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The three I've seen mentioned here that are low carb are:

* Dr. Elsey's Clean Protein (chicken variety is definitely LC, not sure about the other variety).

* Wysong Epigen 90.

* Young Again (can cause GI upsets in some cats - ask them for a free sample first if you want to try it).


Mogs
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Mogs
I just made a post on the Wysong I called and had a very nice convo with one of the reps there today being I found out how much was in the other I was giving him... I was looking to see if there was an actual post on dry food but could not find a list or etc like the one for wet..

Lee
 
The Epigen 90 is 5.3% carb on a dry basis ... not the same as the ME basis, but still will give you an indication of approximate carbs. I feed it to my non diabetics in addition to wet, and occasionally give CC a few as a treat. This is not to be confused with the regular Epigen formula which contains fruits and veggies not ideal for a diabetic.
 
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The Epigen 90 is 5.3% carb on a dry basis ... not the same as the ME basis, but still will give you an indication of approximate carbs. I feed it to my non diabetics in addition to wet, and occasionally give CC a few as a treat. This is not to be confused with the regular Epigen formula which contains fruits and veggies not ideal for a diabetic.
Ughhh well I ordered some of the Epigen being it sounded good by #'s.. still not up on all the lingo whats the diff between 5.3% carbs on dry and ME basis? thanks
 
Ughhh well I ordered some of the Epigen being it sounded good by #'s.. still not up on all the lingo whats the diff between 5.3% carbs on dry and ME basis? thanks
It's a different way of calculating the carbs. Well see how it goes. Let me know.
 
It's a different way of calculating the carbs. Well see how it goes. Let me know.
@JanetNJ
If you could look at the spreadsheet I dropped his dose today as you suggested and been doing hourly BG till 8 just could not get any blood and after 5 tries and him finally starting to growl hes been really good since I started testing till today after the 6th hour in a row lol I will try back again at 9 so ( it looks like his dose seems to hit at weird times from the last few days of testing) do you think I should go back up to 3 at his 12 hr dose ( 1am est) or stay with the reduced dose...I wont be doing him every hour all night prob at +2 then at +4 then I will go to bed about 5-6am I did just give him half of a little sheba portion being hes only had like 10 of the high carb kibbles today I have given him 2 or 3 after each test as a treat.. I need to find some low carb treats.. hes not a big treat eater but figure cant hurt to give as a reward for dealing with testing and not getting a meal after lol

Thanks
 
@JanetNJ
If you could look at the spreadsheet I dropped his dose today as you suggested and been doing hourly BG till 8 just could not get any blood and after 5 tries and him finally starting to growl hes been really good since I started testing till today after the 6th hour in a row lol I will try back again at 9 so ( it looks like his dose seems to hit at weird times from the last few days of testing) do you think I should go back up to 3 at his 12 hr dose ( 1am est) or stay with the reduced dose...I wont be doing him every hour all night prob at +2 then at +4 then I will go to bed about 5-6am I did just give him half of a little sheba portion being hes only had like 10 of the high carb kibbles today I have given him 2 or 3 after each test as a treat.. I need to find some low carb treats.. hes not a big treat eater but figure cant hurt to give as a reward for dealing with testing and not getting a meal after lol

Thanks
he got down to 68 on 2.75.... Don't raise the dose up.
 
Hi Lee,

Great job testing today.

do you think I should go back up to 3 at his 12 hr dose ( 1am est) or stay with the reduced dose...
Definite no to going back up to 3 units. Quite the reverse, in fact. Venge dropped below 90 on the 2.75IU dose today (68 nadir at +3), so he's earned another dose reduction according to the FDMB Vetsulin Guide - down to 2.5IU.


Mogs
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From the FDMB Caninsulin/Vetsulin guidelines:

--------------------------------------------------------

Changing the Dose

Hold the starting dose for at least a week UNLESS
  • your cat won’t eat or you suspect hypoglycemia
  • your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12-hour curve (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours). Note: Random spot checks are essential in order to "fill in the blanks" on your kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

The general guidelines for making dose changes are:
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.

[Emphasis mine]


Mogs
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Hi Lee,

Great job testing today.


Definite no to going back up to 3 units. Quite the reverse, in fact. Venge dropped below 90 on the 2.75IU dose today (68 nadir at +3), so he's earned another dose reduction according to the FDMB Vetsulin Guide - down to 2.5IU.


