new to group Ric A . and Apache

my name is Ric A. i have a female cat Apache who is 10 years old. she was diagnosed with diabetes about 4 months ago. BOY AM I GLAD I FOUND THIS GROUP !!! i have been on my own with this since the onstart. i have 2 vets and both have been minimal help, like they just dont care. one vet actually made me pay an office visit to look at the curve and ask a few questions. Apache is currently on vetsulin and her numbers are all over the place. ive heard about other insulins that may be more effective. can anyone help me decide if i need to get to a new insulin or continue on vetsulin. my numbers have been about 350 ps or higher and 100 low point. she is on 2 units of insulin 2x day. id appreciate any help i can get. i have many questions to see if what i have been doing is correct.

 

Hi Ric and Apache and welcome to the forum.
It sounds as if you are hometesting…Is that correct?
If so what type of glucometer are you using?
Yes there are much better insulins than vetsulin which is really a dog insulin.
I would ask the vet to swap you to Lantus insulin which is a longer acting, more gentle insulin.
But before you do the swap it would be good if you could set up a spreadsheet and add any data you have for the last month or two so we can see what is happening. And we can help you with the dose when you do the swap over and moving forward.
I’ll give you the link to the SS below.

Do you have a hypo kit set up in case it is needed?

What type of food are you feeding and how often food you feed Apache?
With the vetsulin, do you feed then wait 30 minutes before giving the insulin?

Here is the link to the SS and also the signature which is the small writing you see below everyone’s posts. It tells us about your kitty and people, helping with dosing or other issues always look at the SS and signature before helping. If you have any trouble setting up the SS let me know and I can ask someone to help you.
HELP US HELP YOU

Ask all the questions you need to. This is a very supportive and knowledgeable community and are very generous with their time helping others.
Bron

 

Hi and welcome,
My boy was first given vetsulin and his numbers were all over and he was MISERABLE! It was awful..... we went to pro zinc which was ok but he needed longer lasting insulin. Lantus was much better but we ended up with lev because he has a late nadir (lowest reading in a 12 hour cycle)

If you do switch it is important to home test (sounds like you do) to be sure it is ok to shoot insulin...especially if you are moving to a low carb diet.
As far as a curve your better off doing it at home without the stress of the vets office.

Numbers can drop dramatically with just a food change to low carb. You have great instincts will get great input here..

 

i am home testing with vQpet h meter. ive had a few meters.(alpha trac2-best, pettest, and test buddy) and this one is cheap and closest to the Alpha track numbers. the one dollar a strip that alpha offers is way too expensive for me. the vQpet has 50 strips for about $13
i have a hypo kit barring the food because Apache has a food allergy and can only eat one food. Purina pro plan duck wet food. she gets one small can (3oz) every 12 hrs when its time for her shot. no snacks unless numbers get low.
yes i wait 20-30 mins to give vetsulin after eating. should it be 30 and not 20-30 ??
ill get a spread sheet made up for the last month or so as i have made my own record sheet. ill just transfer it over.

thank you for helping. all i can see is that there is absolutely NO WAY a vet can possibly control insulin dosages with a few curves that they ask for. its much more complex and looks like a fantastic money mker for vets. so far i have used common sense and have made it this far. i now welcome this forums expertise. many dayz and nights i havent slept wondering if i made the right call with no one to ask for help or confirmation

 

i do have a question about insulin dosing. does one adjust the dose according to the pre shot numbers ??? i assume thats why i keep curve records. to compare to a similiar dose ?? OR do i want to use one set dose as long as Apache is above 225-250pre shot# ?

 

NO -the dose is based on the lowest number in a 12 hour cycle (nadir)

 

2 X 3 oz cans doesn’t seem much food. How much does Apache weigh?
I would suggest giving a couple of snack around +3 and +5 when giving vetsulin. A snack is a teaspoon or two of low carb food.
I would wait 30 minutes with vetsulin before feeding to make sure there is food aboard as vetsulin is quite a harsh fast acting insulin.

We take the preshot BG to ensure that the BG is high enough to shoot but the dose is based on the nadir or lowest point in the cycle. If Apache drops under 90 you need to reduce the dose

 

Apache is very small 6lbs and shes quite tubby and has had this amount of food most her life. i dont want her getting too fat. she has a food allery and can only eat one food so i have no choice of different foods. if i give her a snack , her numbers shoot up immediately.

as far as dosing according to nadir , i will do that now. the problem is when i reduce the dose when her nadir goes under 90,,,, her ps numbers go up in the 400-500 in the next cycle so when i give the reduced dose with that pre shot #,,,, the nadir only goes in the 200's

 

heres what i have been doing to get her nadir at or around 100 every cycle
preshot# 250-340--- 1 1/2 units
340-440 ---- 2 units
over 440 2 1/2 units.
i use all my past recorded curves to attain the guidelines

so this is incorrect ??

