My cat Timmy was diagnosed with diabetes about 4 months ago, and is currently under veternary care. I currently feed him Fancy Feast Classic and Hill's Perscription Diet MD. The vet advised to give him 2 units of insulin 2 x a day. For the first 3 months or so everything seemed okay, eating, drinking, and using litter box as he normally would. I took him in for a followup visit and blood work, his glucose went from 454 to 343, I was so excited thinking I was finally getting it under control. Everything seemed great, then as of end of September he started acting different. He couldn't jump up on things, urinating outside the liter box, excessive urine (never really changed), and walking for a few seconds then having to lie down, lying down while eating and drinking. Took him back to the vet and he said that Timmy lost more weight, and that he doesnt seem to have a Urinary Tract Infection. So he increased his insulin to 3 units. He also advised to feed him 3 x a day. So for the afternoon feeding I give him cooked chicken, beef, or canned tuna (given every now and then). I also leave the Hill's Prescription MD out at all times. Does anyone have any suggestions of how to help him gain more weight? When should I start seeing a difference? This is a little frightning and I feel so helpless. Does anyone have any suggestions? Timmy is only 8.5 years old. Thank you!!
New diabetic cat owner
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BJM
Member Since 2010
Welcome to FDMB.
Tell us a bit more about the situation:
How much does he weight?
How much should he weigh?
What insulin are you using?
What glucose numbers have been obtained at the vet?
Do you home test the blood glucose?
Tell us a bit more about the situation:
How much does he weight?
How much should he weigh?
What insulin are you using?
What glucose numbers have been obtained at the vet?
Do you home test the blood glucose?
There are a large number of low carbohydrate over the counter foods available which are better than the Hills. You've already got the Fancy Feast Classic. The Fancy Feast Kitten Turkey and Giblets is low carb as well as having slightly higher protein and fat for growth and development. It may help put the weight back on if you can find it in a store near you or order it online. If you must feed dry (we don't recommend it), Evo Cat and Kitten is about 8% calories from carbohydrates. For tons of canned food info, pop over to Cat Info, along with feline nutrition information written by Veterinarian Dr Lisa Pierson.decray said:
Two units is a pretty steep starting dose and may have skipped over the ideal dose. Many cats are started around 0.5 to 1.0 units of insulin.decray said:
Sounds very much like he has diabetic neuropathy, though it might also be electrolyte depletion from all the urination. This may resolve with good glucose control and methylcobalamin, a specific form of Vitamin B-12. One product is Zobalinedecray said:
MommaOfMuse
Member Since 2010
Welcome extra sweet Timmy and your Fur Parent (What do we call you?).
You have now found the best place on the net to help you help Timmy.
Need just a tiny bit of further information to better help you and Timmy.
What type of insulin are you using?
And are you testing his blood sugar at home and if not would you be open to us helping you learn how?
What you are describing sounds like unregulated diabetes. And neuropathy...good news both can be reversed once we get his blood sugar under control.
One of the best things you can do for Timmy and your wallet is learning to test him at home. That way you will know at a moment's notice how the insulin is or isn't working for Timmy.
Next step once you can test at home is ditch the dry food altogether. If he is eating the Fancy Feast Classics fine there is no need for the dry food and it is part of why his numbers are still high.
Insulin is the key for his body's ability to use the food he is eating. An unregulated diabetic can literally starve to death with full bowls of food because their bodies can't use the food they eat correctly. Once we help you get his diabetes under control the weight will come back.
Mel, Maxwell, Autumn and The Fur Gang
You have now found the best place on the net to help you help Timmy.
Need just a tiny bit of further information to better help you and Timmy.
What type of insulin are you using?
And are you testing his blood sugar at home and if not would you be open to us helping you learn how?
What you are describing sounds like unregulated diabetes. And neuropathy...good news both can be reversed once we get his blood sugar under control.
One of the best things you can do for Timmy and your wallet is learning to test him at home. That way you will know at a moment's notice how the insulin is or isn't working for Timmy.
Next step once you can test at home is ditch the dry food altogether. If he is eating the Fancy Feast Classics fine there is no need for the dry food and it is part of why his numbers are still high.
Insulin is the key for his body's ability to use the food he is eating. An unregulated diabetic can literally starve to death with full bowls of food because their bodies can't use the food they eat correctly. Once we help you get his diabetes under control the weight will come back.
Mel, Maxwell, Autumn and The Fur Gang
Thank you for getting back to me so quickly.
Timmy's weight right now is 11.5lbs. Back in February during his regular check up he was at 19lbs. We would like to see him about 16lbs (he's a big cat).
The insulin he is currently on is Prozinc.
When he was first tested his glucose was 454, his glucose level 2 weeks ago was 343, so it did go down a bit. Currently, I don't have a text kit at home, and I was told they are expensive. With the amount of vet bills I can't afford much more.
I think the reason my vet choose Hill's MD dry food is because it has no carbs.
Thank you again!!!
Timmy's weight right now is 11.5lbs. Back in February during his regular check up he was at 19lbs. We would like to see him about 16lbs (he's a big cat).
The insulin he is currently on is Prozinc.
