New member - Diabetic kitty for 1 year (Burnaby, BC Canada)

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Marianne Lima

Marianne Lima

Member Since 2022
Good evening!

First of all, thanks for all the help you’ve been providing on this forum.
I am a member since November last year, but this is my first thread here. I’ve been fighting with Samuka’s diabetes for almost 1 year (diagnosed on July 2022). We are currently at 4.5 units of Lantus, and we are getting readings between 15 to 19 (AlphaTrak 2). Last night we just measured his BG and he got a 9.5mmol/L, which the vet told me to skip the insulin shot (and after reading some threads from the forum, I think it would be wiser to give him a token shot instead). This morning we measured 21.1 (no surprise at all).

He is currently eating Fancy Feast classics 2x per day (pre-shot meals), and during the day we give to him dry freeze chicken. Sometimes he manages to eat a tiny bit of his brother's dry food (Blue Wilderness Indoor kibbles) before we noted, but I do the best to remove the other kitty's food before Samuka steal from him (other kitty is called Tobias, no diabetes). He is a big boy (8.1kg), and I am also giving him 1 capsule of pure Metamucil (which I believe it started helping to keep lower than 21 mmol/L BG).

The vet wants me to pay for an Internal Medicine vet appointment, since they don't know what to do anymore. I truly believe that we can control his diabetes by dosage control, since he got some pretty good results a few months after he started on insulin - after that, the vet recommended to give him only one shot of Lantus by middle of day, instead of two. It definitely didn't work, and since that, it has been pretty hard to have his BG lower than 10 mmol/L.

I've added all of Samuka's BG results through his almost 1 year insulin treatment on his spreadsheet, and it would be great to have some thoughts of things that I can do to try to control it. The vet takes forever to respond to our BG curves, if we need to increase/decrease the dosage, and I saw some of the spreadsheets here that some of the members are managing the dosage daily (reducing/increasing .25; .5' 1 unit) as per BG results. I think this would be wise to try, but it would be great to have some thoughts about it. Samuka never had a hypoglycemic experience.

Thank you all for your help, and I am eager to help
 
Hi and welcome!

We’d love to help you get Samuka’s diabetes regulated. Lantus once a day definitely doesn’t work. It requires consistency in both timing and dosing. Ive always had a vet and and IM for my cats but I never discussed the diabetes with either of them. I don’t believe you need and IM appt they don’t know much more then the regular vets when it comes to feline diabetes. I can’t interpret pet meter numbers, most of us use human meters so I’ll let someone else do that but I see a few issues:
  1. You’re mostly only testing at preshot and this doesn’t tell you how low he’s low he’s going during each cycle. We make dose adjustments based on that and without that data, you just don’t know when to increase or decrease the dose. Would you be able to get at least one more test during the day, alternating a +4,+5,+6 so you can find his nadir, and one in the pm like around +2?
  2. We also recommend making the adjustments by 1/4 units not 1/2 or full. It’s likely that by not doing that you skipped right past the ideal dose
  3. Are you able to switch the other cat to a low cat dry food like Dr. Elseys or Young Cat? That way, it won’t be an issue who eats it.
It’s great that you’re giving smaller meals throughout the day. Most of us do that and then feed the 2 largest meals at shot times. It helps avoid big sugar spikes and it’s also easier on their pancreas. You also have him on a great insulin. We have 2 dosing protocols for Lantus but since he’s occasionally getting into the dry food, you’d have to follow SLGS and not TR. With SLGS, you stay on the same dose for 7 days before making an adjustment and again, that’s based on the nadir not the preshot numbers. I suggest you read all the yellow sticky notes on the Lantus forum and especially the one about the 2 dosing methods:

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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Thank you for your quick response!

I was afraid of going to the IM (which cost a lot!), and at the end they wouldn't add anything else with what we already know about the diabetes...
We use the AlphaTrak 2 because the vet sold it right after diagnosed Samuka's diabetes :( the strips are SO expensive, so after reading about the FreeStyle Lite strips here at the forum, it brought a relief to us after checking that the results are very close to the ones we got with AT strips. I would totally use a human meter if I was aware at the beginning (so many regrets...)