 

It is possible she is bouncing from the lower numners (under 90). Once we can see what is happening in in the SS we will know more.
Here is an explanation on bouncing from the Basics

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

I’m not a vetsulin user so I will tag @Suzanne & Darcy to comment on your dosing.

 

i will give her a steady dose of 2 units from now on no matter what the pre shot# and get those on a ss. i was unaware of bouncing. Apache has had numbers in the 40's as my vet said that was fine,,, common sense told me it wasnt and i set a mark of a nadir of 100. one time her numbers pre shot numbers were 135 and i called my vet and he said to go ahead and give the regular dose shot. i could not ,,,common sense told me that may be too much. i waited till the numbers went higher. now i find out i did the right thing ! this is the kind of bad advise i have been getting from vets. almost that they are mad that you are home testing and not giving them business

 

Wait until you hear from Suzanne about the dosing before just giving her 2 units no matter what.....with vetsulin they do sometimes give a smaller dose if the preshot is lower than normal unlike lantus which likes consistent dosing, but even with lantus, the preshot can be too low and stalling and not feeding is the way to see if the preshot will rise..

With a pet meter, any number under 68 you must take action and give either high carb food or honey or karo. In the 40s is dangerously low for a pet meter and a reduction in dose must be taken.

Until we can see your BG data I would not shoot a full dose if the BG was under 220 on the pet meter. If it was 135 I would have skipped or stalled and not fed and waited to see if the BG rose as you did. This is where a smaller dose could have maybe been given if the preshot was say 170.
But you would then go back to the normal dose at the next preshot if that preshot was high enough.

I am sorry you have been given this advise...it is bad.
Sadly many vets are not up to date with feline diabetes current care, and many vets do not encourage home testing.
However now you have come to the best possible place and I know we can help you.

 

bouncing can be frustrating, my boy was quite good at it
I quickly learned after testing more it was do to him dropping too low in the 12 hour cycle.

 

thanx all ! i have her shot in about 3 hrs from now so i will wait to hear about dosing. if i do not im going to take the advise of the group as less is best. ill only give 1 1/2 units, ive never had a low nadir reading with that dose. i have had low nadir numbers with 2 units but thats when the pre shot # was around 280. if its around 340 ,,,2 units brings the nadir to about 100-125

 

Hi and welcome!

Are you feeding low carb food? LC food has 10% or less carbs and it’s important for diabetic cats to eat LC food. Not sure if you got the advice about feeding x2 a day only from the vets but that’s a dog thing. Vetsulin is also better for dogs. Cats have a much higher metabolism and do much better on smaller meals throughout the day. You don’t have to feed more, just divide it up into smaller portions. Smaller meals are also easier on their already compromised pancreas.

 

Apache has a food allegy and can only eat one type of food/ i heard that the best way to keep cats from becoming diabetic and the best way for remission is food 12 hr 2x a day. i believe it was a youtube video. as far as small meals, my vet said vetsulin is designed to work every 12 hr / one meal

 

That is totally not true. You tube video was also wrong.
We all feed our cats small snacks like Ale and Bron mentioned .
Just divide up what you feed her now.
A snack is like 2 teaspoons . vetsulin does not last for 12 hours at all.
Your vet is so wrong telling you vetsulin is designed to work every 12 hours/one meal

Especially with vetsulin you need to feed snacks during each 12 hour cycle
It hits hard and fast.

All of the kitties here that have gone into remission my cat included have been feed snacks during each 12 hour cycle .
If it wasn't for the experienced members here giving me advice Tyler wouldn't be in remission since 1-24-23 knock on wood

 

i can believe what everyone says on this forum over my vet for sure. i believe if i would have listened to his advise,,,,Apache would have been gone by now a few times,,,,SO
i will feed the 3 oz at shot and then snacks during the cycle. what times should i feed the snacks???
and remember Apache has food allergies and ive only found one food she can tolerate ( thats a whole nother ballgame). Purina proplan duck. sensitive stomach and skin, so i dont have the option for LC snacks

 

Hi Ric - Welcome to the forum. I joined in January and like you it was such a relief to find people who had gone through the same stuff as me and could help me out from their experience.

Can you tell me more about Apache’s food allergy and what food you’re feeding her to manage it?

My Pumpkin also has an allergy. She would regurgitate her food every couple weeks for her whole life. Last year it got so bad at one point she ended up in the hospital from constant vomiting. We switched her to a prescription food that cleared it up so that she was vomit free for the first time in her life. It was such a relief. I never wanted to see her that sick again.

