet food and kibble. Lower carb food might have a significant impact on his BGs and need for insulin.

I wish I could say that treating FD is easy, quick and won't force you to learn some things and change some routines but that wouldn't be true. It is, however, completely manageable and you'll be surprised at how quickly all the things that are challenging for you now just become another part of your day.

 

[Ashley H & Gizmo]

I'm sorry for missing that link to your SS - senior moment!
You say he's becoming less tolerant of testing/injecting. Unfortunately, you'll have to find ways to desensitize him. Freeze dried meat treats are good for this (Orijen brand or Pure Bites are two examples). There are lower carb kibbles you can try too: Young Again Mature Zero is available online from their website and Dr. Elsey's, the litter company, has recently come out with "Clean Protein" low carb wet food and kibble. Lower carb food might have a significant impact on his BGs and need for insulin.

I wish I could say that treating FD is easy, quick and won't force you to learn some things and change some routines but that wouldn't be true. It is, however, completely manageable and you'll surprised at how quickly all the things that are challenging for you now just become another part of your day.

Thanks for the encouragement! I was feeling much better about things until that low number showed up...even then I was feeling pretty positive until it was followed by a super high one, haha. Yes, it's overwhelming, but things were feeling much more normal and, like, 'OK, we can do this!' Plus, I'm a worry-wort...He's my baby and he can't tell me how he feels.

And no senior moment at all, on your part, I just made that Google Doc and really like the color-coding! I might try alternate site testing in the mornings -- I think part of the issue is that he's definitely a morning kitty and likes to know what's going on everywhere at those hours, so he hears cars outside and my partner getting ready for work and wants to be a part of it, right meow!

We have some food from the vet that just came in - GlycoBalance - but after looking at its ingredients online, I think it's actually higher carb than what he's currently eating. But we'll definitely be trying to swap his diet to something low-card, high-protein and hopefully get him liking some wet foods.

 

[Jan Radar (GA)]

These are for you as you try to wrap your head around all the information that's available about diabetes in cats on this site. I remember all too well the early days of feline diabetes at our house... we were unsure about everything. But we were determined to figure out what to do to help our little guy feel better. You've already taken many important steps forward. It really does get easier for both of you.

Here's a few things that really helped our guy get used to the testing routines we had to put in place to keep him safe:
1. We were so anxious and worried that we'd hurt him. When we relaxed and had more of a matter of fact attitude toward the test, Radar followed our lead. Now he tells us that it's time for a test by jumping up on the table where we test at the appropriate times. He even purrs while we do the test.
2. We fumbled around with our equipment and this resulted in us trying to restrain him for a "really long time " in "cat time which is probly no longer than 15 seconds" lol. We learned to get all the stuff ready before we invited the cat to the pokey party. Brief restraint was really key for Radar.
3. In the early days, whether we got enough blood for the test or not, we always gave a low carb treat and some kitty scratches.

 

[Julia & Bandit (GA)]

I created a spreadsheet in Excel, mostly to track BGs and other info for myself and to share with our vet.

We've been testing at least once a day since starting Lantus/Glargine, 2 units last Friday, and recently began doing tests twice a day (AM and PM). However, in recent days I've only be able to get the PM test if we get one at all. He's scheduled for his first curve next week, which we'll be doing at home and I just hope it goes well!

He's currently on dry kibble - Iams Healthy Adult - and has zero interest in canned food, because he's never had it. He did have some tuna water last night, like the vet recommended when we spoke about lowering his dose since he is eating less than I would consider normal. (He's all about the treats he gets post test/shot and will nibble his food in the evening, but is much more likely to eat from my hand.)

Retested him, just now, and it had increased a bit more to 453. I gave him the 1 unit, and will retest again this evening for sure...even if it makes him hate me!