When he was first tested his glucose was 454, his glucose level 2 weeks ago was 343, so it did go down a bit. Currently, I don't have a text kit at home, and I was told they are expensive. With the amount of vet bills I can't afford much more.
I think the reason my vet choose Hill's MD dry food is because it has no carbs.
Thank you again!!!
Mel, Maxwell, Autumn and The Fur Gang,
Thank you!!!!
My name is Dan. Thank you again for the information. I feel much better.
I think the reason my vet advised the Hill's Prescription MD is because it has no carbs in it. I want Timmy to have food whenever he wants it right now.
What do you think?
Thank you again!!!
Thank you!!!!
My name is Dan. Thank you again for the information. I feel much better.
I think the reason my vet advised the Hill's Prescription MD is because it has no carbs in it. I want Timmy to have food whenever he wants it right now.
What do you think?
Thank you again!!!
MommaOfMuse
Member Since 2010
A pet only meter is expensive but most of us use a human meter in fact if you have a Walmart near you they have several excellent meters for under $20 to get all set up to test at home will run you less than $40.
I have two diabetic cats and other than the price of insulin and testing supplies they cost me no more than my other 12 cats, maybe an extra $20 a month and they have never seen a vet for anything other than routine kitty stuff like shots, check ups as they are both seniors.
Hills MD is not free of carbs..I would post you a link to it's actual carb count except I'm on my iphone and still haven't figured out how..lol but I believe if I remember correctly its about 15% carbs which is way too high for a diabetic cat. Plus there is nothing special about prescription foods expect a highly inflated price.
Of my two diabetic cats one Maxwell will celebrate 3 years insulin free and diet controlled on this coming November 1st and my second Autumn is well regulated on less than a unit of insulin bid.
I however have not used your insulin but we have a lot of folks here that do let me see if I can round up a few for you.
Mel, Maxwell, Autumn and The Fur Gang
I have two diabetic cats and other than the price of insulin and testing supplies they cost me no more than my other 12 cats, maybe an extra $20 a month and they have never seen a vet for anything other than routine kitty stuff like shots, check ups as they are both seniors.
Hills MD is not free of carbs..I would post you a link to it's actual carb count except I'm on my iphone and still haven't figured out how..lol but I believe if I remember correctly its about 15% carbs which is way too high for a diabetic cat. Plus there is nothing special about prescription foods expect a highly inflated price.
Of my two diabetic cats one Maxwell will celebrate 3 years insulin free and diet controlled on this coming November 1st and my second Autumn is well regulated on less than a unit of insulin bid.
I however have not used your insulin but we have a lot of folks here that do let me see if I can round up a few for you.
Mel, Maxwell, Autumn and The Fur Gang
MommaOfMuse
Member Since 2010
Hi Dan...that'sso much nicer 
Yep right now Timmy can eat all he wants within reason of course. However you can free feed the wet food, many of us do all you need to do is mix in a little water to help keep it fresh.
When I first adopted Autumn her previous owner didn't treat her at all for 10+ months she arrived as a less than 6lb cat on a 14lb cat frame. Within a month she weighed 10lbs and today she tips the scale at a lean mean 14lbs ...I don't grow them small around my house lol
Mel, Maxwell, Autumn and The Fur Gang
Yep right now Timmy can eat all he wants within reason of course. However you can free feed the wet food, many of us do all you need to do is mix in a little water to help keep it fresh.
When I first adopted Autumn her previous owner didn't treat her at all for 10+ months she arrived as a less than 6lb cat on a 14lb cat frame. Within a month she weighed 10lbs and today she tips the scale at a lean mean 14lbs ...I don't grow them small around my house lol
Mel, Maxwell, Autumn and The Fur Gang
MommaOfMuse,
Thank you. I will check with my vet about that food. He might be unaware of that. I think I will go home and take the food away.
I didn't realize that the cost was that inexpensive, I think I can handle that. How do I do the testing? I certainly don't want to hurt him.lol
Thank you
Thank you. I will check with my vet about that food. He might be unaware of that. I think I will go home and take the food away.
I didn't realize that the cost was that inexpensive, I think I can handle that. How do I do the testing? I certainly don't want to hurt him.lol
Thank you
MommaOfMuse,
Haha!! I guess you don't grow them small.
That's a great idea about having wet food down and mixing water in it. Of course I will do that until he gains some weight.lol
I just want my old cat back. He was so affectionate and loved to be held. Right now he sleeps most of the time.
Thanks!!
Haha!! I guess you don't grow them small.
That's a great idea about having wet food down and mixing water in it. Of course I will do that until he gains some weight.lol
I just want my old cat back. He was so affectionate and loved to be held. Right now he sleeps most of the time.
Thanks!!
MommaOfMuse
Member Since 2010
Well testing is easy in theory but can be a little tricky until you find your groove but after awhile it becomes as natural as brushing your teeth. But the basics are you use a lancet to poke the outer edge of his ear then suck up that drop of blood with a test strip that is loaded in the meter. If you search YouTube for Glucose testing your cat you will find lots of videos. Or if you would like someone to show you in person give us a general location ( city, State) and we can see if we have an experienced member who can arrange a meeting to help.
