New Here! - Need Advice

[Princethecat]

Hello All!
Been "stalking" this page for about a week now and thought it was time to make my own post. My cat, Prince is 9 years old and was diagnosed with diabetes on 5/13/2022. My then (new since we had recently moved) vet had put him on 1 unit of Prozinc (twice a day) and prescribed him Purina Pro Plan Veterinary Diets DM. When his blood glucose level was initially tested he was at 412, since then it has been a fight to lower this level.

About a month into his diagnosis I brought him back to our old vet, who I trust more. The vet increased his insulin to 2 units. Since around mid-June, I have brought Prince back to the vet monthly to get his blood glucose level checked and as a result, upped his insulin amount. He is currently on 5 units of Prozinc twice a day. However, his blood glucose level has rarely dipped. We recently did a Fructosamine Level (on 8/19) and his levels were again high.

A couple of things of note and what I would appreciate advice on:

• In the beginning, Prince would urinate extreme amounts. I would clean the litter boxes multiple times a day just to keep up and even lost a good couch! Via this forum, I figured that his Purina DM dry food had more carbs than probably ideal and switched over to the canned version. Since then he has been going to the bathroom pretty normally and has not had any major accidents. I have also been experimenting with Fancy Feast Pates (since Purina DM is $$) but since the vet hasn't really recommended this - I'm scared to make a drastic change. Does anyone have experience switching from Rx to regular canned food?
• Prince is also…a large cat (he was a little overweight at the beginning of this year but this new regimen has thinned him out a bit). Point being - he loves to eat, and I feel like the canned food (2x daily) doesn't really fill him up but I don't want to overfeed him as well
• Testing: Reading through posts on here, I know that I need and should start home testing his glucose levels, but am admittedly overwhelmed by the process. Are there any recommended beginner devices?

Prince has been doing better overall this month than previously, but I wish so badly to just get him a little more regulated! Any advice is appreciated - thank you!

 

[Chris & China (GA)]

Does anyone have experience switching from Rx to regular canned food?

Pretty much all of us! One thing we've learned though. There's absolutely nothing in the "prescription" foods that cause it to require a script and none of it actually treats diabetes! You're paying a premium price for a food made with inferior grade ingredients with a very well advertised name. The good news is it's 100% guaranteed so can be returned for a refund. A lot of us just told our vet that our cat refused to eat it anymore.

If you don't believe me, compare the ingredients on a can of D/M to the ingredients on a can of Fancy Feast.

D/M pate ONLY (not the "Selects")...Meat By-Products, Water, Chicken, Salmon, Soy Protein Isolate, Oat Hulls, L-Lysine Monohydrochloride, Artificial And Natural Flavors, Guar Gum, (various vitamins and minerals too numerous to list)

Fancy Feast: Tender Liver & Chicken Feast: Chicken Broth, Liver, Meat By-Products, Chicken, Fish, Artificial And Natural Flavors, (various vitamins/minerals)

Turkey & Giblets Feast: Turkey, Liver, Meat By-Products, Turkey Broth, Poultry Giblets, Artificial And Natural Flavors, (various vitamins/minerals)

See anything special in the D/M? If you took it back to your vet and asked them to circle the ingredients that require a script, they wouldn't be able to because there aren't any. There's a great article on "prescription" diets here but here's my favorite quote:

To quote the FDA/CVM Communications Staff Deputy Director:

“‘Prescription diet’ is an industry-coined term and holds no legal meaning.”

In other words, these diets contain no ingredient that actually requires a prescription. The trademarked term “prescription diet” is simply a clever marketing tool between Hill’s and veterinarians. The sale of these diets is restricted (by Hill’s, not by law) to veterinarians only. In return, Hill’s enjoys a boost in perception of quality brought about by this profession’s endorsement of their products. However, this perception of quality is undeserved and this incestuous relationship jeopardizes the integrity of our profession.