Have you seen this guide to transitioning cats to canned food? http://catinfo.org/#Transitioning_Dry_Food_Addicts_to_Canned_Food_ While a lower carb kibble could help out in the short term, it would still be a good idea to try and get him onto canned food for the long term. Diabetes can be hard on their kidneys, and if he's prone to UTIs you definitely want to make sure he's getting as much moisture in his food as possible (unlike people and dogs, cats evolved in the desert, and studies have shown they never fully make up for the loss of moisture from eating dry food at the water dish). If the convenience of leaving dry food out is also a factor, you can get a feeder like this one, and put frozen food in to release when you're at work/sleeping. You may want to get one anyway to help you transition --the first and most important step in transitioning is to stop free feeding dry, and get him used to regular, measured portions at regular meal times. Diabetic cats do best with about 4 meals a day--I feed Bandit every 6 hours--7am, 1pm, 7pm, 1am (We use the feeders at 1am and days when my partner and I aren't home at 1pm). Not only does it help keep BG level, but cats LOVE routines--it's easier to test and shoot them on the same daily routine.

Any infection can cause BG to go high temporarily, but I don't think it would cause him to go that high, especially if he's at the end of his course of antibiotics. Although, I'm surprised they gave him Convenia--that's not usually what's used to treat a UTI. Was a culture done? Was the bacteria e-coli? Sterile cystitis gets mistaken for UTIs quite often, and that is a chronic condition that is best treated by a fully canned diet (for proper hydration of the cat).

As for testing--I was an absolute mess and Bandit was a holy terror the first few weeks I learned to test. The tests don't hurt our cats--they have less nerve endings in their ears than people do in their fingertips. What they don't like is you doing something new and strange to them, all the while sensing that you're nervous and stressed out. Bandit fought me tooth and claw at first, but once I stopped being "Oh, you poor baby, I hate that I'm hurting you!" to "You're getting this test, cat, whether you like or not because we need it to save your life", he sensed that I was calm, and he calmed down. I wrapped him in a fleece blanket like a burrito, put him in a basket, got the test, and gave him a diabetic safe treat after every test. After a while, he was totally ok with it. 8 years of tests later, he comes running to me when he hears the meter beep on, flops down in front of me and starts purring.

Things that help a bunch in the beginning--

1. Put him in a basket or container where he's enclosed all sides but the top. It will help if he struggles. If he sits quietly for you and doesn't try to move all around, bite, or claw you, you may not need this step.
2. Make sure you warm the ear up first--some people use a rice sock, or a pill bottle with warm water. In a pinch I used to put a warm washcloth in a ziploc bag--a lot of things work!
3. Use the correct gauge lancets. Most devices come with ultra-thin ones 30-33g, but those actually make the process harder to get a drop of blood. You want to use 26-28g "Thin" lancets to start.
4. Use a piece of tissue or cotton ball to back the ear and hold it in place while you poke--once you have your drop, you can use it to put pressure on the spot and stop the bleeding. Typically, 20 seconds of pressure is enough to stop the bleeding and prevent bruising.
5. Aim for the sweet spot--you're not looking to poke the vein, but just above it where the capillaries are. Their ears "learn" to bleed better over time because they form more of these capillaries.
6. Put a teeny-tiny dab of Neosporin + pain relief ointment after on the spot.
7. Give him a diabetic safe treat after every test, even if it's unsuccessful.

Trust me, you may be stressed now, but things get way easier once you get things under control, and you WILL get things under control. The first weeks are the hardest. When Bandit was diagnosed, I was working two jobs and going to grad school, but we managed to get his diabetes under control and him into remission. Honestly, his diabetes has probably helped him live a much healthier life because I probably wouldn't have gotten rid of the dry food until my vet told me I had to.

I would start him back out on a smaller dose of Lantus--in the 1u range. With Lantus, you want to get at least 3 tests a day--once before each shot to make sure it's safe to give insulin, and then another test somewhere in the middle of either cycle. Although, additional mid-cycle test or two do help if you can fit them in.

 

[Ashley H & Gizmo]

Thanks everyone!!

I talked with our vet again today, and she's concerned about how little Gizmo is eating, even though it's dry kibble...as am I.

We've never free-fed him - always portioned, regular meal-times even with the kibble. But since he's been feel icky and especially since moving to our new apartment, he's been eating so little. He'll eat about a handful from my hand, but only 2-3 nibbles out of his bowl. However, he loves his post-test/shot turkey slice, devoured the tuna water I offered him last night, and loves the treats-that-I-know-are-terrible-for-him. His kibble feeding schedule was 1/4 cup, 3x a day (7-8am, 5-6pm, and 10pm) and he would come running as soon as he heard the pantry/bag open. Now, he's barely eating!