Mogs
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@Critter Mom
So is it the high dose 3u making his nadir drop to the 50s the last few days which seems to be in the +3 to +6 hour range.. now again I did cut out all of his HIGH carb kibble today besides a few pieces here and there as treats.. also his +8.30 went up to 388 I think I will wait and check him at +10 then at Pmps being hes kinda getting stressed with all the sticking.. then I will test at +2 and +3 before going to bed at the 2.75/2.5( guessing as the syringes vet gave are just full lines I am going to order some with increments NOW lol) dose I have no idea if giving less will make his nadir go up or down just worrying about him going hypo or super hyper while I am alseep....

hes also not drinking a lot he has only urinated 2 times since I scooped litter either last night at 1 am or the day before( the other night when his stuff stayed in the 50s I stayed up all night so I forgot if I had scooped sunday night or if i had done it last night at 1am I usually do it after I give him injection) I remember looking at it at about 5am last night and not seeing anything in box but I forget if I had scooped at 1am or the day before so he would not have urinated for 24hrs.. I did watch him go to the box after he ate lunch today so I know he urinated once at 1pm today lol .. maybe I need to set up a camera to watch what both he and I do.. all of this has my nerves on end and anxiety levels WAY up...

ok question which of these syringes should I get so I can get the dosing of .75 or .5 right without guessing
https://www.amazon.com/Brandzig-U-40-Insulin-Syringes-100-Pack/dp/B08MMLXRH1/ref=sr_1_4?crid=8PNIDQ4HEXQG&dchild=1&keywords=u40 pet insulin syringes 29g 1/2&qid=1606878593&refinements=p_85:2470955011&rnid=2470954011&rps=1&sprefix=u40 pet insulin syringes 29g,aps,161&sr=8-4

or https://www.amazon.com/ULTRICARE-DI...nser/dp/B0868XSWPS/?tag=felinediabetesfdmb-20

not worried about the 10 dollar price difference which every is best for dosing..

I am now using monojet u40 1/2ml 29g x 1/2" which only has single unit lines up to 20 units

Thanks
 
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Hi Lee,

I'm tagging @JanetNJ again to ask her about where she gets her U-40 syringes with half-unit markings.

I'll reply about the BG stuff tomorrow. I'm in the UK and it's past 4am here right now.


Mogs
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ahhh Night and thanks for all the help.. didnt know you were a pommie lol ( hope didnt offend one of my best friends is british and shes as she calls herself an Essex pommie lol)
 
I'm not. Try paddy in exile. ;)

I shall now bid you oíche mhaith agus codladh sámh. :D


Mogs
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Ahh well goodnight and sleep well to you also ;) ( Im 51% irish lol my great grandmother use to say this to me as a wee lad pretty much the only Gaelic I know and it was odd being she wasnt the irish one she was actually almost full blooded Cherokee Indian but my Great Grandfather who came over from Ireland to work the railroads passed away in like 1918 use to say it to my grandmother and etc so she picked it up and they all said it thru that side of the family
lol)
 
@Critter Mom
So is it the high dose 3u making his nadir drop to the 50s the last few days which seems to be in the +3 to +6 hour range.. now again I did cut out all of his HIGH carb kibble today besides a few pieces here and there as treats.. also his +8.30 went up to 388 I think I will wait and check him at +10 then at Pmps being hes kinda getting stressed with all the sticking.. then I will test at +2 and +3 before going to bed at the 2.75/2.5( guessing as the syringes vet gave are just full lines I am going to order some with increments NOW lol) dose I have no idea if giving less will make his nadir go up or down just worrying about him going hypo or super hyper while I am alseep....

hes also not drinking a lot he has only urinated 2 times since I scooped litter either last night at 1 am or the day before( the other night when his stuff stayed in the 50s I stayed up all night so I forgot if I had scooped sunday night or if i had done it last night at 1am I usually do it after I give him injection) I remember looking at it at about 5am last night and not seeing anything in box but I forget if I had scooped at 1am or the day before so he would not have urinated for 24hrs.. I did watch him go to the box after he ate lunch today so I know he urinated once at 1pm today lol .. maybe I need to set up a camera to watch what both he and I do.. all of this has my nerves on end and anxiety levels WAY up...

ok question which of these syringes should I get so I can get the dosing of .75 or .5 right without guessing
https://www.amazon.com/Brandzig-U-40-Insulin-Syringes-100-Pack/dp/B08MMLXRH1/ref=sr_1_4?crid=8PNIDQ4HEXQG&dchild=1&keywords=u40 pet insulin syringes 29g 1/2&qid=1606878593&refinements=p_85:2470955011&rnid=2470954011&rps=1&sprefix=u40 pet insulin syringes 29g,aps,161&sr=8-4

or https://www.amazon.com/ULTRICARE-DI...nser/dp/B0868XSWPS/?tag=felinediabetesfdmb-20

not worried about the 10 dollar price difference which every is best for dosing..

I am now using monojet u40 1/2ml 29g x 1/2" which only has single unit lines up to 20 units

Thanks
These both hold 20 (1/2 cc)which make it harder to do small increments. Try one that holds 3/10 cc...

Try these. They only hold 12u, are a thinner gauge so they don't poke as much, and have half unit markings. https://www.countrysidepet.com/prod...00-syringes-total?_pos=1&_sid=6d13e401f&_ss=r



This is another good choice. Adw often has coupon codes.

https://www.adwdiabetes.com/product/18553/ulticare-u40-pet-29g-3-10cc-1-2in-half-unit
 
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These both hold 20 which make it harder to do small increments.

