NEW MEMBER 4/29/2026 - Disappointed

[Satora]

Caregiver Name: Satora
Cat’s Name: Khloe
Age: 11
Sex: Female (Spayed)
Current Medication: Vetsulin 2 Units

Hi everyone, I don’t have a question but more looking to just vent my disappointment. Hope that’s ok to post about.

My cat was diagnosed on 2/17/2026 with a BG of 555 mg/dL (Alpha Trac 3 at Vet’s office). She was considered a good candidate for Bexacat and with my fear of needles, we gave it a try. After 8 weeks of treatment, she was deemed a partial responder due to her curves never averaging below 250 mg/dL (8 week curve average was 267 mg/dL).
We debated trying to optimize her diet more and stay with Bexacat but after some research, I realized all of them are out of my price range. Even with a 100% FF pate diet, it still would be more than I can afford (I have 2 cats, one of which isn’t a diabetic so the diet would have to change for both cats. Khloe would 100% steal the others food if not. Also, my cats are chunky and like to snack all day. Khloe is nearly 13 lbs and the other is 11 lbs)

So we made the decision to switch to insulin, and it’s surprisingly easier than I imagined. But we are on day 8 of Vetsulin (2 Units twice a day) and her BG is still 500+ every pre-shot reading, she’s still urinating outside the litter box, and I just feel defeated. 9 weeks of treatment, over a grand spent in vet visits and nothing, still feels like we are at day 1.
I’m just.. sad. I just want things to go back to semi normal and my cat to finally feel better.

Anyways, my vet didn’t want the first curve until week 4 of insulin but I’m thinking of reaching out tomorrow to get his opinion.

Fingers crossed for a good outcome soon.

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
Well done getting the spreadsheet and signature set up. That’s very helpful.
I see you are free feeding dry food. I understand you need to watch costs but really dry food is very high carb and you will find it very difficult to regulate your kitty while feeding high carb dry.
There are some low carb wet foods in larger cans that are cheaper than FF. Would you consider swapping your those.
Which country do you live in? We may be able to suggest some canned food.

If you swap to a low carb wet food you will notice a drop in the BGs. I would therefore not increase the dose if you are considering swapping the food to low carb.

I would also suggest buying a bottle of Ketostix from Walmart or a pharmacy and testing her urine first ketones with those high BGs

 

[Bron and Sheba (GA)]

I see you live in the US so I’ll attach a food chart for you
Lisa Pierson's food chart

 

[Satora]

Hi and welcome to the forum.
Well done getting the spreadsheet and signature set up. That’s very helpful.
I see you are free feeding dry food. I understand you need to watch costs but really dry food is very high carb and you will find it very difficult to regulate your kitty while feeding high carb dry.
There are some low carb wet foods in larger cans that are cheaper than FF. Would you consider swapping your those.
Which country do you live in? We may be able to suggest some canned food.

If you swap to a low carb wet food you will notice a drop in the BGs. I would therefore not increase the dose if you are considering swapping the food to low carb.

I would also suggest buying a bottle of Ketostix from Walmart or a pharmacy and testing her urine first ketones with those high BGs

Hello, thank you for the reply and food list. I would be open to swapping to low carb wet food in larger cans than FF. I’ll be taking a look at that list tomorrow. My only concern is her routine of snacking all day long, maybe I would just have to transition her very slowly to a set schedule feeding so she can get used to the change?

I have mentioned home ketone testing to my vet multiple times and he’s firmly shut me down everytime. I do know he does ketone tests in office before every curve tho. I’ll probably just grab them anyways, knowing more info can never be a bad thing.

Edit: Just for clarity, she was between 180-350 mg/dL while on Bexacat. She’s only been back in the 500s since being on Vetsulin.

 

[Bron and Sheba (GA)]

Yes please get the Ketostix. Can’t imagine why the vet shut you down on those. You don’t have to tell him you have them.
Yes do any change over of food gradually. If they are used to grazing, You could offer snacks every couple of hours if you are at home. Otherwise you could get a couple of auto feeders.
The current dose of Vetsulin may not be enough but do the change over of food first… as long as there are no ketones in the urine

 

[Chris/China (GA)/Garfield]

Your cats will complain LOUDLY for awhile, but if you can get them on scheduled feeding, it will make it easier on you. Scheduled feeding doesn't mean only feeding twice a day. You can break up their total calories into small "mini-meals" as often as every 3 hours or as long as every 6. Most of us feed around every 4 hours.