Regarding the questions:
1. I just tested him +4, and will do it again on +8, PMPS, AND +2 after PMPS (the vet never told us to do this, only to do a BG curve test 3 weeks after increasing the dosage)
2. This sounds great, in case I have to increase the dosage, I will go to 4.75; 5; 5.25... if I past the ideal dose, should I decrease the dosage and start increasing again as needed? For example, should I go back to the dosage that worked before the vet changed to 1 Lantus shot per day, which was 3 units?
3. I found Dr. Elseys on PetSmart, but couldn't find Young Cat (maybe it is not available in Canada?). I will definitely give a try on the Dr. Elseys to the other cat (he is a bit picky, but hopefully it will be easy)

Regarding the SLGS, I would keep him on either 4.75u, or start on 3u (on your experiences, it would be wise to decrease right away?), and have a BG curve test after one week. Regarding the glucometer, the article says we should use a human meter. Should I buy a human one, or is ok to keep the pet meter? If I have to buy a new one, is there any brand that you recommend considering the meter and test strips being affordable?

Once again, thank you a lot for sharing your thoughts, I have hope again that Samuka will have his diabetes controlled :)
 
Just a couple of additions/corrections to Ale's post. The name of the dry food is not Young Cat -- It's Young Again Zero Carb. Although from Red's note above, it is likely irrelevant.

How much you increase the dose depends on the dosing method that you're using (either Tight Regulation or Start Low Go Slow) and how high your cat's numbers are. With SLGS, the increase/decrease is always 0.25u. With TR, if numbers are over 300, you can increase by 0.5u.

I would encourage you to get a minimum of four tests per day. Just like you've been doing, you need to get your AM and PM pre-shot tests to make sure it's safe to give insulin. You also want to get at least one test during both the AM and PM cycles. Right now, there's no way to know if Samuka's numbers are dropping lower toward the middle of the cycle. He may be seeing better numbers and you'd never know. As an example, early on in my cat's diabetic journey, she started a cycle with numbers in the 400s. She dropped into the 40s at mid-cycle and was back into the 400s at the next shot time. If I hadn't been testing, I would have never known that I needed to reduce the dose.

The other concern is how long you're holding any given dose. SLGS is the more conservative approach to dosing. With this strategy, you don't hold the dose for more than a week if numbers aren't in a desirable range. If a dose is being maintained and you're not seeing better numbers, you can risk glucose toxicity developing. This is a terrible name for a phenomenon that means your cat gets used to being in higher numbers and it's harder to get the numbers to be better regulated.

All of the above said, it could be possible that Samuka needs more insulin. We can help you get this figured out!
 
Hello and waving welcome from the mountains on other side of the Ironworkers Memorial Bridge. Thank you for putting together the spreadsheet.

A couple of thoughts for you, you might also want to get the Freestyle meter instead of using the AlphaTrak, since you are using the Freestyle strips anyway. The AlphaTrak 2 is being phased out, and you won't even be able to buy the AlphaTrak 2 test strips as of September. I've occasionally seen "buy 100 test strips, get a free meter" deal at London Drugs.
Red & Rover (GA) said:
Your choices are Dr. Elsey's Complete Protein and Epigen Wysong 90.
Click to expand...
I've never seen the Epigen Wysong 90 for sale in stores here. Just on line. But I haven't scoured all the stores.

A suggested approach going forward. Let's first see how he's doing on this 4.75 units dose. If you can get the preshot test, plus at least one other test for the AM and PM (maybe just before bed) for the next three days, we'll have a good idea how low this dose is taking him. If you see anything under 5.0 (90), the dose is too high and you reduce immediately by 0.25 units. We change doses based on how low the dose is taking him, not the high numbers - which tend to be the preshot values.

If you see a preshot test less than 11.1 (200), do not feed, and post here for help on what to do.

Lastly, since this server is hosted in the US, and the largest number of members are from the US, we report our blood sugar values in mg/dL, instead of mmol/L. Multiple mmol/L by 18, or let the spreadsheet do the conversion for you. You'll be bilingual in no time. :)
 
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Sienne and Gabby (GA) said:
Just a couple of additions/corrections to Ale's post. The name of the dry food is not Young Cat -- It's Young Again Zero Carb. Although from Red's note above, it is likely irrelevant.

How much you increase the dose depends on the dosing method that you're using (either Tight Regulation or Start Low Go Slow) and how high your cat's numbers are. With SLGS, the increase/decrease is always 0.25u. With TR, if numbers are over 300, you can increase by 0.5u.

I would encourage you to get a minimum of four tests per day. Just like you've been doing, you need to get your AM and PM pre-shot tests to make sure it's safe to give insulin. You also want to get at least one test during both the AM and PM cycles. Right now, there's no way to know if Samuka's numbers are dropping lower toward the middle of the cycle. He may be seeing better numbers and you'd never know. As an example, early on in my cat's diabetic journey, she started a cycle with numbers in the 400s. She dropped into the 40s at mid-cycle and was back into the 400s at the next shot time. If I hadn't been testing, I would have never known that I needed to reduce the dose.