The great thing about testing at home besides peace of mind knowing Timmy is safe while on insulin is that your readings are more accurate because stress inflates BGs and who isn't stressed at the doctor's? Plus no more hauling him back and forth to the vet's for curves because you can do them at home then share with your vet via email or online link to his spreadsheet sheet.
Now human meters do read lower than pet only one's but we have protocols in place for both. Just hypo range on a human meter is anything under 40 while on a pet only it is under 70.
Mel, Maxwell, Autumn and The Fur Gang
The great thing about testing at home besides peace of mind knowing Timmy is safe while on insulin is that your readings are more accurate because stress inflates BGs and who isn't stressed at the doctor's? Plus no more hauling him back and forth to the vet's for curves because you can do them at home then share with your vet via email or online link to his spreadsheet sheet.
Now human meters do read lower than pet only one's but we have protocols in place for both. Just hypo range on a human meter is anything under 40 while on a pet only it is under 70.
Mel, Maxwell, Autumn and The Fur Gang
MommaOfMuse
Member Since 2010
oh almost forgot the most important part...TREATS! low carb of course some favs here are water packed sardines and plain boiled chicken breast. And chocolate for dad.
Mel, Maxwell, Autumn and The Fur Gang
Mel, Maxwell, Autumn and The Fur Gang
Wendy&Tiggy(GA)
Member Since 2011
I wish the Hills M/d was zero carbs - its 14% - too high for a diabetic cat. I would just stick to the Fancy feast classics since he seems to like it - plus wet food is good for his kidneys.
But as everyone said, its important to home test because his blood sugar may drop immediately on the food change to low carb. Heres some testing tips https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub and a shopping list below.
Getting started shopping list
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast
Wendy
But as everyone said, its important to home test because his blood sugar may drop immediately on the food change to low carb. Heres some testing tips https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub and a shopping list below.
Getting started shopping list
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast
Wendy
Chris & China (GA)
Member Since 2013
Hi Dan and welcome to the FDMB!!
Home testing is vital, and once you're over the first days of thinking you're going to hurt Timmy, caring for him will bring you even closer to him!
The majority of us use human meters...WalMart carries Relion brand and the meter is about $15...they have Relion Prime, Confirm and Micro. The Prime has the cheapest strips ($9 for 50) but take a larger blood sample. The Confirm and Micro take really tiny samples but the strips are a little higher ($18 for 50). I tell new people that if they can afford it, go with the Confirm or Micro at first anyway. Once Timmy's ears "learn to bleed", you can switch to the Prime to save the extra money on strips.
Here's our "Getting started shopping list"
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast
Next, get rid of the dry food. It's all too high in carbs. Here's a list of pretty much any food you can buy and the carb percentages (Column C) We want him eating under 10% carbs Dr. Pierson's Food Chart
Luckily, Friskies Pate versions and Fancy Feast Classics are all reasonably priced and readily available!
Good luck to you and Timmy, and we have lots more help to give you, so don't be worried about asking questions! Sometimes we all get going and throw so much information at you so fast that your head starts spinning...don't be afraid to tell us to slow down!!
Edited to add...You can take the 911 down by going to your first post and choosing "None" instead of the 911 icon. We use that for medical emergencies mostly. If you have a question, add the ? icon to that first post. It makes it easier for us to scan quickly through the posts for the ones that contain questions. Thanks and once again, welcome!
Home testing is vital, and once you're over the first days of thinking you're going to hurt Timmy, caring for him will bring you even closer to him!
The majority of us use human meters...WalMart carries Relion brand and the meter is about $15...they have Relion Prime, Confirm and Micro. The Prime has the cheapest strips ($9 for 50) but take a larger blood sample. The Confirm and Micro take really tiny samples but the strips are a little higher ($18 for 50). I tell new people that if they can afford it, go with the Confirm or Micro at first anyway. Once Timmy's ears "learn to bleed", you can switch to the Prime to save the extra money on strips.
Here's our "Getting started shopping list"
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast
Next, get rid of the dry food. It's all too high in carbs. Here's a list of pretty much any food you can buy and the carb percentages (Column C) We want him eating under 10% carbs Dr. Pierson's Food Chart
Luckily, Friskies Pate versions and Fancy Feast Classics are all reasonably priced and readily available!
Good luck to you and Timmy, and we have lots more help to give you, so don't be worried about asking questions! Sometimes we all get going and throw so much information at you so fast that your head starts spinning...don't be afraid to tell us to slow down!!
Edited to add...You can take the 911 down by going to your first post and choosing "None" instead of the 911 icon. We use that for medical emergencies mostly. If you have a question, add the ? icon to that first post. It makes it easier for us to scan quickly through the posts for the ones that contain questions. Thanks and once again, welcome!
Sue and Oliver (GA)
Member Since 2009
You have already gotten great advice. If you get the supplies, we can help you learn to test at home. We'll want to know his blood glucose number before the shot(we urge new diabetics not to shoot under 200) and then a number midcycle (somewhere between 5-7 hours after the shot). That number will tell you how low the insulin is taking him. And how well your dose is working.
MommaOfMuse
Member Since 2010
Dan and you too Timmy
Sue can help you out once you are testing at home figure out what the numbers all mean and how to adjust dosing as she is well versed in the use of your insulin...So I will leave you in her very capable hands. She will take great care of you both.