Friskies pates (not the Indoor) are low carb and come in 5.5oz cans (you can sometimes find them in 12-13oz cans too). 9-Lives ground is usually even cheaper than Friskies, and still a low carb food. Special Kitty pates from Walmart are even less, and are in 5.5oz and 12-13oz cans (in some stores or online)

You might also want to consider changing insulin. Vetsulin isn't recommended for cats anymore. It's a better insulin for dogs (in the rest of the world, Vetsulin is called Caninsulin.....that "canin" prefix tells you who it was developed for). It tends to hit hard, drop them quickly and then wear off long before the next shot is due. A lot of vets tend to treat their feline patients like small dogs and it usually just doesn't work The insulin's that are currently recommended for cats by the 2026 AAHA Guidelines for diabetes treatment in cats are Lantus (Glargine) and Prozinc. They are gentler and longer-lasting.

From the 2026 AAHA Guidelines: (highlights are my own)

Insulin Selection​

A number of insulins are available for treating DM, and some are more effective than others in feline patients (Table 7.1). The most common choices for cats remain glargine (U-100) (approved for use in people) and protamine zinc recombinant human insulin (PZI) (approved for use in cats and dogs). Both have an acceptable duration of action in cats, provide more consistent glycemic control, and have been commonly associated with inducing diabetic remission. Lente insulin (porcine insulin zinc suspension) (also known as Vetsulin) is approved for and often used in cats; however, it is not routinely recommended by task force members as a first-choice insulin due to having a shorter duration of action as compared to other starting insulin options. Neutral protamine Hagedorn (NPH) insulin is not considered an acceptable choice for cats owing to a very short (<8 hr) duration of effect.

If your vet is pushing back on ketone testing, they may also not be open to changing the insulin to something more appropriate so you may need to find a new vet that's a little more up to date on treatment for cats.

 

[Satora]

Your cats will complain LOUDLY for awhile, but if you can get them on scheduled feeding, it will make it easier on you. Scheduled feeding doesn't mean only feeding twice a day. You can break up their total calories into small "mini-meals" as often as every 3 hours or as long as every 6. Most of us feed around every 4 hours.

Friskies pates (not the Indoor) are low carb and come in 5.5oz cans (you can sometimes find them in 12-13oz cans too). 9-Lives ground is usually even cheaper than Friskies, and still a low carb food. Special Kitty pates from Walmart are even less, and are in 5.5oz and 12-13oz cans (in some stores or online)

You might also want to consider changing insulin. Vetsulin isn't recommended for cats anymore. It's a better insulin for dogs (in the rest of the world, Vetsulin is called Caninsulin.....that "canin" prefix tells you who it was developed for). It tends to hit hard, drop them quickly and then wear off long before the next shot is due. A lot of vets tend to treat their feline patients like small dogs and it usually just doesn't work) The insulin's that are currently recommended for cats by the 2026 AAHA Guidelines for diabetes treatment in cats are Lantus (Glargine) and Prozinc. They are gentler and longer-lasting.

From the 2026 AAHA Guidelines: (highlights are my own)

Insulin Selection​

A number of insulins are available for treating DM, and some are more effective than others in feline patients (Table 7.1). The most common choices for cats remain glargine (U-100) (approved for use in people) and protamine zinc recombinant human insulin (PZI) (approved for use in cats and dogs). Both have an acceptable duration of action in cats, provide more consistent glycemic control, and have been commonly associated with inducing diabetic remission. Lente insulin (porcine insulin zinc suspension) (also known as Vetsulin) is approved for and often used in cats; however, it is not routinely recommended by task force members as a first-choice insulin due to having a shorter duration of action as compared to other starting insulin options. Neutral protamine Hagedorn (NPH) insulin is not considered an acceptable choice for cats owing to a very short (<8 hr) duration of effect.

If your vet is pushing back on ketone testing, they may also not be open to changing the insulin to something more appropriate so you may need to find a new vet that's a little more up to date on treatment for cats.

Thank you for all those wet food suggestions, I believe I can make those options work!
I’m not always home enough to feed every 3-4 hours but I have been looking into an auto feeder. I notice she wants to snack about every 1-2 hours so hoping I can work her into a good schedule.

As for the Vetsulin, I have to say I agree. Based on what I’m seeing, it seems the duration isn’t long enough on her. But I’m going to give it alittle longer and see if diet helps before messing with the insulin. But I do wish my vet would have just started with Lantus or at least explained the difference in insulins.

Today I tried wet food only with the morning shot and didn’t offer any dry until the afternoon. She at least made it down to the 300s within the first 2-4 hours.

Again, thank you for your reply. It was very very informative.

 

[Bron and Sheba (GA)]

If you get auto feeders ( which I think is a great idea for you) I would get two . One for each cat and make sure they open at the same time. This way they will both get food.
Can you put in the remarks column of the SS what you are feeding each day please. That way, we can see the effect of the type of food on the BGs.

 

[Satora]

If you get auto feeders ( which I think is a great idea for you) I would get two . One for each cat and make sure they open at the same time. This way they will both get food.
Can you put in the remarks column of the SS what you are feeding each day please. That way, we can see the effect of the type of food on the BGs.

Absolutely. I’ll keep that updated as much as possible.