The other concern is how long you're holding any given dose. SLGS is the more conservative approach to dosing. With this strategy, you don't hold the dose for more than a week if numbers aren't in a desirable range. If a dose is being maintained and you're not seeing better numbers, you can risk glucose toxicity developing. This is a terrible name for a phenomenon that means your cat gets used to being in higher numbers and it's harder to get the numbers to be better regulated.

All of the above said, it could be possible that Samuka needs more insulin. We can help you get this figured out!
Click to expand...
Since Samuka is occasionally getting dry food, she needs to do SLGS until she changes the dry to LC dry correct?

I will memorize that name one of those days. Young Again Zero Carb o_O
 
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I agree with Wendy. Stick with the current dose and if he needs less, he’ll let us know by dipping under 90. Most of us in the US use Walmart’s ReliOn which has the cheapest test strips and is reliable but I don’t think it’s available in Canada
 
To clarify, if you get a low preshot number and are not sure what to do, you post here and stall for 20 minutes without feeding so you can retest and see if the numbers are going up without food. Once you post, someone will advise you on what to do :cat:
 
Ale & Bobo & Minnie (GA) said:
Most of us in the US use Walmart’s ReliOn which has the cheapest test strips and is reliable but I don’t think it’s available in Canada
Click to expand...
Correct, not available in Canada, unless you cross border shop. The Freestyle Lite needs the smallest blood drop (same as the AT2) and test strips are reasonable price. Sometimes you can get even better prices on eBay.
 
Sienne and Gabby (GA) said:
Just a couple of additions/corrections to Ale's post. The name of the dry food is not Young Cat -- It's Young Again Zero Carb. Although from Red's note above, it is likely irrelevant.

How much you increase the dose depends on the dosing method that you're using (either Tight Regulation or Start Low Go Slow) and how high your cat's numbers are. With SLGS, the increase/decrease is always 0.25u. With TR, if numbers are over 300, you can increase by 0.5u.

I would encourage you to get a minimum of four tests per day. Just like you've been doing, you need to get your AM and PM pre-shot tests to make sure it's safe to give insulin. You also want to get at least one test during both the AM and PM cycles. Right now, there's no way to know if Samuka's numbers are dropping lower toward the middle of the cycle. He may be seeing better numbers and you'd never know. As an example, early on in my cat's diabetic journey, she started a cycle with numbers in the 400s. She dropped into the 40s at mid-cycle and was back into the 400s at the next shot time. If I hadn't been testing, I would have never known that I needed to reduce the dose.

The other concern is how long you're holding any given dose. SLGS is the more conservative approach to dosing. With this strategy, you don't hold the dose for more than a week if numbers aren't in a desirable range. If a dose is being maintained and you're not seeing better numbers, you can risk glucose toxicity developing. This is a terrible name for a phenomenon that means your cat gets used to being in higher numbers and it's harder to get the numbers to be better regulated.

All of the above said, it could be possible that Samuka needs more insulin. We can help you get this figured out!
Click to expand...
Thank you for all your clarifications, we appreciated a lot!
I just started testing his BG more than 2 times per day. So far he has been at 300, and I will test one more time before bed (+4 after PSPM).
Regarding the glucose toxicity, I really hope that he didn’t get this, but it may be possible, since we’ve been holding the same dosages for more than a month… For this week I will keep the 4.75u, and will test him 4 times per day during a week, so hopefully we can understand what would be better to do… it is so frustrating :( I understand the vet has always helped us, but now it look like that if I’ve had followed the procedures from the forum, he may even got better long time ago… anyways, I will keep you posted about the spreadsheet updates, thank you!!!
 
Wendy&Neko said:
Hello and waving welcome from the mountains on other side of the Ironworkers Memorial Bridge. Thank you for putting together the spreadsheet.

A couple of thoughts for you, you might also want to get the Freestyle meter instead of using the AlphaTrak, since you are using the Freestyle strips anyway. The AlphaTrak 2 is being phased out, and you won't even be able to buy the AlphaTrak 2 test strips as of September. I've occasionally seen "buy 100 test strips, get a free meter" deal at London Drugs.

I've never seen the Epigen Wysong 90 for sale in stores here. Just on line. But I haven't scoured all the stores.

A suggested approach going forward. Let's first see how he's doing on this 4.75 units dose. If you can get the preshot test, plus at least one other test for the AM and PM (maybe just before bed) for the next three days, we'll have a good idea how low this dose is taking him. If you see anything under 5.0 (90), the dose is too high and you reduce immediately by 0.25 units. We change doses based on how low the dose is taking him, not the high numbers - which tend to be the preshot values.