Mel, Maxwell, Autumn and The Fur Gang
Sue can help you out once you are testing at home figure out what the numbers all mean and how to adjust dosing as she is well versed in the use of your insulin...So I will leave you in her very capable hands. She will take great care of you both.
Mel, Maxwell, Autumn and The Fur Gang
C
Carl & Polly & Bob (GA)
Hi Dan,
Just wanted to emphasize a couple of points already made.
The Hills m/d is junky stuff. Apparently they have really good sales reps that convince vets that Hill's is fantastic. Must be, it's "presciption" right? Not so much. My vet prescribed the same thing, both wet and dry, for my cat, Bob. As soon as I saw the carb content on them, I returned the canned for a full refund. Bob hated it anyway. And I fed all the dry to the raccoon herd in the back yard. (hope they don't get diabetes from all those carbs ;-) ). The FF classics are a perfect choice though.
And you will want to be home testing before you ditch the dry food. Most cats show an immediate improvement when dry food is removed from the menu. And the current dose of insulin which might have worked well with dry food on board, can suddenly become "too much" on just low carb canned food. In a perfect world, we'd switch to all low carb canned food before starting insulin. But who knew? I sure didn't.
Just wanted to emphasize a couple of points already made.
The Hills m/d is junky stuff. Apparently they have really good sales reps that convince vets that Hill's is fantastic. Must be, it's "presciption" right? Not so much. My vet prescribed the same thing, both wet and dry, for my cat, Bob. As soon as I saw the carb content on them, I returned the canned for a full refund. Bob hated it anyway. And I fed all the dry to the raccoon herd in the back yard. (hope they don't get diabetes from all those carbs ;-) ). The FF classics are a perfect choice though.
And you will want to be home testing before you ditch the dry food. Most cats show an immediate improvement when dry food is removed from the menu. And the current dose of insulin which might have worked well with dry food on board, can suddenly become "too much" on just low carb canned food. In a perfect world, we'd switch to all low carb canned food before starting insulin. But who knew? I sure didn't.
C
Carl & Polly & Bob (GA)
Oh, one other thing.
On the "walking a few steps and then lying down" thing. Has Timmy been checked to see what his potassium levels look like? Bob's were very low when he was diagnosed, and he exhibited the same behavior. Low potassium can cause overall muscle weakness. Bob's was most noticeable in his back legs, and he couldn't jump up or run around for a long time until I got his levels back up to normal with potassium supplements. You don't want to give those supplements unless directed to by your vet, as too high a level can be just as bad as too low. But you might ask your vet if the bloodwork shows where Timmy's potassium level is at.
On the "walking a few steps and then lying down" thing. Has Timmy been checked to see what his potassium levels look like? Bob's were very low when he was diagnosed, and he exhibited the same behavior. Low potassium can cause overall muscle weakness. Bob's was most noticeable in his back legs, and he couldn't jump up or run around for a long time until I got his levels back up to normal with potassium supplements. You don't want to give those supplements unless directed to by your vet, as too high a level can be just as bad as too low. But you might ask your vet if the bloodwork shows where Timmy's potassium level is at.
Okay, I finally took Timmy's glucose level, and the meter said 390.
Is there a difference with the meter? I went to Walmart and purchased the ReliOn Confirm. Should I be adding or subtracting numbers, because this is for human blood?
Update on Timmy. He seems much better. He's moving around more, he is not urinating as much or as often, but still goes regularly. He actually slept with me last night. He hasn't done that for awhile.
Thank you everyone again for the wonderful support!
Dan
Is there a difference with the meter? I went to Walmart and purchased the ReliOn Confirm. Should I be adding or subtracting numbers, because this is for human blood?
Update on Timmy. He seems much better. He's moving around more, he is not urinating as much or as often, but still goes regularly. He actually slept with me last night.
He hasn't done that for awhile.Thank you everyone again for the wonderful support!
Dan
Sue and Oliver (GA)
Member Since 2009
How far is that number in relation to food? (food raises blood glucose levels)
We just stick with the numbers on the human meter - we're looking for ranges and patterns. So 390 is fairly high, but he is still eating high carb food ,right? When you switch to a lower carb and all wet, he should come down.
General ranges:
We consider a cat generally regulated if they are in mid 200s at preshot and 100 or lower at midcycle. (but no lower than 40). We usually advise new diabetics not to shoot under 200, but to wait 20 minutes, without feeding, and retest. You want to Be sure the number is rising and not falling and that it is near 200 or over.
How about putting together a spreadsheet to chart his numbers? It's color coded and easy for you, your vet and us to figure out what is happening over time. Here are the directions:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
We just stick with the numbers on the human meter - we're looking for ranges and patterns. So 390 is fairly high, but he is still eating high carb food ,right? When you switch to a lower carb and all wet, he should come down.
General ranges:
We consider a cat generally regulated if they are in mid 200s at preshot and 100 or lower at midcycle. (but no lower than 40). We usually advise new diabetics not to shoot under 200, but to wait 20 minutes, without feeding, and retest. You want to Be sure the number is rising and not falling and that it is near 200 or over.
How about putting together a spreadsheet to chart his numbers? It's color coded and easy for you, your vet and us to figure out what is happening over time. Here are the directions:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
Chris & China (GA)
Member Since 2013
Hi Dan!!
