New Member - advice needed!

Hi, my boy Loki is 11 and newly diagnosed with diabetes (3weeks ago) He got skinny and was drinking excessively and it transpired his BG was 27. He also had acute pancreatitis. The vet had him in for 2 days on IV fluids and started him on Caninsulin. We immediately switched him from his dry kibble to a high protein low carb wet food (Nature's Menu senior - we're in England)
3 weeks later we can see a little improvement - Loki is bright and seeking out cuddles etc but he has only put on 0.3kg and still drinking/weeing loads & is famished. Today I've started doing home BG testing and his BG pre-prandial was 24.4, 2hrs post was 21.4 and 5 hrs was 14.9. I don't have a full curve yet.
(Last night I did a one-off pre-prandial BG before his dinner & insulin just to see if I could do it and it was 27.1)
He is on 2 units twice a day of Caninsulin but I'm really concerned that his sugars are still so high
As of today I'm starting to switch him onto a raw diet (Natural Instinct), which I believe has the recommended levels of protein/fat/carbs.
I don't know what else to do. Any advice/reassurance/anything will be greatly appreciated. TIA, Tamsin and Loki

 

It takes a while. I'm glad your are getting him on a better food. Keep taking those readings. Track for a while and we can help with dosing.


Here's how you can make a spreadsheet like the ones you see in our signatures. It will be super helpful in giving us the data we need to help you.
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

I'm sorry about the diagnosis, but you have come to the right place. Diabetes is not a death sentence and they can live long healthy lives with it. It's a marathon so it may take a while to get regulated. You aren't alone.

 

Thanks very much, I'll have a look at that spreadsheet

 

A 14.9 really isn't bad in a newly diagnosed cat. My cat didn't see numbers like that for the first couple of months.

 

Oh ok, that's reassuring. I got disheartened by the 27.1 last night because it was that high on diagnosis so I feel we haven't made any progress. I'm scared of him developing kidney problems.
Do you know of the best places to buy BG monitors etc? We're currently borrowing one from the vet. It's an Alphatrak.

 

Cannisiliun often only lasts about 6-8 hours... that's why you are going to see such high preshot numbers and lower in the middle (usually peeks 4-6 hours after the shot). If you want something longer lasting that might bring those preshots down, when it's time to get a new vial ask about getting Lantus or Prozinc insulin. Some cats do well on cannisilun... My cat did good on it... others it doesn't last long. it's really more of a dog insulin (which explains the name).

 

Oh forgot to answer your monitor question. I use an alphatrak... I love the meter because it takes such a small sample and gives accurate readings the same readings as the vet. That being said, I know the strips can be pricy.

You can get a human bg meter at any pharmacy or online... doesn't really matter the brand. Just find one that takes a small .3-.5 size sample, and make sure the strips are affordable to you.

 

Tagging some UK members for you.
@Elizabeth and Bertie
@Dyana
@Critter Mom

The two blue links listed below are excellent resources.

• UK Diabetic Cat Food Info (includes some supplies) and UK Cat Food List

And welcome. Waving from Canada.

 

Hi Tamsin,

Great that you're already home testing! Some UK members use the Gluco Navii meter. I think it's the most affordable meter available here at the moment. The strips are certainly much more affordable than the Alphatrak. It is a human meter so you need to use a different feline blood glucose normal reference range with it (2.8-6.7mmol/L). You can get the meter on Amazon (and, I would presume, eBay). If you go for it, make sure to order a good supply of test strips so you won't have the risk of running out of them while waiting for the next order to be delivered.

As Janet mentions above, a nadir of 14.9 isn't bad at all for a newly-diagnosed cat. Because of the way it works, Caninsulin typically produces 'bucket-shaped' curves, so the higher numbers you're seeing at the beginning and end of each cycle are not unusual. This diagram shows what an ideal 12-hour curve might look like:



As you can see from the graphic, Caninsulin typically doesn't have sufficient duration to keep numbers lower throughout the 12-hour cycle. You can learn more about Caninsulin and dosing of the insulin at the following link:

FDMB Caninsulin Guide

It would be great if you could get one of our shareable spreadsheets going to record Loki's dosing info and BG readings. Here's the how-to guide:

How to create a spreadsheet

How to use your spreadsheet

The shareable spreadsheet will enable you to track Loki's progress, and it will enable members replying to your posts to help you better. If you'd like some assistance with set-up, just give a shout and we'll find someone to help you.

On the excessive drinking/peeing, that too should improve when Loki's numbers get into a better range. In the meantime, if you've not already tried it I can't recommend OKO Plus Cat's Best wood-based litter (the granules, not the pellets). It's lightweight, is superb for odour control, clumps form really well and are easy to remove so the litter stays fresher longer. You can top up the box, so it's more economical in use too. No, I don't have shares; it's just an excellent product and I was very glad to discover it so I spread the word.

Because Loki's in higher numbers at the moment, he's not currently able to properly use the nutrients in his grub properly but he should become less ravenous as his BG numbers improve. How often are you feeding Loki?


Mogs
.

 

Wow, thanks everyone for your replies.
There's so much information, it's going to take a while to process it all! I can see how this takes over your life.....

We've been feeding Loki 3 times a day because he lost so much weight and really REALLY pesters us if we don't give him lunch.
Having said that, we were discussing today about going down to twice a day, having been told the Caninsulin is shorter acting - what do you think?

 

As you note in your opening post, Tamsin, Loki still needs to regain the weight he lost and that's currently going quite slowly. Loki needs extra food at the moment, so I'd suggest perhaps feeding him a bit more, not less, but you can time the feeds to be given when the insulin is working at its strongest.

As per the Caninsulin guide, the normal drill for each cycle is:

1. Withhold food for two hours prior to the preshot BG check (unless you're in the middle of a situation where numbers are low and you need to feed to keep numbers up).

2. Do the preshot BG check.

3. Give a substantial feed and wait 30 minutes (Caninsulin tends to hit hard and fast early in the cycle so time is allowed to get digestion under way).

4. Administer the Caninsulin dose (assuming BG is high enough to do so).

A Caninsulin dose typically starts to kick in around +1 hour after dose administration, and the drop in BG is usually well underway by +2 hours post-dose. Nadir BG (lowest) typically somewhere between +3 and +6 hours post-dose (though it can move around a bit). The dose effect starts to wane after that (see diagram in earlier post).

Giving small feeds around the +2 mark can sometimes help slow the drop and go some way to even out the cycle. (Steep drops may trigger steep rebounds later in the cycle.)

For cats that need to regain weight another small meal some time later in the cycle should be OK, ideally not later than around the +5 hour mark so that it gets eaten while the insulin dose is still exerting a reasonable BG-lowering effect.

Many members use timed feeders to provide mid-cycle snacks when they're at work or asleep. The rotary ones are great (e.g. Petsafe 5) because you can set them to rotate to an empty compartment 2 hours prior to the time the preshot BG is due.

The initial learning curve is indeed a bit steep, but it will all soon become second nature. Ask away for any help you need.


Mogs
.

 

Thanks for that info on Caninsulin. There more I read about it the more I think he might need a different insulin, as has been suggested.
With regards to the small meals, yesterday we gave him one (LC) around 2.30pm and his BG at 5pm was 23. However, his BG pre-dinner at 7.30 was 14, and at 9.30 was 27, making me think that at least one of those results was erroneous - is that a possibility? I get good blood drops as he's easy to bleed.
I'm thinking that we shouldn't have fed him as late as 2.30 because it's more than +5 from his shot, is that correct?
I'll try and get working on his spreadsheet today, which will help see what's going on.