This week, he has eat to even eat full 1/4 cup of food!!!

I know his diet needs to change, but until we get him back to normal meal-times, I don't want to discourage him from eating ANYTHING. I did buy some wet food (one in gravy, for shame, but it was turkey which I know he likes). I've got the "Transitioning to Wet Food" thing bookmarked for reference, but right now he is not about it at all and just needs to eat. I did pick up his Rx (GlycoBalance) food from the vet today, which I know isn't the ultimate solution, and plan to mix it with his usual kibble to get him switched to that.

After another convo with the vet, we have a new a "game plan..."

• Test his BG tonight and give insulin, as needed...1 u if he's eaten and it's high (which he had a my-sized-handful of kibble about an hour ago, about 1/3 of 1/4 cup of food); or .5 u if it's high and he hadn't eaten. If low again, like last night, we'll do nothing.
• Stop insulin, altogether, and see if we can't get him back on his usual meal-time eating schedule.
• Buy KetoStix to check his urine to make sure we don't have any DKA scares. (Going to have cat-daddy pick these up tomorrow for us!)
• Take him in for another blood test and "full panel" (can anyone tell me what exactly that means?!?) and in-house glucose curve so they can get a better read of where he's at throughout the day...This probably won't be until after 4th of July due to the holiday and my pay schedule.
• Also, make turkey his full-time treat rather than those nasty Temptations treats!

Also, I just really appreciate this website/forum even existing...my boyfriend and I are very different when it comes to emotions and stress, so are handling things together but very differently. I also have a different relationship with Gizmo since I've had him since he as a kitten and he's been there with me through a lot of very big life events, and the boyfriend has only 'had' him for the past 5 years.

 

[Jan Radar (GA)]

Take him in for another blood test and "full panel" (can anyone tell me what exactly that means?!?) and in-house glucose curve so they can get a better read of where he's at throughout the day...This probably won't be until after 4th of July due to the holiday and my pay schedule.

The vet may be talking about doing all the blood tests to check for everything that's going on inside Gizmo. The "in house glucose curve" is actually much more accurate (and much cheaper too) if you do it at home because fear of the vet can significantly raise BG readings. All you would have to do is test Gizmo every 2 hours for 12 hours so you can see what the insulin is doing for Gizmo over time. You can then report those numbers to the vet. More accurate BG information means better decision making about adjusting the dose of insulin.

 

[Julia & Bandit (GA)]

Thanks everyone!!

I talked with our vet again today, and she's concerned about how little Gizmo is eating, even though it's dry kibble...as am I.

We've never free-fed him - always portioned, regular meal-times even with the kibble. But since he's been feel icky and especially since moving to our new apartment, he's been eating so little. He'll eat about a handful from my hand, but only 2-3 nibbles out of his bowl. However, he loves his post-test/shot turkey slice, devoured the tuna water I offered him last night, and loves the treats-that-I-know-are-terrible-for-him. His kibble feeding schedule was 1/4 cup, 3x a day (7-8am, 5-6pm, and 10pm) and he would come running as soon as he heard the pantry/bag open. Now, he's barely eating!

This week, he has eat to even eat full 1/4 cup of food!!!

I know his diet needs to change, but until we get him back to normal meal-times, I don't want to discourage him from eating ANYTHING. I did buy some wet food (one in gravy, for shame, but it was turkey which I know he likes). I've got the "Transitioning to Wet Food" thing bookmarked for reference, but right now he is not about it at all and just needs to eat. I did pick up his Rx (GlycoBalance) food from the vet today, which I know isn't the ultimate solution, and plan to mix it with his usual kibble to get him switched to that.

After another convo with the vet, we have a new a "game plan..."