If you see a preshot test less than 11.1 (200), do not feed, and post here for help on what to do.

Lastly, since this server is hosted in the US, and the largest number of members are from the US, we report our blood sugar values in mg/dL, instead of mmol/L. Multiple mmol/L by 18, or let the spreadsheet do the conversion for you. You'll be bilingual in no time. :)
Click to expand...
It is great to hear that I have a sugar kitty partner living nearby :) thank you a lot for your reply!
I didn’t know about the AlphaTrak being phased out, oh boy… we’ve spent so much money to buy it + the expensive strips… I will definitely buy the FreeStyle meter, since we are using their strips already.
I will keep the 4.75 for the next few days, testing him at least 4x per day, and will keep you posted :) so far he has been around 300 during the entire day.
Thank you for the heads up! I will start being bilingual right away :)
 
Ale & Bobo & Minnie (GA) said:
Since Samuka is occasionally getting dry food, she needs to do SLGS until she changes the dry to LC dry correct?

I will memorize that name one of those days. Young Again Zero Carb o_O
Click to expand...
I am trying my best to remove the other cat’s dry food before Samuka sneak into his plate, but this cat is SO audacious!
I think I will be trying on the SLGS, and hopefully will see some improvements (also because I am a bit afraid of trying the other way right now…). We feed Samuka with Fancy Feast 2x per day before shots, and dry freeze chicken during the day (sometimes we algo give him a bit of tuna when he sees we giving tuna to the other cat).
Thanks for your reply!
 
Ale & Bobo & Minnie (GA) said:
To clarify, if you get a low preshot number and are not sure what to do, you post here and stall for 20 minutes without feeding so you can retest and see if the numbers are going up without food. Once you post, someone will advise you on what to do :cat:
Click to expand...
Sounds great, thank you all for this amazing support! I am finally hopeful again that Samuka can get into remission one day!
 
Marianne Lima said:
I am trying my best to remove the other cat’s dry food before Samuka sneak into his plate, but this cat is SO audacious!
I think I will be trying on the SLGS, and hopefully will see some improvements (also because I am a bit afraid of trying the other way right now…). We feed Samuka with Fancy Feast 2x per day before shots, and dry freeze chicken during the day (sometimes we algo give him a bit of tuna when he sees we giving tuna to the other cat).
Thanks for your reply!
Click to expand...
SLGS is a great place to start.

I just wanted to mention as far as food, if he’s hungry you should feed him. Not dry necessarily but more food. Diabetic cats can’t process the nutrients in food well so they eat but are always hungry and will still lose weight. How much does he weigh and what’s his ideal weight? A good rule of thumb for daily calorie intake is 20 x ideal weight. So if he should be 15 pounds, he should be eating at least 300 calories a day. 2 cans of FF a day may not be enough depending on his weight and it could be why her trying to get into your other cat’s food
 
Just a thought -- would your other cat transition to a canned food diet? In general, canned food is better for all cats since it has more moisture. (Cats are not great at drinking water and tend to get most of their moisture from eating prey when in the wild.) If your other cat and Samuka will eat the same food, it will remove the temptation for Samuka to steal your other cat's food.
 
Hi guys! I just did his pre-shot test, and I got 196 :)
Do you think should I give him a smaller dosage of Lantus? Like 4.5 units?
 
Ale & Bobo & Minnie (GA) said:
SLGS is a great place to start.

I just wanted to mention as far as food, if he’s hungry you should feed him. Not dry necessarily but more food. Diabetic cats can’t process the nutrients in food well so they eat but are always hungry and will still lose weight. How much does he weigh and what’s his ideal weight? A good rule of thumb for daily calorie intake is 20 x ideal weight. So if he should be 15 pounds, he should be eating at least 300 calories a day. 2 cans of FF a day may not be enough depending on his weight and it could be why her trying to get into your other cat’s food
Click to expand...
Samuka has an average of 8kg (17.6 lbs) since we started his treatment on July 2022! Never understood how this cat never lost weight, even on a diet of wet food.
We are giving him 2 cans of FF and 1/2 can during the day (sometimes we give him tuna, or a portion of dry freeze chicken). He loves dry food, he just eat the FF because he doesn’t see any other option… :( If I complete the daily calories with the dry food Dr Elseys by mid-day, would it be a problem? I am pretty sure he will love to have some dry food without need to steal from his brother (such a picky cat)
 