I feel like the canned food (2x daily) doesn't really fill him up but I don't want to overfeed him as well

Another "old school" idea was feeding a cat only twice a day. It's actually easier on the pancreas to deal with small, more frequent meals (which is why human diabetics are told to eat 6 small meals instead of 3 big ones). Not only does feeding more frequent meals help keep the blood glucose more stable, it also makes for a much happier kitty (and human!). The only time we don't want them to eat are the 2 hours immediately before shot times so that when we test, we get a number that's not influenced by food. We always test before shooting to make sure they're high enough to get insulin at all (just like humans always test before giving themselves insulin)

Are there any recommended beginner devices?

The most popular meter here is probably the Relion Premier Classic from WalMart ($9), strips are $17.88/100. There are pet meters like the Alpha Trak, but the strips for it cost about $1 EACH and when we test at least 4 times a day (more if they're dropping fast or low) that can get costly really fast. You'll also want some lancets like the Relion THIN (not micro thin or ultra thin)....they're less than $2. A lot of us just freehand the lancets but if you feel you need one, you can get a lancet device (about $6) but if it has lancets with it, they are too thin for new ears. You want 26-28 gauge lancets which the THIN are. A package of cotton cosmetic pads are handy too. Gives you something to put behind the ear to protect your finger when you test and then you can just fold it over to apply a little pressure to prevent bruising.

 

[Diane Tyler's Mom GA]

Welcome I don't know if you have seen the food chart, we like to feed 6% carbs preferably 2 or 3% carbs. Most of us do feed FF Pates
Here's the chart
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
I also suggest you start home testing
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up
A video one of our members posted
VIDEO: How to test your cat's blood sugar

If you bought a human meter it doesn't need to be coded ,only a pet meter does like Janet is using

We also use a spreadsheet to track our cat's BG numbers to see how the insulin is working and how low it's dropping and in case you need any advice , if you are interested in setting one up just ask , we have a member who will be happy to do it for you


We don't increase insulin by whole units, we increase or decrease by 0.25 units at a time so you don't skip over a good dose for Prince
Are you using U-40 syringes with the half unit markings, it's easier when you have to adjust the dose by 0.25 units.
They come in half unit increments but still make it easier when adjusting by 0.25 units

 

[Princethecat]

@Chris & China (GA) Thanks for the reassurance on the food - I think I'm going to switch him over to Fancy Feasts. One thing I think he does miss is his dry food (I find him eating the dog's dry food and now have to completely change where I feed them both) He's definitely an eat everything kind of cat and BEGS for treats. Are those a no-go at this point?
Thanks also for the meter rec - I definitely do want to track this and will look into it.

@Diane Tyler's Mom Thanks for the vid - watched it and it was helpful. Once I get a meter I will be setting a spreadsheet. And yes I am using U40 syringes. Question: How often do you test?
A question that I now had read these replies is am I feeding/giving his insulin dose at the correct times? His shots are spread out every 12 hours. As per recommended by the vet, I feed, wait 30 min, and then give the shot. Is this correct?

 

[Diane Tyler's Mom GA]

As for treats any freeze dried treats are fine
Freeze dried treats
https://www.chewy.com/halo-liv-littles-grain-free-100/dp/29214

You can give her any freeze dried treats for a snack
most members give freeze dried treats , they are low carb, you can probably find them in some local pet stores also
I did a search for you on here and copied what some members said they use,

When testing you can give them a treat so they will associate after testing they will get a reward, any freeze dried treats are ok such as
PureBites Freeze-Dried Cat Treats with Chicken Breast 2.3 oz ()https://www.amazon.com/dp/B071P

Also chewys has freeze dried treats also


The freeze dried treats you can get at petsmart, petco and order from chewy. Purebites is popular (cheaper if you buy the dog food ones). My crew like vital essentials it's dehydrated freeze dried raw comes in flavors

freeze dried minnows, made by Vital Essentials. I also buy the ones made for dogs. They're the same as the freeze dried minnows for cats. just cheaper. They also carry other freeze dried treats. I ordered mine through Amazon.

I think the vital essentials are more of a crunchy texture than the purebites

If you cat likes any of these you can buy the bigger bags for dogs they are the same ,you will get more for your money just break then up into smaller pieces
.