No, you don't need to add anything to the number just because you're using a human meter...Most of us use the human meter so we're used to that! The only difference we tell people about is that the AlphaTrak (besides being a LOT more expensive) generally runs about 30 points higher than the human meters, but again, it's not important.
Next, it's important for you to start keeping records of Timmy's blood glucose numbers. Sue gave you the link to the spreadsheet we use here and by putting the link into your signature, we can help advise you on doses.
You need to get at least 4 tests per day. 1 in the morning before giving any insulin (to make sure it's high enough to safely shoot---we suggest you don't shoot under 200 until you have more data on how Timmy reacts to insulin and food) and 1 in the evening before shooting. These are called the AMPS (AM pre-shot) and PMPS (PM pre-shot) tests.
During the AM cycle, try to get a test somewhere between +5 and +8...this is important so you can try to learn where Timmy's nadir is. (Nadir is the point in the cycle where the insulin is working it's BEST)
For the PM cycle, you should always get a "before bed" test so you have an idea of where his BG levels might go overnight. Most cats do go lower at night, so this is important so you know if you should maybe set an alarm to get up and test later in the night.
Of course the more tests you can do, the more you're going to learn about how Timmy reacts, but those 4 are the really important ones.
This may help you understand some of the numbers.
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}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.
> 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 mid-cycle 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.
Last but not least, could you please go ahead and add some information to your Signature? Your name, cats name, Diagnosis date, Name of meter, Type of Insulin, Food you're feeding...things like that. (and the link to your spreadsheet when you have it set up) It just makes it easier for us to have that information handy.
To do it, go to the User Control Panel (top left side of page)
Go to "Profile"
Go to "Edit Signature"
Add Information and "Submit"
Look forward to helping you get Timmy under control..and maybe even OTJ completely!
No, you don't need to add anything to the number just because you're using a human meter...Most of us use the human meter so we're used to that! The only difference we tell people about is that the AlphaTrak (besides being a LOT more expensive) generally runs about 30 points higher than the human meters, but again, it's not important.
Next, it's important for you to start keeping records of Timmy's blood glucose numbers. Sue gave you the link to the spreadsheet we use here and by putting the link into your signature, we can help advise you on doses.
You need to get at least 4 tests per day. 1 in the morning before giving any insulin (to make sure it's high enough to safely shoot---we suggest you don't shoot under 200 until you have more data on how Timmy reacts to insulin and food) and 1 in the evening before shooting. These are called the AMPS (AM pre-shot) and PMPS (PM pre-shot) tests.
During the AM cycle, try to get a test somewhere between +5 and +8...this is important so you can try to learn where Timmy's nadir is. (Nadir is the point in the cycle where the insulin is working it's BEST)
For the PM cycle, you should always get a "before bed" test so you have an idea of where his BG levels might go overnight. Most cats do go lower at night, so this is important so you know if you should maybe set an alarm to get up and test later in the night.
Of course the more tests you can do, the more you're going to learn about how Timmy reacts, but those 4 are the really important ones.
This may help you understand some of the numbers.
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}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.
> 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 mid-cycle 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.
Last but not least, could you please go ahead and add some information to your Signature? Your name, cats name, Diagnosis date, Name of meter, Type of Insulin, Food you're feeding...things like that. (and the link to your spreadsheet when you have it set up) It just makes it easier for us to have that information handy.
To do it, go to the User Control Panel (top left side of page)
Go to "Profile"
Go to "Edit Signature"
Add Information and "Submit"
Look forward to helping you get Timmy under control..and maybe even OTJ completely!
I will have to start spreadsheet tomorrow. I'm using my smart phone to write this.
I took the reading before feeding him. He's been eating Fancy Feast with fresh cooked chicken or beef mixed with water. He's been eating very well. I will take a ready tonight before bed, then first thing in the AM before feeding him.
I took him off all dry food on Wednesday.
Thanks!!
I took the reading before feeding him. He's been eating Fancy Feast with fresh cooked chicken or beef mixed with water. He's been eating very well. I will take a ready tonight before bed, then first thing in the AM before feeding him.
I took him off all dry food on Wednesday.
Thanks!!
Sue and Oliver (GA)
Member Since 2009
Great! Glad the dry food is gone. We would expect his numbers to come down some with the food change. Hope so!
"During the AM cycle, try to get a test somewhere between +5 and +8...this is important so you can try to learn where Timmy's nadir is. (Nadir is the point in the cycle where the insulin is working it's BEST)"
Could you please clarify this for me?
I'm not understanding the +5 and +8 or the nadir.
I will up date my signature shortly.
Thanks!!
Dan
Could you please clarify this for me?
I'm not understanding the +5 and +8 or the nadir.
I will up date my signature shortly.
Thanks!!
Dan
BJM
Member Since 2010
Nadir = lowest glucose/maximal effect of insulin between 2 shots.
It can move around a bit.
The average time frame depends on the insulin.
The nadir for Prozinc is often between +5 to +6 hours after a shot.
In comparison, the nadir for Lantus is often between +5 to +7 hours after a shot.
It can move around a bit.
The average time frame depends on the insulin.