• Test his BG tonight and give insulin, as needed...1 u if he's eaten and it's high (which he had a my-sized-handful of kibble about an hour ago, about 1/3 of 1/4 cup of food); or .5 u if it's high and he hadn't eaten. If low again, like last night, we'll do nothing.
• Stop insulin, altogether, and see if we can't get him back on his usual meal-time eating schedule.
• Buy KetoStix to check his urine to make sure we don't have any DKA scares. (Going to have cat-daddy pick these up tomorrow for us!)
• Take him in for another blood test and "full panel" (can anyone tell me what exactly that means?!?) and in-house glucose curve so they can get a better read of where he's at throughout the day...This probably won't be until after 4th of July due to the holiday and my pay schedule.
• Also, make turkey his full-time treat rather than those nasty Temptations treats!

Also, I just really appreciate this website/forum even existing...my boyfriend and I are very different when it comes to emotions and stress, so are handling things together but very differently. I also have a different relationship with Gizmo since I've had him since he as a kitten and he's been there with me through a lot of very big life events, and the boyfriend has only 'had' him for the past 5 years.

How is Gizmo doing today? You're right, if he's inappetent your number one priority is getting him to eat. Have you ever tried Fancy Feast with him? I know it's a canned food, but a lot of cats gobble it up like kitty crack (it's the only thing Bandit will eat when he's been sick). BFF is another food that is enticing--unfortunately I don't know any dry foods that people have luck with getting inappetent cats to eat. I would also run to the store and get some baby food, and see if he'll eat it--Beech Nut makes some that are just meat--Turkey, Beef, and Chicken. He needs to get something in him.

From what you're describing, I'm concerned there's something else going on with him in addition to the diabetes. Diabetic cats usually act hungrier than usual, not inappetent. I hate to frighten you with DKA, but I'd test for ketones as soon as possible and take him in immediately if he's throwing ketones. You have a few of the warning signs of DKA--he's stopped eating, his BG is high, and there's an infection on board.

If there's no Ketones, yes, I'd take him in for a full panel as soon as you can get him in--that's screening for a lot of different things including his complete blood count, his kidney function, his liver values, etc. One thing that stood out to me from your previous post is that Convenia is not the best antibiotic to get rid of a bacterial infection, if a culture was done (and a culture should always be done before prescribing antibiotics to make sure it's a UTI and not Cystitis). Clavamox or Amoxicillin (or something in the penicillin family) are usually prescribed for bacterial infections.

Turkey is a great treat--if you have a PetSmart or PetCo near you, they both have freeze dried cat treats in the treat section now. Anything that's 100% freeze dried meat is great--Bandit's favorite is Salmon. You can also order freeze dried cat treats on Amazon if you don't have any pet stores near you--Purebites, Halo Liv-a-littles, and Origen Freeze dried cat treats are all good brands I've bought in the past.

I hope he feels better soon.

 

[Ashley H & Gizmo]

Since dropping his insulin to 1 unit, he perked up and ate a full dinner of mixed Iams and GlycoBalance. Since he wasn't eating, we tried taking him off insulin to reestablish his meal schedule...He ate dinner 6/29, full breakfast and dinner 6/30, and breakfast today, 07/01.

Although he was eating regularly, he was back to being the thirstiest kitty in town and urinating more (and in the hamper, twice). I spoke with a different vet, at our office, that I actually like better from our conversations yesterday. Any suggestions for politely asking to have her be our primary doctor??

She advised me to check his BG about 6 hours after breakfast and let her know the level so she could try to better assess what might be going on since it could be several things. When I called her back with the number she said he wasn't in danger of DKA, to let him run high for the rest of the day then retest before dinner and give 1 unit if above 200 and he'd eaten. It was over and he ate, so he got a shot and shortly after used the litter box rather than the hamper.

It seems, to me, that 2 units was too much for him. With 1 unit, he's definitely more of his lively, curious, morning-snuggle-loving self. Cool Vet said she'd check in with us this morning to see how things were going...and although he still seems to be drinking quite a bit more than usual, he is eating and doing his usual cat things.

I'm not entirely convinced he doesn't still have some sort of urinary track issue going on, but his urinalysis didn't show any crystals (which he's had before). I honestly don't know if there was a culture done to confirm infection. And after reading about Convenia, I was pretty disappointed with the vet tech for giving me little to no information about it, aside from how long it lasted. We'll be exploring wet food options as soon as I get paid...because he's usually not a finicky eater, at all!