Try these. They only hold 12u, are a thinner gauge so they don't poke as much, and have half unit markings. https://www.countrysidepet.com/prod...00-syringes-total?_pos=1&_sid=6d13e401f&_ss=r



This is another good choice. Adw often has coupon codes.

https://www.adwdiabetes.com/product/18553/ulticare-u40-pet-29g-3-10cc-1-2in-half-unit[/QUOTE


Ok will look into those and ughh venge dropped down to 50 earlier his #s had been good all day..I didn't drop from the 2.75 to 2.5 as critter mom suggested..should I have or ?? Lost to why his #s dropped so low tonight...I gave him a few drops of Karo syrup and some high carb kibble and 30 mins later was back up to 75..I am going to test him again in 5 mins that will be another 30 mins ..if he's still going up the curve I might try and sleep...ughhh
 
Good catch! You kept him from going hypo! Yep time to lower that dose! That's a good thing! It means he's improving. 2.5 this morning. :). And I have a feeling another reduction is in the near future.
 
Good catch! You kept him from going hypo! Yep time to lower that dose! That's a good thing! It means he's improving. 2.5 this morning. :). And I have a feeling another reduction is in the near future.
@JanetNJ yeah I am worried about him going hypo bad... hes still at 75 which is what he went up too after 30 mins after I gave him some karo syrup and high carb kibble... so I think hes evened out he didnt drop back down.. was hoping it would have went back up a bit more .. I am having to do paw pricks right now being his ears have NO blood being I poked him so many times today onces since pmps have been in rear pad thou when he hit 50 I did double check and squeezed out enuff from ear to see it was same at ear and paw... so now going to try and sleep.. hes been acting normal the whole time but it scares me so Im taking no chances...

also the syringes I have now are 20 units as well... I did see amazon has the 3-10 cc as well with 1/2 markings.. will look into that tomorrow. thanks so much https://www.amazon.com/UltiCare-VetRx-UltiGuard-Insulin-Syringes/dp/B07XYGG1QJ/ref=pd_sbs_121_4/145-1857658-7980847?_encoding=UTF8&pd_rd_i=B081D6W3W2&pd_rd_r=eac6ac06-e10a-43a7-bd88-86bfd5d7139c&pd_rd_w=ZXGCu&pd_rd_wg=pcK4c&pf_rd_p=ed1e2146-ecfe-435e-b3b5-d79fa072fd58&pf_rd_r=EFCPEJX6QXE9E8SG2D8F&refRID=EFCPEJX6QXE9E8SG2D8F&th=1
 
ok just tested at hour after the 60 at +3 and hes at 52 so guess its dropping hes also staying at the water fountain drinking and yesterday he didnt drink very much.. so guess I will have to give some high carb kibble and check again in 15-30 dont want him to drop lower ... UGHH ( could he be in some kinda of withdrawal from the high carb kibble being left out all the time? and him snacking to keep it up between meals) but hes acting normal was just scratching on the scratching post 10 mins ago... I dont think I will ever understand this stuff.. (now he looks nappy but he is usually napping this time of day) gave him .75Ml of karo syrup and small handfull of the high carb kibble which he is eating like crack... back up to 89 hour after the karo and kibble..seems like I am fighting possible hypo daily last 3 days..also put him out some FF reg to nibble on like 1/4 of can between now and next check at 12:30am before dose..should I try the 2.5 and see if there is less of a drop in in Nadir tonight or stay at the 2.75ish which I'm not pulling plunger flush with the line so its about 1/4 between marks..

@Critter Mom @JanetNJ. Thanks for all the help
 
Hi Lee,

Sorry I couldn't get to you till now. How many hours ago did you give the insulin dose? (Well done catching the low again and responding.)

Just doing a re-read of some of the earlier part of your thread. Back shortly...


Mogs
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Hi again, Lee.

Please can you tell me the following:

1. The foods you're giving now and Venge's feeding schedule.

2. Are you testing Venge daily for ketones?

3. Is Venge eating and drinking plenty?


Mogs
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Hi again, Lee.

Please can you tell me the following:

1. The foods you're giving now and Venge's feeding schedule.

2. Are you testing Venge daily for ketones?

3. Is Venge eating and drinking plenty?


Mogs
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1: Fancy Feast chicken pate or the Salmon or any of the reg pates (I tried the tiki shredded chicken but he sorta nibbled at that not really eat much of it he is a pate cate) Feeding is normally at 12:45pmish and 12:44amish and I left him out 1/4 of a can of the pate to nibble on at about 7pmest today being he went almost hypo I have taken away the free grazing of the High carb food.. I do have a low carb food to leave out a small amount for him to graze on between can meals.. he is not a voracious eater never has been he will normally eat 1/2 of a can of (FF 1.5 oz of wet food) or 1 portion size of Little sheba (1.5oz of wet food) twice a day which but until recently he is use to then nibbling thru out the day and night but I have for the past 6 months or so tried to keep that to about 1/2 cup a day mixed urinary food and weight loss kibble (being the vet wanted him to loose weight as until I saw him start to loose weight he was 16.8lbs and when I took him in on the 20th he was 11.4 then when I took him back on fri and they found he was diabetic he had lost another lb over night from dehydration due to vomiting up all water he was gorging) .. until the last week I was feeding both cats the same thing they are now secluded apart being any food around and Nightwing will eat it ALL.. he is a eating machine...