 

[Satora]

I was curious if anyone has a calories per pound chart? I’m buying Friskies Pate today to start the switch from dry and getting conflicting info from Google. The only thing I could find on here was a post from 2012 that still wasn’t clear to me. I’m sure there’s one on here somewhere, I’m just having a hard time finding it.

Her most current weight is 12.6 lbs and the 5.5 oz cans are 175 calories per can. Would 2 cans a day be too much to start with? I personally would rather start with too many calories than to little due to how high her BG has been lately. (Ketone tests ordered and on the way, my local stores didn’t have any in stock.)

 

[Chris/China (GA)/Garfield]

A good starting point is 20 calories per pound of IDEAL weight. Then you should weigh him every 4-7 days and adjust the calories as needed.

So if his IDEAL weight is 12.6 pounds, you'd start at about 252 calories per day. If he loses weight (he doesn't need to lose), increase the calories per day. If he gains weight (he doesn't need to gain), decrease the calories slightly.

 

[Satora]

I did a glucose curve today at home for the 2 week mark since starting Vetsulin.

She’s been going through a diet change over the last few days (SS for details) that I originally pushed too quickly on her. Over the next week, I will be doing a slow transition to wet only. She should be on wet only by 5/13/2026.

Her 4 week curve (the first curve the vet asked for), will be on 5/19/2026.

Should I keep pushing forward with diet and wait till week 4 for any dose changes? Or is this 2 week curve enough to show it’s not working well enough?

This curve looks so extremely different than her 8 week Bexacat one.

 

[Chris/China (GA)/Garfield]

I think it shows exactly what we've discussed. That the Vetsulin hits hard, drops her early (by +4) and then wears off before the next shot time.

Did she have trouble transitioning straight to canned? Is that why you're going back to the high carb kibble and transitioning slowly now?

2U is a higher than recommended starting dose in the first place but as long as she's eating the kibble it's hard to know what to do with the dose since once she's strictly on low carb canned, her numbers should come down and the dose may be too high, but you could go up to 2.25 IF you can start getting more tests in, like an extra test around +4/5 on the AM cycle and at least 1 "before bed" test on the PM cycle. Don't forget that most cats go lower at night so it's important to know she'll be safe while you're sleeping. Only testing on the AM cycle is only giving you half the picture.

 

[Satora]

I think it shows exactly what we've discussed. That the Vetsulin hits hard, drops her early (by +4) and then wears off before the next shot time.

Did she have trouble transitioning straight to canned? Is that why you're going back to the high carb kibble and transitioning slowly now?

2U is a higher than recommended starting dose in the first place but as long as she's eating the kibble it's hard to know what to do with the dose since once she's strictly on low carb canned, her numbers should come down and the dose may be too high, but you could go up to 2.25 IF you can start getting more tests in, like an extra test around +4/5 on the AM cycle and at least 1 "before bed" test on the PM cycle. Don't forget that most cats go lower at night so it's important to know she'll be safe while you're sleeping. Only testing on the AM cycle is only giving you half the picture.

Is it relevant at all that her nadir was at +4 on Bexacat too?

And yes she struggled super hard going straight to canned, even with it spread out during the day. She was even trying to steal the dog’s food! Which she has never done before.

Thankfully she will pick wet over dry so she’s starting to get used to filling up on wet and being less interested in the dry. I notice alittle more kibble left in the bowl instead of it being completely empty.

Tomorrow I plan to cut the dry out of the AM and adding the +6 canned but keeping the PM kibble available. PM is where she struggles the most, which lines up with what you’re saying. Once I get those auto feeders, I’ll most likely split the wet across 4 servings over 24 hours but I definitely can’t get up at 3am right now to feed her.

So I’ll keep chugging along with the diet change since it very clearly did make a difference. I’ll be back in 1-2 weeks with the results!

Also, on a lighter note, my non-diabetic cat has gotten with the program and has started to refuse dry kibble because she knows that delicious wet food will be available! Lol

Edit: And thank you so much for your help with everything. I truly appreciate it.

 

[Chris/China (GA)/Garfield]

Also, on a lighter note, my non-diabetic cat has gotten with the program and has started to refuse dry kibble because she knows that delicious wet food will be available! Lol

When my first diabetic cat was diagnosed, I had 2 others (who were quite overweight). Once I found out what I SHOULD be feeding her, I just tossed the rest of the kibble in the trash and started putting down canned for everybody. (luckily, none of them had any tummy trouble from the quick switch). They did however give me some dirty looks that said something like "So you've been holding out on us all this time? Why haven't we gotten this yummy stuff before"?

I also noticed that both the obese cats started to lose the weight they needed to lose. Not having kibble available 24/7 meant they didn't eat out of boredom and calories were restricted since they were on a feeding schedule. I also noticed huge changes in their coats. They became softer and shinier than they'd ever been (thanks to the extra moisture they were getting by eating canned).