The nadir for Prozinc is often between +5 to +6 hours after a shot.
In comparison, the nadir for Lantus is often between +5 to +7 hours after a shot.
Okay I updated the spreadsheet. My problem is I can only do blood 3 times a day for most of the week. My schedule right now is a little crazy.
I attached the link to the spreadsheet, let me know if anyone has any problems seeing it.
Health update: Timmy is eating well, his walking has improved considerably. More active, and he is playing more.
Thanks!!
I attached the link to the spreadsheet, let me know if anyone has any problems seeing it.
Health update: Timmy is eating well, his walking has improved considerably. More active, and he is playing more.
Thanks!!
Chris & China (GA)
Member Since 2013
Hi Dan!
Yes, your spreadsheet is visible so that's great! A little tweaking for you when you have a chance. On 10/11, the 390 IS the PMPS...the AMPS (AM Pre-shot) and PMPS (PM Pre-shot) are the tests you get right before you shoot/feed. You just need to move the 390 over into the PMPS column. The 254 that you have on the 2nd line should be moved to the same line as the 390, only in the +4 column.
Each day, you will use 1 line. The Morning cycle (AMPS) is the first cycle of each day. You test/shoot/feed and the clock starts. Each cycle lasts 12 hours. Since we all live in different time zones, instead of using actual times, we use the + system, so 4 hours after you shoot would be a +4, 7 hours after you shoot would be a +7, etc.....When you get to the Evening cycle (PMPS) you test/shoot/feed and the clock starts over again.
You can just enter the number (in your case, 3) in the "U" column. We understand that's the "Units" of insulin you gave.
It might help for you to look at China's spreadsheet. The link is in my signature. Using China's numbers as an example, this morning, her AMPS reading was 114 at 6am...(we are on a 6am/6pm schedule) and I gave her 1 unit of insulin. At +3 (9am) she was at 65...then at +5 (11am) she was at 51.....At 6pm tonight, I'll be starting her PM cycle, so will test/shoot/feed again, and the 12 hour clock starts over again.
Over in the Remarks column you can put anything you think would be helpful for you to know, like what you fed Timmy, or if Timmy's appetite wasn't good, or he puked..just anything that will help to remind you of things when you need to go back and look at how he's done in the past several days to try to see if there's any "pattern" going on.
We understand you might not be able to get some of those mid-day tests during the week, but it's really important that you try to get them on weekends or any day during the week that you can. Do you have anyone who could do a mid-day test for you during the work week if you can't?
You need to always get those Pre-shot tests..those 2 are very important. You wouldn't want to give insulin if the number is too low. We suggest that until you learn how Timmy responds, your No Shot number is 200 or under. This doesn't necessarily mean you don't EVER shoot. It means that you should "Stall" (DON'T feed, retest in 30 minutes) and ask for help. As you get more data on how Timmy reacts, that number will come down. (As you can see, I shot China this morning at a 114, and last night at a 85, but I know how China reacts and know how to keep her safe)
It's GREAT that Timmy is feeling better!! Once you get him under better control, I think you'll be as amazed as I was at how much better he'll look!!
Keep asking those questions too!!
Yes, your spreadsheet is visible so that's great! A little tweaking for you when you have a chance. On 10/11, the 390 IS the PMPS...the AMPS (AM Pre-shot) and PMPS (PM Pre-shot) are the tests you get right before you shoot/feed. You just need to move the 390 over into the PMPS column. The 254 that you have on the 2nd line should be moved to the same line as the 390, only in the +4 column.
Each day, you will use 1 line. The Morning cycle (AMPS) is the first cycle of each day. You test/shoot/feed and the clock starts. Each cycle lasts 12 hours. Since we all live in different time zones, instead of using actual times, we use the + system, so 4 hours after you shoot would be a +4, 7 hours after you shoot would be a +7, etc.....When you get to the Evening cycle (PMPS) you test/shoot/feed and the clock starts over again.
You can just enter the number (in your case, 3) in the "U" column. We understand that's the "Units" of insulin you gave.
It might help for you to look at China's spreadsheet. The link is in my signature. Using China's numbers as an example, this morning, her AMPS reading was 114 at 6am...(we are on a 6am/6pm schedule) and I gave her 1 unit of insulin. At +3 (9am) she was at 65...then at +5 (11am) she was at 51.....At 6pm tonight, I'll be starting her PM cycle, so will test/shoot/feed again, and the 12 hour clock starts over again.
Over in the Remarks column you can put anything you think would be helpful for you to know, like what you fed Timmy, or if Timmy's appetite wasn't good, or he puked..just anything that will help to remind you of things when you need to go back and look at how he's done in the past several days to try to see if there's any "pattern" going on.
We understand you might not be able to get some of those mid-day tests during the week, but it's really important that you try to get them on weekends or any day during the week that you can. Do you have anyone who could do a mid-day test for you during the work week if you can't?
You need to always get those Pre-shot tests..those 2 are very important. You wouldn't want to give insulin if the number is too low. We suggest that until you learn how Timmy responds, your No Shot number is 200 or under. This doesn't necessarily mean you don't EVER shoot. It means that you should "Stall" (DON'T feed, retest in 30 minutes) and ask for help. As you get more data on how Timmy reacts, that number will come down. (As you can see, I shot China this morning at a 114, and last night at a 85, but I know how China reacts and know how to keep her safe)
It's GREAT that Timmy is feeling better!! Once you get him under better control, I think you'll be as amazed as I was at how much better he'll look!!