2:No my vet didnt tell me to do anything but give him Food then 3 units of Insulin twice a day 12hrs apart... she did say he had ketones in his urine when he was in the brought in that friday and they tested him and mentioned they were still in his urine etc when he was in there for the 4 days but no mention of them when they released him to me on 11/25 just showed me how to give insulin.. I had already read on here about testing etc so I asked her and she said no need to test that they would be doing a Insulin curve on him.. what I had thought I read was most vets would call you back a few days after going home of you doing the insulin and want to do the cycle.. but I said ok so bring him back next week and she said No in about a month??? Do I need to buy one of the ketone blood testers or the strips for urine ( then I gotta figure out how to cat him peeing???)

3. soso one day he will eat a whole can at once I will usually put down a whole can in the bowl or 1/2 then watch him and see if he wants more after he eats the portion I have given him he has eatin a whole can of FF at one sitting 1 day this week but usually 1/2 can he will eat or about that much then scratch at the ground near the bowl and walk off and be done.. then I give him his shot about 10 mins later.. his drinking has been soso as well the fountains I have gauges on them and I have put a piece of painters tape and mark it off every 24 hrs sometimes it looks like hes drank nothing but he will have peeded in the litter box 2-3 times during the 24hr period.. I do now also have a bowl of water in my bedroom that I have water in to try and get him to drink some now and then and have seen him and I measure it out as well. but its not a large amount he drinks from it.. I dont know if peeing 2-3 times a day is normal or not??? I do know he is peeing much less than before he started in the insulin... I have kept an eye on the peeing/water since his First urinary blockage in Feb..

I did buy a can of Friskies today to see how well he would eat that oddly both my cats will go nuts over cheap food like meow mix or friskies etc ( all their lives they have been fed grain free etc suppose to be good food, I feed the outside once feral cats less expensive food being they all still HUNT and they refuse to eat any good cat food I tried) if I drop some cheap dry cat food or open a can of friskies ( they always got FF or other semi good wet food ) they loose their minds and want it.. so maybe to try and get him to eat more I might try friskies can food ??

Sorry lots of info I always try and provide too much than not enough..
 
so his BG has not changed in 4 hrs he did eat about a tablespoon of FF at 830pmish his BG at +9 was 171 at 12:30 time for his PMPS its 172 I tested twice to make sure... so I am going to stall feeding and shot for 30 mins if not moving up I will feed but no shoot and check him over the next 5-6hrs DO I wait to reshoot only at AMPS no inbetween shot correct??? and what to I reshoot at his amps we had thought of dropping down to 2 if his #'s are up over 200 I think it might jump up high being he is normal now? what is up with this cat.. lack of the carbs? dosing working? totally lost now and hes pissed he wants food lol but will wait till 1am might wait extra 15 or so so its 45 mins between tests.. then feed

@Critter Mom
@JanetNJ
 
OK +1 since no shoot being he had stayed at 170s for 5+ hrs hes now at 232.. he also didnt eat very much about 1/4 to maybe 1/2 of FF chicken pate( use to be his fav he would swallow it whole now he licks at it mostly then will eat some) I also tried to get him to try some of the friskies chicken N liver and he licked the sauce off the food and took a few mouthfuls.. will test again at his +3 which is when he has dropped before but being hes on no shot at PMAS will see what I get.. if numbers are going up should I give him small dose at like +6 half way or skip all the way to Day dose?? should I try and get him to eat some more later?
 
Hi Lee,

First up, the 2.75IU dose is too high and needs to be reduced again. Second, with a history of ketones in the mix, it's critical that Venge eats enough. He's underweight so it's OK to let him eat throughout the cycle - with the exception of the two hours before each preshot BG test is due (needs to be a fasting BG test).

I have taken away the free grazing of the High carb food..
Changing to an exclusively low carb diet can potentially drop the overall BG range by around 100 points.

what is up with this cat.. lack of the carbs?
I think the removal of the dry kibble for grazing is part of why Venge's dose keeps needing to be reduced.

dosing working?
The insulin is definitely working but because you've reduced the carb load it's taking him down to a range that's too low when the insulin is working at peak effect, and he now needs to race down the insulin dosing scale.

now he licks at it mostly then will eat some
he licked the sauce off the food and took a few mouthfuls..
I strongly recommend you test for ketones ASAP, just in case this might be nausea-related behaviour (cats throwing ketones can become nauseated). See checklist of symptoms here:

Nausea symptoms and treatments

Urine test strips are cheaper but blood beta ketone meters (pricey strips) are great because you can test on demand and don't have to wait to collect a urine sample (trickier again in a multi-cat household). Also, BBK meters can detect ketones sooner. See:

Ketones, DKA, and ketone meters

Tips for collecting urine samples

Given that Venge was hospitalised for several days to treat ketones there's a definiite possibility he had diabetic ketoacidosis (DKA). I suggest you ask your vet to confirm whether or not Venge was treated for DKA. If DKA is confirmed, there is usually some infection, inflammation or other systemic stressor present and that needs to be identified and treated, so also check this with your vet.