You can Google freeze dried treats and see what other ones there are and different flavors
Just make sure that is the only ingredient in them meaning turkey, chicken, minnows etc

Here is another one , I see you can get these in different flavors also just look
You may have to break any freeze dried treats in half if they are too big
https://www.amazon.com/Vital-Essent...ocphy=9003521&hvtargid=pla-630511512365&psc=1

 

[Diane Tyler's Mom GA]

Thanks for the vid - watched it and it was helpful. Once I get a meter I will be setting a spreadsheet. And yes I am using U40 syringes. Question: How often do you test?
A question that I now had read these replies is am I feeding/giving his insulin dose at the correct times? His shots are spread out every 12 hours. As per recommended by the vet, I feed, wait 30 min, and then give the shot. Is this correct?

Home testing is the only way to keep Prince safe
Do the syringes have half unit markings?
You would test first thing in the morning , but you need to withhold feeding any food 2 hours prior to testing because you don't want the BG to be food influenced
First test in the morning is called AMPS it means AM Pre Shot
Then feed , then give insulin you don't have to wait 30 minutes , it's good he's a good eater
Then we like to get a test at +2 ( 2 hours after giving insulin) we use the + numbers not the time because we are all in different time zones
Then another test around +4. and +6 or +7
You want to see how the insulin is working and how low he's dropping
We adjust the number of units we give by how low he's dropping not the Pre Shots

Then the same thing goes for his PMPS cycle
Yes you give insulin every 12 hours
It's important to test at night because cats usually drop lower at night

Every day and night you want to test at different times scatter them around
It's like filling in pieces of a puzzle

Once you get your supplies and your spreadsheet set up. I'll give you the link
If you need help just ask we have a member who will be happy to do it for you.
So once you start recording Prince's numbers the members will follow along and give you advice
5 units of prozinc is a lot of insulin to give
That's why we have a spreadsheet too see if that dose is too high
By increasing by full units you can be skipping over a good dose for Prince

Let us know when you have every thing ready and we can take it from there
Let me give you the link to the spreadsheet and the link to read about Prozinc , read all the yellow stickys about Prozinc

https://felinediabetes.com/FDMB/forums/prozinc-pzi.24/
Read about the 2 dosing methods, then you can pick which line is easier for you to follow
They will let you know when a decrease or increase is needed.

Spreadsheet link
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
If you have trouble setting it up just ask , we have a member who will gladly set it up for you

 

[Diane Tyler's Mom GA]

Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose
• How to do a Curve - a simple explanation

An easier explanation on how to do a curve
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.


Make sure you have a hypo kit in case Prince drops to low and you need to bring those numbers up to a safe number

Med and High Carb food and some honey



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

Between 11% and 17% is medium carbs.

18% and over is high carb.

 

[Diane Tyler's Mom GA]

Hello All!
Been "stalking" this page for about a week now and thought it was time to make my own post. My cat, Prince is 9 years old and was diagnosed with diabetes on 5/13/2022. My then (new since we had recently moved) vet had put him on 1 unit of Prozinc (twice a day) and prescribed him Purina Pro Plan Veterinary Diets DM. When his blood glucose level was initially tested he was at 412, since then it has been a fight to lower this level.

About a month into his diagnosis I brought him back to our old vet, who I trust more. The vet increased his insulin to 2 units. Since around mid-June, I have brought Prince back to the vet monthly to get his blood glucose level checked and as a result, upped his insulin amount. He is currently on 5 units of Prozinc twice a day. However, his blood glucose level has rarely dipped. We recently did a Fructosamine Level (on 8/19) and his levels were again high.

A couple of things of note and what I would appreciate advice on:

• In the beginning, Prince would urinate extreme amounts. I would clean the litter boxes multiple times a day just to keep up and even lost a good couch! Via this forum, I figured that his Purina DM dry food had more carbs than probably ideal and switched over to the canned version. Since then he has been going to the bathroom pretty normally and has not had any major accidents. I have also been experimenting with Fancy Feast Pates (since Purina DM is $$) but since the vet hasn't really recommended this - I'm scared to make a drastic change. Does anyone have experience switching from Rx to regular canned food?
• Prince is also…a large cat (he was a little overweight at the beginning of this year but this new regimen has thinned him out a bit). Point being - he loves to eat, and I feel like the canned food (2x daily) doesn't really fill him up but I don't want to overfeed him as well
• Testing: Reading through posts on here, I know that I need and should start home testing his glucose levels, but am admittedly overwhelmed by the process. Are there any recommended beginner devices?

