New member, please double-check my plan?

[Mary & Salem]

My 16 year-old Salem was diagnosed yesterday by blood test (322) and confirmed via urine this morning. I'm going in to the vet to discuss our plan of attack in 2 hours (and to pick up my beautiful boy who stayed overnight to get a urine sample- I could have done it at home but the vet is on a strange schedule and I wanted to get things moving quickly!)

Salem currently eats Taste of the Wild dry food. I want to switch him to a low-carb wet food (probably Friskies, going to buy it on the way to the vet.) I don't want to switch things too quickly, so should I hold off on the food switch if we are starting insulin today? He is currently 13 pounds, which is normal for him, though he could stand to lose a little weight. I currently free feed but am able to switch to multiple meals and snacks if needed.

I'm prepared to home test and have tried downloading the spreadsheet template but am currently on mobile so it isn't working. I've read over other spreadsheets and am trying to determine how frequently I should be home testing? I am optimistic that the food change will help Salem and want to carefully monitor everything so he doesn't go too low.

On average, will I be testing multiple times a day, or is this just an initial process? Could someone give me a mini-breakdown of my first few days? I'm hoping to do shots at 7:30am and pm. This weekend I'll be able to test at 1:30pm to get the low (right?), though I usually work from 8-2, so I may need to adjust? I am willing to wake up in the middle of the night if I have to, though would obviously prefer to find another way. I just love this cat so much and want to be sure I'm doing things right!

I don't know my vet very well, I worked at a vet clinic in Virginia and loved our doctors there, but we just moved to Ohio and I still haven't built up the trust with this one? I'll update this afternoon when I have the supplies, too!

 

[Sue and Oliver (GA)]

Welcome! Looks like you have done your homework.

Do you know what kind of insulin? As you've read, we suggest Lantus, Levemir or ProZinc. And we like to start on a low dose, .5 to one unit twice daily, increasing as home numbers indicate. (we know stress raises bg levels and most cats are very stressed at the vet.)

You could get the testing down while changing the diet and then start insulin, depending on how high the numbers are. (my thinking is it may take a few days to get your testing routine down. If you are changing food and adding insulin, that may make the levels lower faster than you expect. If you make the food change first, while testing, you can get a handle on what his levels are before adding insulin.). Usually we like 3 tests - am preshot, pm preshot and midcycle. Lots of us work so we can help you find ways to adapt.

The suggested program for changing to wet is 25% wet, 75% dry and then increasing the percentage of wet. Some cats have no troublr with the switch (we changed and saw a difference in the numbers overnight) some have a little stomach upset with wet at first. You should be able to tell pretty fast.

Let us know how things go!

 

[Mary & Salem]

Just got back from the vet-- I definitely feel better after this visit. We did a practice shot with saline and discussed everything. He's going back in on Monday to get his blood pressure medication and levels tested. The vet was excited that I wanted to test his blood with a home kit. (Thank goodness, I was worried she'd try to milk us for money and more visits!) I'm going to give it a go tonight and she said if it didn't work out, she could teach me at our meeting on Monday.

Salem was prescribed 1 unit of Lantus/Glargine twice a day. I figure I'll practice testing tonight and see what his numbers are-- pick up the prescription and start insulin before changing his food. I'm worried about changing things too quickly but also want to have him started on insulin before our meeting on Monday-- since that's what the vet expects?

She said we'd come back in 2 weeks for a curve.

I was able to get copies of all his medical records and am in the process of setting him up a binder so we can have everything in one place (and also something easy to grab in case of emergencies!) I'm so grateful for this forum, thank you for your help!!

 

[terri1962]

Hello Mary,

Sounds like you are off to a good start. You have a very good plan in place. I am in Ohio as well, Columbus. What city did you relocate to? unit of Lantus twice a day sounds like a very good starting dose. Best of luck to you and Salem.

Terri

 

[Chris & China (GA)]

Welcome Mary and Salem!!

It looks like you're heading in the right direction! It's wonderful that you have a vet that supports home testing. So many of them don't!

I'm worried about changing things too quickly but also want to have him started on insulin before our meeting on Monday-- since that's what the vet expects?

I would suggest you concentrate on the food change first, and not rush the insulin, even if it's what your vet wants because just changing to low carb food can bring a cat down into normal numbers! Not always, but it happens enough that it's the first step I'd recommend! I would think your vet would understand if you just tell her that you wanted to try to see how a low carb diet worked for Salem first since the first treatment for any diabetic (human or feline) is an appropriate low carb diet!

You can also spend this time learning to home test and not worrying so much about the shots. A few more days isn't going to make any difference in the long term health of Salem, but IF changing to low carb food brings his numbers down, and you're also giving insulin, you could go too low. High numbers take time to do any damage. Low numbers kill quickly. We have a saying here, "Better too high for a day, than too low for a minute"

She said we'd come back in 2 weeks for a curve.