Cats who have a history of throwing ketones are typically more prone to them going forward (particularly if they're underweight). It is critical that ketone-prone kitties get enough food and insulin to keep ketones at bay. It's also a really important safety precaution to test daily for ketones. Any higher than trace means one needs to seek veterinary advice/treatment immediately (ketosis and DKA are medical emergencies).

It's sometimes better to feed cats recovering from an episode of ketosis/DKA a medium carb diet for a while so as to ensure they get enough insulin every day. Such a regimen may also help a kitty to regain lost weight. If Venge continues this race down the dosing scale, I am wondering whether you might need to bump his carb load up a little again - especially if he's not reliably eating as much as he needs to - to ensure he gets enough insulin to keep ketones at bay and makes a solid recovery from his earlier ketone episode. (@JanetNJ - what do you think?).


if numbers are going up should I give him small dose at like +6 half way [...] or skip all the way to Day dose??
After a skipped dose, in general one waits till the next scheduled shot time. It's not a straightforward thing to skip insulin for ketone-prone kitties. If preshot BG is lower than normal or if appetite is iffy, it may be possible to give a token dose of insulin. Please ask your vet to give you guidance on dosing in such a circumstance and also post for help here.

If you did skip a dose and then gave insulin, say, 6 hours later, you would then need to wait 12 hours before giving the following dose (i.e. your whole schedule would change, and to go back to the old schedule you'd then need to adjust each shot time by 15 minutes until you eventually get back to your normal schedule).


sometimes it looks like hes drank nothing but he will have peeded in the litter box 2-3 times during the 24hr period.. I do now also have a bowl of water in my bedroom that I have water in to try and get him to drink some now and then and have seen him and I measure it out as well. but its not a large amount he drinks from it. I dont know if peeing 2-3 times a day is normal or not?
Two, possibly three, pees a day is fairly normal PROVIDED the volume of urine voided isn't excessive and PROVIDED the cat is drinking enough. With diabetics it's tricky - especially when, like Venge, they're spending time over the renal threshold (est. 200-230 on human meter). When over the renal threshold glucose is excreted in the urine and that also draws extra water out of the cat's body, creating the potential for it to become dehydrated. It's advisable to regularly check for dehydration (check gums to see if they're sticky, or pull up the loose skin round the scruff/shoulder area into a tent and release - if gums are sticky and/or skin is slow to return to normal position or remains tented then the cat is dehydrated). Excessive vomiting and diarrhoea can also lead to dehydration.


Mogs
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Hi Lee,

First up, the 2.75IU dose is too high and needs to be reduced again. Second, with a history of ketones in the mix, it's critical that Venge eats enough. He's underweight so it's OK to let him eat throughout the cycle - with the exception of the two hours before each preshot BG test is due (needs to be a fasting BG test).


Changing to an exclusively low carb diet can potentially drop the overall BG range by around 100 points.


I think the removal of the dry kibble for grazing is part of why Venge's dose keeps needing to be reduced.


The insulin is definitely working but because you've reduced the carb load it's taking him down to a range that's too low when the insulin is working at peak effect, and he now needs to race down the insulin dosing scale.



I strongly recommend you test for ketones ASAP, just in case this might be nausea-related behaviour (cats throwing ketones can become nauseated). See checklist of symptoms here:

Nausea symptoms and treatments

Urine test strips are cheaper but blood beta ketone meters (pricey strips) are great because you can test on demand and don't have to wait to collect a urine sample (trickier again in a multi-cat household). Also, BBK meters can detect ketones sooner. See:

Ketones, DKA, and ketone meters

Tips for collecting urine samples

Given that Venge was hospitalised for several days to treat ketones there's a definiite possibility he had diabetic ketoacidosis (DKA). I suggest you ask your vet to confirm whether or not Venge was treated for DKA. If DKA is confirmed, there is usually some infection, inflammation or other systemic stressor present and that needs to be identified and treated, so also check this with your vet.

Cats who have a history of throwing ketones are typically more prone to them going forward (particularly if they're underweight). It is critical that ketone-prone kitties get enough food and insulin to keep ketones at bay. It's also a really important safety precaution to test daily for ketones. Any higher than trace means one needs to seek veterinary advice/treatment immediately (ketosis and DKA are medical emergencies).

It's sometimes better to feed cats recovering from an episode of ketosis/DKA a medium carb diet for a while so as to ensure they get enough insulin every day. Such a regimen may also help a kitty to regain lost weight. If Venge continues this race down the dosing scale, I am wondering whether you might need to bump his carb load up a little again - especially if he's not reliably eating as much as he needs to - to ensure he gets enough insulin to keep ketones at bay and makes a solid recovery from his earlier ketone episode. (@JanetNJ - what do you think?).



