New to FDMB, need help with regulation

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Jackie & Fiefel

Jackie & Fiefel

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Hello!

I'm hoping to get some help regulating my cat, Fiefel, who was diagnosed as diabetic in July. We are still struggling to get his numbers down, which I especially notice now that I have his spreadsheet setup as (I think) everyone else on here does. At one point, my vet advised me not to give any insulin if he is under 288... which now to me doesn't seem to make sense. I believe she was worried because his numbers were a bit erratic, but still she seemed to be so scared of him going to low, that we never got him even into slightly high but not so bad range.

He's has very healthy appetite, he only eats Purina DM canned food - even though the vet initially set me up with the dry food as well as the M/D wet food. I have since taken him off everything but Purina DM. He has a sensitive belly for new foods unless they are very slowly introduced.

He's on Lantus insulin, and has been since we started.

He likes to eat - a lot - and we give him quite a few meals through the day. I'm not sure if this is ideal? The problem with only feeding him twice a day is that my boyfriend works from home, and Fiefel will be sure to let him know when he's hungry - with a delicate nip to the shin, and with intense pleading eyes.

I also dehydrated Tuna as a treat - since I wanted to have something handy and treat like for him - any thoughts on that? I haven't given it to him too much since I wasn't sure if it was good for him or not. But I don't see why it wouldn't be..

I really want to get him regulated, and it's been difficult working with the vet. Sometimes doing a full proper curve is difficult, it is also $60 per curve I give her so doing one every few days becomes very expensive.

He's a great cat, and it felt like he was a kitten again once we got him on the insulin. He was quite sick and lost a lot of weight, and was quite lethargic when I finally took him to the vet to figure out why he was peeing on the carpet. I assumed he was lethargic because it was so hot out and we didn't have an air conditioner, and I put the weight loss down to the litter box moving to the bottom of the stairs, and him having to get extra exercise.

Not sure what else I should go over; I think my spreadsheet is alright, I linked to it in my signature. I guess next I need to make a profile? I will start on that today as well.

Thanks for any help anyone can provide!

Jackie
 
Welcome Jackie and Fiefel.

You are testing at home, right? I ask because you mentioned the vet doing curves... ? I don't think any of us have the vet do curves - just too expensive and the numbers are pretty useless as vet stress elevates the BG, they don't eat like they do at home and they aren't active like they are at home. So do curves at home, on a weekend or something when you are there to test.

I think his dosing should be more consistent. Lantus (I don't use it, but I use levemir which is similar) works when it is shot every 12 hours and the same dose, even as those preshot numbers vary a little. It is safe to shoot lower numbers, certainly as low as 150-ish. So my first suggestion would be to get him on 1u consistently unless he drops below 150. Then, if you are going to be home go ahead and shoot the 1u, but get spot checks to monitor him. If you won't be home, and don't feel comfortable shooting 1u, reduce it to .75u. If he is really low (below 100) post here. It is better to give some insulin than to skip shots.

ETA: Actually numbers as low as 50 are safe numbers, but you don't want to give the full dose until you have data that shows that is safe. I don't shoot a full dose below about 85, but that is just me.

Also, the MD food is not the best food. It is higher in carbs (14%) than some other foods and it has a poor quality protein. A better food is Wellness canned chicken or turkey. They are about 4% carbs and have high quality protein. Obviously you would want to make a very slow food change, but it will probably help with his BG numbers and regulation. Feeding several small meals is good. Unregulated diabetics eat a lot because they can't process food, so that is not unusual. Beau ate about 10-11 ozs when he was unregulated. Now he eats about 6 ozs. He is off insulin (in remission) but that is what he was eating after I got him regulated.

Nice to see a newbie with a spreadsheet of the past 6 months! It helps to see what you have been doing and how Fiefel has been responding.
 
Thanks for your response!!

I will start giving him 1u of insulin as you recommended. I was lurking here for a bit prior to posting, which is when I realized not giving insulin for anything under 288 didn't seem quite right.

I've been home testing Fiefel since the diagnosis - my vet was good to encourage that, especially since she said he was quite stressed when he stayed there for the first day. She said he just kept staring at her with his 'angry man eyes'. However, after each curve, I would pay $60 to have the vet look at it and let me know what I should be doing.

I'm not sure of Wellness food - I'm in Canada and it's not one I'm familiar with, but I'll take a look. Again, from what I've seen on this board, I've realized that Purina DM may not be the best food for him, and it is likely also more expensive.

Again, thanks for the help. I'll give an update after we stay stable at 1u for a few days.

Jackie & Fiefel (who is sleeping behind me on the computer chair while I sit teetered on the edge)
 
I looked at your spreadsheet and for the latest numbers you get little drop with one unit. However, you have not been giving one unit consistently. However, some previous data shows a good drop on one unit and very high numbers on two units suggesting that two units may be to much. I have two questions:
- Could something be "wrong" with Fiefel such as a UTI or bad teeth:
- Are you feeding consistently every day? If Fiefel is getting different amounts of food at different times it is impossible to get good regulation.
 
Wow! Impressive - you have your spreadsheet up, you are hometesting and feeding good stuff!

You may want to start posting over on the Lantus support group forum. viewforum.php?f=9 They all use your insulin and can be of great help with adjusting your dose. Read the stickies at the top of the page; they do post a little differently than this forumm
 
Hi Sue & Larry,

Thanks for your response! Fiefel did have some dental work when he was first diagnosed in July, so I'm hoping his teeth are still okay, though I haven't been brushing them as much as I should. I'm not sure if something else could be wrong, he did get what I think was a full checkup in July. He seems okay... I'm assuming with a UTI there would be some symptoms? Sometimes I can hear his breathing, but it doesn't seem to strain him or cause distress or anything.

For the most part he gets the same amount of food at the same time each day. Sometimes when he starts begging for food a lot earlier than he normally receives it, I will give him some, and then give less at his normal feeding time. I will also work on getting his meal times fixed.

Yes certainly it seems giving the insulin consistently was crucial; it seems my vet had me so concerned about hypoglycemia at the expense of getting him regulated.
 
Hi there from Alberta...where are you approximately? If you are looking for higher quality foods like Wellness, look for a petfood store that is nicer than petsmart/petcetera etc. Petplanet is one option although I don't know if they still sell Wellness. You can try the old mother hubbard website to find a store. Just note that not all cats even like wellness. There are a variety of options of foods available even fancy feast and other grocery store brands.
 
Hi Jen,

I'm in Montreal, Canada, so I'm sure there must be quite a few options available to me. Thanks for mentioning the Old Mother Hubbard website, there is one store listed within walking distance, so I'll check that out next weekend. There is also a specialty pet store right around the corner from me which may have it. I looked there today,and now that I see what the cans look like on the website, I think they might actually have Wellness. They also had freeze dried liver and chicken treats, which Fiefel should enjoy!

Fiefel is not very fussy at all. Though he never gets it anymore, he loves sweet potato, pumpkin, seaweed (he once stole my sushi off my plate and ran off with it). So hopefully he will like Wellness.
 
Hi all,

Just tested Fiefel this morning for his AMPS, he was at 68.4, after being at 210.6 for his PMPS last night... should I still give him insulin this morning?

Thanks,
Jackie

Update: gave .25u , my boyfriend will be here today to watch Fiefel and do a couple spot tests - have to leave for work!
 
Jackie,

You will be more likely to get on going support and answers for your dose questions on the Lantus forum: viewforum.php?f=9 They all use your insulin and have seen lots of different situations. The Health forum will have some Lantus users, but not nearly as many.
 
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