Keep asking those questions too!!
Thanks Chris!!
I guess I'm still unclear why his glucose level was so high this morning. All I feed him now is Fancy Feast and cooked chicken or hamburg, and I have been doing that since Wednesday.
My roommate said that he peed on the floor again. My vet said that he does think he has a UTI? Any ideas or suggestions?
Also, do you know anyone in my area or vet in my area that specializes in feline deabetes? (I know this is a long shot.)
Thanks!!
I guess I'm still unclear why his glucose level was so high this morning. All I feed him now is Fancy Feast and cooked chicken or hamburg, and I have been doing that since Wednesday.
My roommate said that he peed on the floor again. My vet said that he does think he has a UTI? Any ideas or suggestions?
Also, do you know anyone in my area or vet in my area that specializes in feline deabetes? (I know this is a long shot.)
Thanks!!
Sue and Oliver (GA)
Member Since 2009
The answer is in that midcycle number, Dan, which is why they are so important. It's possible that he went lower than usual last night and bounced back up for the am number. (when their body senses a lower than normal number, it releases extra glucose which sends the number up.). More numbers today will help us figure out what is going on.
If he has a UTI, it is important to get him in and get some medicine right away. Infections and higher numbers for new diabetics can cause DKA, which can be deadly.
If he has a UTI, it is important to get him in and get some medicine right away. Infections and higher numbers for new diabetics can cause DKA, which can be deadly.
Chris & China (GA)
Member Since 2013
Dan, on the 10/11 line, in the "remarks" you say that the 254 was at 12:15am, 4 hours after the PMPS test of 390, so you'd put that 254 in the +4 column on the PMPS side..You moved it to the AMPS side. If you look, you'll see there's +1 through +11 for each cycle
As for this morning's number, it's just too soon to know what might be going on. It's great that you're testing now, so that will help. There's many reasons why we get high numbers...Too little insulin, too much insulin, getting into food they're not supposed to be eating, "bouncing", etc. etc. etc. If it's possible he has a UTI, you NEED to get that checked out. Infection will always cause the blood glucose numbers to go up
I don't THINK that 543 is a bounce though. "Bouncing" happens when the Blood Glucose goes lower than Timmy's liver is used to, so it "panics" and sends out hormones and glucogen (sugar) to bring it back up to where it's used to being. It can take up to 72 hours for a bounce to clear, but as the liver gets more used to lower numbers, they won't bounce as high, and will clear them faster. Bouncing is normal (although frustrating) but it doesn't look like Timmy went that low during his PMPS cycle last night.
Bouncing can also happen if the blood glucose drops quickly....Like if it went from 390 to 150 in two hours..same reason though...the liver thinks it's going too low and brings it back up.
I'm not real familiar with using Pro Zinc...China's on Lantus, so I can't really advise you much on dose. I know with Pro Zinc the Pre-shot numbers are what the dose is based on more than with Lantus and it usually uses a sliding scale, like Over 500 gets 5 units, over 400 gets 4, 300 gets 3 units, etc. (and those are EXAMPLES..not the actual dosing sliding scale)
For now, I'd just hold the 3 units and get as much data as you can so we can start to see how Timmy reacts to the Pro Zinc as well as getting him checked for a UTI if you think that might be going on. I'll see if I can find some more experienced eyes that use Pro Zinc to help advise you too
As for this morning's number, it's just too soon to know what might be going on. It's great that you're testing now, so that will help. There's many reasons why we get high numbers...Too little insulin, too much insulin, getting into food they're not supposed to be eating, "bouncing", etc. etc. etc. If it's possible he has a UTI, you NEED to get that checked out. Infection will always cause the blood glucose numbers to go up
I don't THINK that 543 is a bounce though. "Bouncing" happens when the Blood Glucose goes lower than Timmy's liver is used to, so it "panics" and sends out hormones and glucogen (sugar) to bring it back up to where it's used to being. It can take up to 72 hours for a bounce to clear, but as the liver gets more used to lower numbers, they won't bounce as high, and will clear them faster. Bouncing is normal (although frustrating) but it doesn't look like Timmy went that low during his PMPS cycle last night.
Bouncing can also happen if the blood glucose drops quickly....Like if it went from 390 to 150 in two hours..same reason though...the liver thinks it's going too low and brings it back up.
I'm not real familiar with using Pro Zinc...China's on Lantus, so I can't really advise you much on dose. I know with Pro Zinc the Pre-shot numbers are what the dose is based on more than with Lantus and it usually uses a sliding scale, like Over 500 gets 5 units, over 400 gets 4, 300 gets 3 units, etc. (and those are EXAMPLES..not the actual dosing sliding scale)
For now, I'd just hold the 3 units and get as much data as you can so we can start to see how Timmy reacts to the Pro Zinc as well as getting him checked for a UTI if you think that might be going on. I'll see if I can find some more experienced eyes that use Pro Zinc to help advise you too
Sue and Oliver (GA)
Member Since 2009
Do you have more numbers today? Is he still peeing outside the box or does it seem like the antibiotic is working? DKA can happen with an infection (even while being treated) and high numbers. Are you testing for ketones? (use the same kind of ketone strips from the pharmacy humans use and stick it into his urine stream. If he won't let you do that, we have other tricks)
If he is acting off kilter (very sick, weak etc) get him to the vet and have him tested for ketones)
If he is acting off kilter (very sick, weak etc) get him to the vet and have him tested for ketones)
Sue and Oliver (GA)
Member Since 2009
Those numbers are still really high. Be sure to test for ketones with such high numbers.