After a skipped dose, in general one waits till the next scheduled shot time. It's not a straightforward thing to skip insulin for ketone-prone kitties. If preshot BG is lower than normal or if appetite is iffy, it may be possible to give a token dose of insulin. Please ask your vet to give you guidance on dosing in such a circumstance and also post for help here.

If you did skip a dose and then gave insulin, say, 6 hours later, you would then need to wait 12 hours before giving the following dose (i.e. your whole schedule would change, and to go back to the old schedule you'd then need to adjust each shot time by 15 minutes until you eventually get back to your normal schedule).



Two, possibly three, pees a day is fairly normal PROVIDED the volume of urine voided isn't excessive and PROVIDED the cat is drinking enough. With diabetics it's tricky - especially when, like Venge, they're spending time over the renal threshold (est. 200-230 on human meter). When over the renal threshold glucose is excreted in the urine and that also draws extra water out of the cat's body, creating the potential for it to become dehydrated. It's advisable to regularly check for dehydration (check gums to see if they're sticky, or pull up the loose skin round the scruff/shoulder area into a tent and release - if gums are sticky and/or skin is slow to return to normal position or remains tented then the cat is dehydrated). Excessive vomiting and diarrhoea can also lead to dehydration.


Mogs
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thanks for the reply I think I will order one of the machines being trying to catch him peeing will be a pain.. but I will get some strips at the store today and see if I can in the mean time.. when I gave him the kibble last night for the near hypo he gobbled it up like crack so I dont think its nausea I think its him being finicky eater maybe pretty sure if I stuck the kibble in his face right now he would swallow it whole( hes always been weird about food).. and yes the vet mentioned ketones and I want to think she said he was in ketoacidosis when I brought him in but he was also Severely dehydrated due to the vomiting out any fluids he drank for 2 days .. right now I am not sure what to do about dealing with my vet being they started him on the 3 units told me not to get a meter and check him and they would contact me in a month to do a cycle..and havent contacted me since I brought him home to check on him.... I have been using them for 30 years... and there really isnt another vet here that I can use( had issues with other vet due to Long story) I just checked his scruff draws back fine smelled his breath not sweet and when I touched his gums they are slick and shiny he is in sleep mode right now being its when he wants to sleep normally but hes had plenty of energy to jump on my bed and was using the scratching post last night even at the edge of hypo and multiple times today.. he also has jumped up onto his platform which is 3ft off the ground with no problem a few hrs ago when I was typing my replies ( he watches me at the computer) so most of the dangers signs arent there but I will get test strips and try today and will order one of the meters and strips.. just to have.. I skipped an hour and his BG went up 32 points in 2 hrs where it had been going up that much per hour since the skipped dose so I think thats slowing down.. I was thinking of seeing if he would eat some FF or Friskies in a min or 2 or should I not feed him until lunch? I also just ordered a meter will be here sat but I am going to stay up till walmart opens(being an insomniac has issues lol) run in get some strips and see if I can get some pee out of him somehow lol..

OK just decided to see if he would eat and he swallowed almost half of a normal sized can of Friskies chicken and liver pate in about a minute... so appetite OK he was just being finicky yesterday...

@Critter Mom
 
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OK so wasted 20 bucks trying to test the ketones lol... bought a new box and some kinda pellet stuff and he refused to get in it... but I did get a test just had to take lid off reg box and once he started just stuck my hand in there and got it on 3 strips all neg :) and his PMPS after no shot last night was 369.... so I gave 2 units will check him at 1 and +3 and etc thru the day and see what I get maybe being off the high carb kibble he is getting into correct area thanks to everyones help with dosing etc.. and he getting more and more annoyed with testing which is more and more like HIM lol I have been testing using paws being his ears are raw from the cycle I did the other day... I wipe with alcohol swab then blow that dry then poke him milk out a drop and test if its is weird I will go for the ear but for right now the pad seems to be working.. thou if I stay with pads I need to get a bigger lancet as I have to milk the pad to get out a good drop.. Thanks again for all the help ..
@Critter Mom
@JanetNJ
 
OK so skipped the dose last night his AMPS was 369 gave him 2units at +2 he was 109 now at +4 hes at 59 ( ughh) going to retest in 30 see if still dropping before I give any Karo syrup or high Cal kibble to pull up # dont want him to go Hypo ( weird being his #'s seemed GOOD) should I have given him less today? I did get in my 1/2 unit 3/10cc syringes today should I see how he does and tonight go to 1.5? could his BG be changing this fast due to being off the high carb food and the steroid coming more out of his system Yesterday was 2 weeks since the Steroid shot.. as usual no signs of hypo but rather give him a bit of syrup and nibbles to keep him from going further down... sorry to be a pain was so happy with his# being 369 after all night with no insulin and no ketones and now numbers drop...

@Critter Mom
@JanetNJ
 
See if he'll eat a teaspoon of low carb food for you, Lee, and then do your test in 30 mins. Don't give him more than that in case you need him to eat again.