Prince has been doing better overall this month than previously, but I wish so badly to just get him a little more regulated! Any advice is appreciated - thank you!

@FrostD
5 units seems like a high dose?
She will buy a meter and set up a SS

 

[Larry and Kitties]

The most popular meter here is probably the Relion Premier Classic from WalMart ($9), strips are $17.88/100.

Some caretakers like the Premier Compact since it is smaller than the classic. Some other like the Premier Blue which connects to an app on your smartphone. A few like the Premier Voice that says the BG value.
https://www.walmart.com/ip/ReliOn-Premier-Compact-Blood-Glucose-Monitoring-System/352439457

I use the now discontinued Relion Prime Classic which came with my Merle and find it a little big compared with the iHealth I use for my other diabetic cats.

 

[FrostD]

Yes 5U is a high dose...

When did you switch to the DM wet?

To explain a few fundamentals - dose is based on nadir. A dose that is too high can cause make the cat go too low then do what we call "bounce". This is when the liver panics and dumps stored glycogen and counterregulatory hormones in order to spike BG back up. The effects of that can last up to 6 cycles/3 days, where the BG just stays high and flat.

So - the downside of doing curves, and doing them only once a month, is that you may very well be catching one of those high and flat days and completely missing the lows. Additionally, BG is often much higher at the vet due to stress. That's where the home testing will help.

Fructosamine is basically an average of the BG over the last two weeks roughly. So if his dose is too high and he drops low, then skyrockets for a few cycles, yes that result will be elevated.

Do NOT change food at the moment, as the carb change can drastically drop BG. The first priority is to figure out if the dose is too high (experience tells me it is, unless he has an underlying condition causing it). Once you get your meter, you will want to get a test around +4 to +7 every cycle (day and night) for 4 days in a row. If your schedule doesn't allow for this, I may be able to tell based on +2s and +8/9s.

So firat we get him at a good, safe dose. Then once we have a little more data we slowly transition food and keep a close eye on BG.

 

[Diane Tyler's Mom GA]

@FrostD
I see @Princethecat said I figured that his Purina DM dry food had more carbs than probably ideal and switched over to the canned version.
Isn't what she's feeding now low carb even though she said it's too expensive and she been experimenting with FF Pates but since her vet hasn't recommended it she scared to make a drastic change

The Purina Pro Plan DM canned is 6% carbs

@Prince’s Mom
Is this what you are feeding now





@FrostD

 

[FrostD]

@FrostD
I see @Princethecat said I figured that his Purina DM dry food had more carbs than probably ideal and switched over to the canned version.
Isn't what she's feeding now low carb even though she said it's too expensive and she been experimenting with FF Pates but since her vet hasn't recommended it she scared to make a drastic change

The Purina Pro Plan DM canned is 6% carbs

@Prince’s Mom
Is this what you are feeding now





@FrostD

It would depend if it's the regular pate or savory shreds...even still some of the FF are lower carbs so I'd rather check dose first before making any changes (mostly because that dose is so darn high)

 

[Diane Tyler's Mom GA]

It would depend if it's the regular pate or savory shreds...even still some of the FF are lower carbs so I'd rather check dose first before making any changes (mostly because that dose is so darn high)

Yep you're absolutely right

 

[Princethecat]

Hi all thanks for the advice.

I have purchased a glucose meter! Relion Premier Classic per the suggestions I found here. Hoping to receive it by the weekend so I can set up a spreadsheet and start testing.

Yes @Diane Tyler's Mom I am currently feeding Purina DM (pate - the same one in the Diane Tylers Mom image)

@FrostD Yes the dosage is one of my main concerns. He seems to be handling it alright for now but I'm hoping testing will bring more clarity