Sienne and Gabby (GA) said:
Just a thought -- would your other cat transition to a canned food diet? In general, canned food is better for all cats since it has more moisture. (Cats are not great at drinking water and tend to get most of their moisture from eating prey when in the wild.) If your other cat and Samuka will eat the same food, it will remove the temptation for Samuka to steal your other cat's food.
Click to expand...
Ohhh we tried so many wet food brands with the other cat… he is the pickiest cat that I ever saw, he likes only dry food, tuna, dry freeze chicken, and Churu… we tried raw food, he even acts like he is covering his poop once he smells any wet or raw food :( it would be amazing to find a good wet food that both of them like
 
Marianne Lima said:
Hi guys! I just did his pre-shot test, and I got 196 :)
Do you think should I give him a smaller dosage of Lantus? Like 4.5 units?
Click to expand...
Sorry you didn't get an answer. 196 is practically 200, I think you could have shot. One option is to NOT feed, test again 15-20 minutes after a test like that and see if he's gone up on his own.

One more thing, we request that people start a new thread each day that they post, due to the number of cats here. Include a link in that new post to the previous day. As a result of the volume here, old posts don't get as much attention. With a new post you could title it something like Samuka - PMPS 196 - Shoot? and use the "?" prefix to the subject line. That would get attention.
 
Marianne Lima said:
It is great to hear that I have a sugar kitty partner living nearby :) thank you a lot for your reply!
I didn’t know about the AlphaTrak being phased out, oh boy… we’ve spent so much money to buy it + the expensive strips… I will definitely buy the FreeStyle meter, since we are using their strips already.
I will keep the 4.75 for the next few days, testing him at least 4x per day, and will keep you posted :) so far he has been around 300 during the entire day.
Thank you for the heads up! I will start being bilingual right away :)
Click to expand...

If you need the freestyle lite meter, some lancets and strips, I have a set you can have. My baby boy passed 3.5 weeks ago and have no need for it anymore. I’m just east of Burnaby. Just let me know
 
Wendy&Neko said:
Sorry you didn't get an answer. 196 is practically 200, I think you could have shot. One option is to NOT feed, test again 15-20 minutes after a test like that and see if he's gone up on his own.

One more thing, we request that people start a new thread each day that they post, due to the number of cats here. Include a link in that new post to the previous day. As a result of the volume here, old posts don't get as much attention. With a new post you could title it something like Samuka - PMPS 196 - Shoot? and use the "?" prefix to the subject line. That would get attention.
Click to expand...
No worries at all, I didn’t know about the new thread - I will definitely create a new one once I have a question, thanks for letting me know :)
Yesterday I gave him 4u instead of 4.75u, and tested one more time before bed (167 at the time).
This morning his AMPS was 211, so I am back to the 4.75 - after a week I will have a new BG curve to share on his spreadsheet :) I think the 4.75 is helping him, but it may be good to go to 5 (let’s see).
Thank you!
 
bubbasmom (GA) said:
If you need the freestyle lite meter, some lancets and strips, I have a set you can have. My baby boy passed 3.5 weeks ago and have no need for it anymore. I’m just east of Burnaby. Just let me know
Click to expand...
First of all, I am I sorry for the passing of your baby boy ❤️ it is really hard to say goodbye to our babies, but the great memories live forever with us, my thoughts are with you - please let me know if you need anything :) we leave nearby, and I am more than happy to help!

The freestyle set is even more special since it came from a very well-loved baby’s home, and I would love to meet you and buy the set from you. Please let me know how it would be better to meet you - I am sharing my phone via Conversations.

Thank you a lot for your message, we are sending lots of love and positive thoughts for you and your family ❤️
 
Marianne Lima said:
Samuka has an average of 8kg (17.6 lbs) since we started his treatment on July 2022! Never understood how this cat never lost weight, even on a diet of wet food.
We are giving him 2 cans of FF and 1/2 can during the day (sometimes we give him tuna, or a portion of dry freeze chicken). He loves dry food, he just eat the FF because he doesn’t see any other option… :( If I complete the daily calories with the dry food Dr Elseys by mid-day, would it be a problem? I am pretty sure he will love to have some dry food without need to steal from his brother (such a picky cat)
Click to expand...

the formula works for pounds, sorry. So you think his ideal weight would be 15 or 16 pounds maybe? Your vet should be able to tell you. If you want him to lose weight and his ideal weight is 15, he should get 300 calories a day and you can try a bit less but not a lot less. It sounds like he’s getting around 250 right now? If you’re going to have both eat Dr Elsey's dry, yes you can supplement with that. If you think the amount of food is working right now and he’s not losing weight, then you can keep doing what you’re doing. I just wanted to mention because sometimes when cats are “stealing” food from the others it can mean they’re hungry and diabetic cats tend to be hungrier.
 
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