Mogs
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OK so skipped the dose last night his AMPS was 369 gave him 2units at +2 he was 109 now at +4 hes at 59 ( ughh) going to retest in 30 see if still dropping before I give any Karo syrup or high Cal kibble to pull up # dont want him to go Hypo ( weird being his #'s seemed GOOD) should I have given him less today? I did get in my 1/2 unit 3/10cc syringes today should I see how he does and tonight go to 1.5? could his BG be changing this fast due to being off the high carb food and the steroid coming more out of his system Yesterday was 2 weeks since the Steroid shot.. as usual no signs of hypo but rather give him a bit of syrup and nibbles to keep him from going further down... sorry to be a pain was so happy with his# being 369 after all night with no insulin and no ketones and now numbers drop...

@Critter Mom
@JanetNJ
Wow glad you went all the way down to 2.... Any more and he would really be crashing. No need for Karo unless he's much lower. A little regular food should do the trick.

So he earned another reduction. At the next shot that is over 200 go down to 1.75.
 
Wow glad you went all the way down to 2.... Any more and he would really be crashing. No need for Karo unless he's much lower. A little regular food should do the trick.

So he earned another reduction. At the next shot that is over 200 go down to 1.75.
hes up to 65 at +30 will check him again at next +30 so maybe 59 was the low yeah what # should I really worry(when its under 70 or so I freak) and give him syrup and a lot of the high carb kibble...I just gave him about 3 big tablespoons of Friskes pate he gobbled it up, so will check him again at +30 and see how his #'s go I found the 12cc 3/10 u40 needles on amazon they got them to me over night so I can at least see better dosing now.. thanks for the suggestion
@JanetNJ
 
hes up to 65 at +30 will check him again at next +30 so maybe 59 was the low yeah what # should I really worry(when its under 70 or so I freak) and give him syrup and a lot of the high carb kibble...I just gave him about 3 big tablespoons of Friskes pate he gobbled it up, so will check him again at +30 and see how his #'s go I found the 12cc 3/10 u40 needles on amazon they got them to me over night so I can at least see better dosing now.. thanks for the suggestion
@JanetNJ
You are on a human meter so no need to worry unless you are under 50. If it's close to 50 just give some regular carb food. Under 50 you pull out the higher carb stuff. Normal on a human meter is 50-120
 
Wow glad you went all the way down to 2.... Any more and he would really be crashing. No need for Karo unless he's much lower. A little regular food should do the trick.

So he earned another reduction. At the next shot that is over 200 go down to 1.75.

its 2 hrs from next shot and hes at 153... so I dont think unless something weird happens that hes going up 47 in 2 hrs being he went up 62 over the last 4 if hes under 200 or right at it what dose should I give 1u or .5

@JanetNJ
 
I gave him .5 just to keep some in his system so maybe he wont drop #'s tonight or tomorrow after his AMPS #'s like he did today thou I did give him 2 at amps today after his non shot last night and then his #'s dipped today for a while... he did eat well also ate almost half a full size can of Friskes which is odd so hes gettin a appetite appetite.. will check him at +1 and +3 +4 tonight... maybe we are eyeing in on a correct does now that hes off the kibble and the further the steroid is out of his system..can only pray..

@JanetNJ
@Critter Mom
 
I did a BG test at 3 and 3+30 after the 71 to see if it was dropping (I did give him a tiny(tinyy) piece of purebites freeze dried chicken as a treat after each shot dont) the 71 shot at 3 and one after the 102 I dont think that a tiny tiny piece of the freeze dried chicken would have brought it up 31 points in 30 mins.. hopefully his bounce is leveling off with the lower doses will do one more check at +5 and will see what we get at the AMPS what should I give tomorrow at AMPS .5 or 1 and at what range
if under 200 do I shoot anything or stay at the .5
if 200 to 300 do I go to .75 or 1
if 300+ do I go 1 to 1.25

@Critter Mom @JanetNJ BTW I really appreciate all the help from yall.. being no one else seems to be chiming in or I dont know who else would be the experts to tag here yall seem to be the Alpha cats :cat:

update at +5ish BG 104 being I test at 12:30 then feed then shot at 1am/pm going to give him some food before I go to bed about 1/4 can of friskies pate for him to nibble on for till lunch.. the low carb kibble will be here today.. then I will test with that between main meals and maybe see about a feeder maybe for mid 12hr feedings of small amounts..
 
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I gave him .5 just to keep some in his system so maybe he wont drop #'s tonight or tomorrow after his AMPS #'s like he did today thou I did give him 2 at amps today after his non shot last night and then his #'s dipped today for a while... he did eat well also ate almost half a full size can of Friskes which is odd so hes gettin a appetite appetite.. will check him at +1 and +3 +4 tonight... maybe we are eyeing in on a correct does now that hes off the kibble and the further the steroid is out of his system..can only pray..