Forget the curve. If you're home testing, you'll be doing a curve all the time if you're home testing. Having it done at the vet doesn't make it any more "right" and can actually make things worse, because when cats are under stress (like after being put in a carrier, taken for a car ride, barked at, poked and prodded at the vet), their numbers can increase up to 200 points higher. The vet see's those "artificially high" numbers and suggests you need to give more insulin. Then you go home, Salem calms back down, his numbers drop back to what's REALLY normal for him, and you're giving too much insulin. Once you have your spreadsheet set up, you can invite your vet to look anytime she wants by giving her the link.

I see you're thinking of trying Friskies. That's a good option, and affordable too. Just make sure it's the pate's and nothing with gravy or sauces. Fancy Feast Classics are another good choice. Here's the Food Chart we use. It has pretty much any food you can buy on it. You want to keep the carb percentage under 10% (column C )

There's a lot to learn, but you've done a great job educating yourself already! Keep asking questions! We're all here to help you any way we can!

 

[Mary & Salem]

Thank you so much for your help. I did the our first test at home and it says 268. I'm thinking low-carb could be the way to go!! We're going with Friskies since it's easily available and affordable for us. Salem is going to be in heaven because wet food has previously just been a treat for him!

We also found Boots and Barkley at Target but I couldn't find it on the sheet I printed off. I did some quick Googling in the store and found it pop up here and there, so I bought a few of them (had a coupon!) Is this a good low-carb option?

 

[Chris & China (GA)]

The ingredients in the Boots & Barkley look comparable to Fancy Feast, but nowhere can I find nutritional information....Just an ingredient list.

If you have some there and can find the Gauranteed Analysis information, we can use a carb calculator to check. (we prefer "As fed" numbers, but very few foods list it)

I totally agree that if your first test was only 268, you should continue with the change to low carb food and Salem may not need insulin at all!!

 

[Deb & Wink]

You're so lucky that your kitty Salem loves the wet food.

My sugardude Wink didn't think that canned food was edible and it tooks weeks of effort to convince him to eat it. Now, he loves it.

 

[Mary & Salem]

We are definitely lucky that he loves wet-food!! I gave him 5.5 oz of it (spread over time) last night and he's already had half a can of Friskies this morning. I've been leaving his old dry food out in case he wants a snack in between our new meal times (and because I am hoping he will eat some dry and some wet before we transition totally to wet) but he is snubbing the kibble now!

We've successfully done 3 tests so far which I've been logging on a spreadsheet. He seems to be fluctuating around 250s (268-243) and I finally feel confident about testing him :thumbup -- I used the lancing device that came with the glucometer this morning and it was much easier on both of us. I think I'm not confident enough about pricking him freehand, so I end up poking him too many times and he gets annoyed with all of the ear attention. (He's never liked having his ears touched.) I'm hoping to get in a routine of 3 tests per day for now, mostly because I feel bad for pricking his ears so much!

:?: My question right now is: do I just add 30 to my numbers to get what the vet is reading? I'm using the spreadsheet from this site (for use with human glucose meters) but my vet mentioned calibrating our machine for cats (which I don't plan to do!)-- but I want to be able to tell her what we're doing and be able to compare his numbers to the one the vet gave us. So, for example, the vet told me his glucose was at 322 at her office-- would that be 292 on my machine?

And thank you so much for the offer to convert the Boots & Barkley-- I've found a spreadsheet formula and will do that on my own and post it here for you all to double-check! pc_work

 

[Chris & China (GA)]

he is snubbing the kibble now!

That's actually a good thing. If he's happy with the wet, and isn't having any problems with loose stools, you might as well just get rid of the dry altogether, especially since you're not giving insulin yet.

We've successfully done 3 tests so far which I've been logging on a spreadsheet.

Welcome to the Vampire club!!

do I just add 30 to my numbers to get what the vet is reading?

No, it's not necessary, especially for us. The vast majority of us use human meters, so we're used to dealing with those numbers. The actual numbers (while important) aren't as important as seeing how Salem reacts to each dose...This is only an example, and nowhere near reality, but it'll give you the idea. If 1 unit only brings the nadir down to the 200's, then you know you need more, so you go to 1.25..if that takes Salem to nadirs of mid 100's, you know it's not enough and go up...when you start to get results that drop below 50, you know that's too much. We watch for "waves" or "patterns", not so much the individual numbers. If your vet really has to know, you can always just add 30 when you tell her the numbers. What's important to know isn't necessarily the exact numbers as much as it's "how well is this dose working?"

 

[BJM]

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

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How to use the glucose reference values chart:

When you get a test, look for the number on the chart that either equals, or contains, the test value you have. Read the information. As needed, make a decision and act.

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)