This is a quandry. You started at a high dose. We suggest starting at one unit, keeping your numbers at home and increasing every 3 cycles if the numbers warrant, by .25-.5 units. It's what we call starting low and going slow. It makes sure you don't pass a good dose by starting too high and increasing too fast.
If Timmy was well with no possible infection, I'd probably suggest going back to one unit and keeping good records and testing for ketones daily and see if the numbers are better.
Because he has a possible infection and is at risk for DKA, I think your best choice at the moment is to increase by .5 units and monitor carefully. This may be a good idea because you did get a yellow midcycle a few cycles ago so the dose is doing something. The problem with this is if the insulin is more than he needs, he might suddenly throw a low number and you need to be monitoring and be ready. With the increase if you continue to get reds and blacks, it's either time to reduce or try another insulin.
The cavat is as always - I am not a vet. I have used your insulin and helped many others who used or are using it. Timmy is your cat and you hold the needle. You make the choices.
This is a quandry. You started at a high dose. We suggest starting at one unit, keeping your numbers at home and increasing every 3 cycles if the numbers warrant, by .25-.5 units. It's what we call starting low and going slow. It makes sure you don't pass a good dose by starting too high and increasing too fast.
If Timmy was well with no possible infection, I'd probably suggest going back to one unit and keeping good records and testing for ketones daily and see if the numbers are better.
Because he has a possible infection and is at risk for DKA, I think your best choice at the moment is to increase by .5 units and monitor carefully. This may be a good idea because you did get a yellow midcycle a few cycles ago so the dose is doing something. The problem with this is if the insulin is more than he needs, he might suddenly throw a low number and you need to be monitoring and be ready. With the increase if you continue to get reds and blacks, it's either time to reduce or try another insulin.
The cavat is as always - I am not a vet. I have used your insulin and helped many others who used or are using it. Timmy is your cat and you hold the needle. You make the choices.
Chris & China (GA)
Member Since 2013
Hi again Dan!!
Sue is one of those "More experienced eyes with Pro Zinc" I told you about. She can help you with the dosage much better than I can on how best to use Pro Zinc
Got one question for you on your spreadsheet though....On your 10/12 line, it looks like his AMPS was at 7:55am and was 543. Then you fed (and shot??) Then you say that the 303 was at 5:30, but you put it in the PMPS column. If you tested at 5:30pm and you shot at 8am, that number would go in the +9 column on the AMPS side of the cycle. (actually, you would put 303 @ 9.5 into the +9 column)...it won't color itself though...You would have to add the color yourself by clicking on the little bucket of spilling paint icon along the top of the page and choose the correct color for a 303 (Pink)
Your PMPS number should be the number you get right before shooting/feeding in the evening, so if you shot Timmy at 8am, your PMPS time would be 8pm. It's important to do those pre-shot tests right before you shoot/feed so you know he's high enough to safely give insulin (Not a problem right now, but as he gets better regulated, you wouldn't want to give 3 units of insulin if his pre-shot number was 45)
Happy to hear Timmy is feeling better!! A lot of the time the first encouraging things we see are in our cats behavior..returning to purring, playing, preening (and peeing and pooping appropriately too) We call those the 5 P's
If you still don't understand about the spreadsheet, please let me know. I can get some screenshots to show you how to use the spreadsheet better.
Sue is one of those "More experienced eyes with Pro Zinc" I told you about. She can help you with the dosage much better than I can on how best to use Pro Zinc
Got one question for you on your spreadsheet though....On your 10/12 line, it looks like his AMPS was at 7:55am and was 543. Then you fed (and shot??) Then you say that the 303 was at 5:30, but you put it in the PMPS column. If you tested at 5:30pm and you shot at 8am, that number would go in the +9 column on the AMPS side of the cycle. (actually, you would put 303 @ 9.5 into the +9 column)...it won't color itself though...You would have to add the color yourself by clicking on the little bucket of spilling paint icon along the top of the page and choose the correct color for a 303 (Pink)
Your PMPS number should be the number you get right before shooting/feeding in the evening, so if you shot Timmy at 8am, your PMPS time would be 8pm. It's important to do those pre-shot tests right before you shoot/feed so you know he's high enough to safely give insulin (Not a problem right now, but as he gets better regulated, you wouldn't want to give 3 units of insulin if his pre-shot number was 45)
Happy to hear Timmy is feeling better!! A lot of the time the first encouraging things we see are in our cats behavior..returning to purring, playing, preening (and peeing and pooping appropriately too) We call those the 5 P's
If you still don't understand about the spreadsheet, please let me know. I can get some screenshots to show you how to use the spreadsheet better.
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