@JanetNJ
@Critter Mom
Good call
 
I did a BG test at 3 and 3+30 after the 71 to see if it was dropping (I did give him a tiny(tinyy) piece of purebites freeze dried chicken as a treat after each shot dont) the 71 shot at 3 and one after the 102 I dont think that a tiny tiny piece of the freeze dried chicken would have brought it up 31 points in 30 mins.. hopefully his bounce is leveling off with the lower doses will do one more check at +5 and will see what we get at the AMPS what should I give tomorrow at AMPS .5 or 1 and at what range
if under 200 do I shoot anything or stay at the .5
if 200 to 300 do I go to .75 or 1
if 300+ do I go 1 to 1.25

@Critter Mom @JanetNJ BTW I really appreciate all the help from yall.. being no one else seems to be chiming in or I dont know who else would be the experts to tag here yall seem to be the Alpha cats :cat:

update at +5ish BG 104 being I test at 12:30 then feed then shot at 1am/pm going to give him some food before I go to bed about 1/4 can of friskies pate for him to nibble on for till lunch.. the low carb kibble will be here today.. then I will test with that between main meals and maybe see about a feeder maybe for mid 12hr feedings of small amounts..
I didn't notice that 71 on your chart. Can you manually turn it green? The 59 in the morning, too.
 
see what we get at the AMPS what should I give tomorrow at AMPS .5 or 1 and at what range
if under 200 do I shoot anything or stay at the .5
if 200 to 300 do I go to .75 or 1
if 300+ do I go 1 to 1.25
If it's under 200 in the morning stall without food for up to an hour and see if it's going up. If still under 200 you can decide if you want to skip or give 0.25-0.5. You did great last night! Got down to a nice Healing 71!!

200-300 I'd try 1 and over 300 1.5.
 
I didn't notice that 71 on your chart. Can you manually turn it green? The 59 in the morning, too.
Now at +9 hes at 176...

I had waited and restest at + 30 so I had typed in the higher numbers with +30 in the box(which is why no colors spread sheet only wants single number) I have now used a 2nd line under any areas for info at the BG test which is what I will do for any +30 rechecks .. so far last night till today best hes had... unless it jumps up above 200 at Amps at 12:30 I will stall till 1:30pm if still under 200 but 190+ I will give .25 but if still under 185 no shot? or am I looking at too small a difference thats not really there between those #'s

@JanetNJ
@Critter Mom
 
I had waited and restest at + 30 so I had typed in the higher numbers with +30 in the box(which is why no colors spread sheet only wants single number)
You can color or yourself.... There's a paint bucket. Select the cell and tap the bucket and pick a color to change it. I'll show a picture....
5AE86659-DCE3-48BF-BEA9-ACA55F775D22.jpeg
 

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still under 200 but 190+ I will give .25 but if still under 185 no shot? or am I looking at too small a difference thats not really there between those #'s
I think the 0.5 units worked well for you at 160... As long as you can test I think that worked for you. If you can't test or your nervous you could do 0.25 160-190.
 
I think the 0.5 units worked well for you at 160... As long as you can test I think that worked for you. If you can't test or your nervous you could do 0.25 160-190.
yeah I can test till the cows come home.. I work for myself and I work from home (Graphic Designer/Artist) thus why I am around Vengeance 24/7 pretty much and can test unless I am trying to get some sleep lol and even then if need be Venge is more important... and fixed my SS never used google SS before soo... will do the .50 and see how the day goes will test at +3 seems to be his dropping point and then test from there... Im just glad that I found this board I hate to say it but if I had stayed on the 3 units and never tested.............:( ....thus why me and my vet will have to have a talk when I do take him in...
 
so his AMPS is 163 dropped since his +9(176) will wait another +30 then see where hes at if still in same range or dropped I am gonna just feed and no shot if its dropped again and see how his numbers go thru the rest of the day if it goes up I will feed then .25 ... could he be normalizing this fast? since hes off the high carb food? not sure if no shot will make #'s go back up higher or if keeping a small dose would help equalize #'s

@Critter Mom @JanetNJ
 
so his AMPS is 163 dropped since his +9(176) will wait another +30 then see where hes at if still in same range or dropped I am gonna just feed and no shot if its dropped again and see how his numbers go thru the rest of the day if it goes up I will feed then .25 ... could he be normalizing this fast? since hes off the high carb food? not sure if no shot will make #'s go back up higher or if keeping a small dose would help equalize #'s

@Critter Mom @JanetNJ
I'll be curious how he does. :)
 
hes 137 at PMPS... he got no shot at AMPS I only took 2 BG today at +4 and +6 which would be where he usually drops both in Blues.. So I decided to not stress him with tests, I am going to no shot again tonight and will check him every couple of hours till I go to bed.. going to feed now and see how he does in a few hrs...is this a good thing or should I be concerned that hes leveling out fast..
@Critter Mom @JanetNJ
 
Ok so no shots at all today at PMPS +3 155 +4 160 if hes still under 200 at AMPS do I just not give him insulin till #'s go back up or do I do like .25 or .50 to try and bring them lower?will do another at +5 and update here

@Critter Mom @JanetNJ
 
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