Thanks for all your support and advice!

 

[Kris & Teasel]

When I called her back with the number she said he wasn't in danger of DKA,

I wouldn't take this for granted. There are kitties on FDMB who have gone into DKA when BG was in the 200s. Learning to do urine ketone tests is another valuable skill to prevent complications. I see that issue came up earlier in this thread.

It seems, to me, that 2 units was too much for him.

I agree. But there are many doses between 1 and 2 u that could be his "good dose" for where he is right now: 1.25 u, 1.5 u, 1.75 u. Do you have half unit marks on your syringes? I think you need to experiment with these doses.

I'm not entirely convinced he doesn't still have some sort of urinary track issue going on,

What signs are you seeing? They can have what's called "sterile" cystitis that doesn't involve any infection. Good hydration helps with that. Adding warm water to every wet food meal to make a sort of stew is what many of us do. I hope you can get him onto more wet food as soon as possible. Even low carb kibbles are dehydrating and most cats won't drink enough from the water bowl to compensate.

 

[Ashley H & Gizmo]

I wouldn't take this for granted. There are kitties on FDMB who have gone into DKA when BG was in the 200s. Learning to do urine ketone tests is another valuable skill to prevent complications. I see that issue came up earlier in this thread.

We bought ketone strips yesterday and will be periodically testing, for sure!

I agree. But there are many doses between 1 and 2 u that could be his "good dose" for where he is right now: 1.25 u, 1.5 u, 1.75 u. Do you have half unit marks on your syringes? I think you need to experiment with these doses.

We do have 1/2 marks on your U100 syringes. I'm not super comfortable with just testing out different doses, at this point. I should be talked to the Cool Vet (who did her internship/residency) in feline medicine and surgery, so she's much more upbeat, positive and, honestly, helpful than the vet we initially saw...Hence, why I'd like her to be our full-time, go-to vet. She's also the only one out of the three at the practice who owns kitties.

What signs are you seeing? They can have what's called "sterile" cystitis that doesn't involve any infection. Good hydration helps with that. Adding warm water to every wet food meal to make a sort of stew is what many of us do. I hope you can get him onto more wet food as soon as possible. Even low carb kibbles are dehydrating and most cats won't drink enough from the water bowl to compensate.

He's just drinking more and peeing more, but at least in the litter box now. He did go in the hamper, twice, yesterday--once when it had clothes in it and once when it was empty--when we were trying our 'no insulin to eat' plan. But he's eating again on the 1 u. There is no blood in his urine, so I'm not concerned about blockages. And that's really it as far as signs go.

As soon as I get my paycheck (next week), I'm going to try some varieties of FF, at least to get started. We didn't have luck with the brand we tried right after DX, last week, so I spoke with my aunt to see how she got her Siamese mix babies to love it. We had a turkey one that I shredded it into smaller pieces and mixed with a bit of water, as my aunt recommended, he still wasn't into it. I even tried mixing some of his dry kibble in, but no luck...This is was before we lowered his dose and he'd been sicking a lot in the mornings. But now that his appetite is back, I think it'll be much easier to get him to try something new, as he's been totally fine with dry food swaps we've done in the past.

 

[Kris & Teasel]

I'm not super comfortable with just testing out different doses, at this point.

I understand. Ask your new vet for her opinion on half unit doses at least. My guess is you'll need them.

Good luck with the food issue. They can be so picky!

 

[Ashley H & Gizmo]

UPDATE:
Gizmo is eating regular meals again (yay!) and has gone 2.5 days without urinating outside his litter box (more yay than can be expressed!).

We're currently doing 1.5 units, twice a day and are nearly done with our first glucose curve (which I think will likely increase his dose again). We have several canned foods to try and, with any luck, he'll like at least one of them so we can slowly wean him off his kibble. He's acting much more normal...excited about meal time, not constantly hiding in the closet, exploring our new apartment in the mornings and evenings, and waking us up in the morning as he jumps on the bed.