I’m pretty sure that food led to her diagnosis though. She had lots of blood tests in the couple of years before she took it, and her blood glucose was fine. When I took her in a year after the switch, she was diabetic.

I was very nervous about changing her diet, but after doing a lot of research I knew I had to try. There are a lot of single or limited ingredient foods that are helping me figure out what she can and can’t tolerate. I’ve been taking it very slow, trying just a teaspoon of new foods at first and slowly increasing it to see how she reacts. Based on her reaction to one food I think peas are a no-go for Pumpkin. I’ve started to see a real difference in her energy level and in her blood glucose curves since I found a low carb food she would tolerate.

I know allergies are scary and a lot of people who haven’t gone through them don’t get just how hard and stressful it is to handle them. But, there are options and we’d really love to help you find the right food for Apache.

 

Apache has food allergies and ive only found one food she can tolerate ( thats a whole nother ballgame). Purina proplan duck. sensitive stomach and skin,. everything else she throws up. she also gets infection by her temples. itried top post a pic but i cant. ive even tried just chicken, tuna and a plethera of canned foods. im afraid to try new foods after what she went through. what other options do you suggest?

 

ive ordered an automatic feeder so i can get Apache her snacks during the cycles !!

 

Ric, good news, you’re already on a low carb food. It’s pretty unusual for cats to come to us already on a good diet for diabetics, but the food you’re feeding her is basically nothing but duck and minerals/vitamins. That means there’s no ingredient that adds a bunch of carbs. Unless someone else knows about some kind of issue with the Purina Proplan, I don’t think you need to make any changes.

 

not having to change the diet is a MAJOR WIN !!!

 

I can't find the food on dr piersons list, but we can do the carb math with a picture of the can

 

https://www.purina.com/pro-plan/cats/wet-cat-food/sensitive-skin-stomach-grain-free-duck

It's under 10% carbs.

 

It's 4.54 so that's great!

 

So I have 2 diabetic cats and they get another whole can of food at nadir! 4 times a day. Food at amps food at nadir food at pmps and food at nadir. Might I recommend a diy churu for your sensitive baby? Blend your safe food up and put it in a zip lock. Snip the tip and bam, new treat

 

I see Bron suggested above in post #7

giving a couple of snack around +3 and +5 when giving vetsulin. A snack is a teaspoon or two of low carb food.

 

It's great that you're already on a low carb food. And it's good that you already have a hypo kit because it's a very low carb food.

If you're using Karo corn syrup, then one teaspoon mixed in with a can of her food will make it "mid-carb", and two teaspoons will make it "high carb". Just so you're prepared in case you run into a situation where someone suggests feeding one of those options.

(The Karo corn syrup has 120 calories per 2 tablespoons. So one teaspoon is 20 calories. Your food is 87 calories per can. Let's assume for now it's 0% carbs. If you add a teaspoon to a can, that makes it 18% calories from carbs. If you add two teaspoons, it's 31% calories from carbs. If Apache doesn't lap up all the broth, you might need to use a bit more corn syrup.)

 

As Diane said your vet is wrong on both accounts. The main problem with Vetsulin is that it doesn’t last a full 12 hours and so cats are not fully covered for 24 hours. Glad to hear she’s already on LC food. Not sure if these are things she can eat but any freeze dried treats are good. There may be some duck ones out there. Also baby food

 

what kind of karo corn syrup, dark ? light with vanilla?/

 

Not vanilla. I’d use regular. I personally always used honey instead. In a real emergency, you can just apply it to her gums instead of mixing with the food.

 

i have honey too, but feel it wont hurt to have the Karo available

 

Apaches last cycle with 1 1/2 unit 1-3oz can of food
preshot 346
3hrs 202
5hrs 152
7hrs 199
12 hrs (next preshot) 429

 

do you mean " i would wait 30 minutes with vetsulin before SHOOTING or should i shoot 30 mins before eating as you suggest ?????

 

It's test, feed, and shoot so get your bg test, feed 30min before vetsulin shot to ensure he doesn't drop super fast, then shoot after you're positive there's a good meal in the kitty

 

thats what i have been doing. it seemed like the response i refered to said-I would wait 30 minutes with vetsulin before feeding to make sure there is food aboard as vetsulin is quite a harsh fast acting insulin. ............BEFORE FEEDING !!!!?!

 

Do you need help getting your spreadsheet set up? It’s be a lot easier for us to interpret the numbers and give dosing advice

 

1. Test (to make sure the number will be high enough to shoot).
2. Feed (to make sure sufficient food is on board to handle the insulin and to make sure there is not a 'scarf and barf' situation).
3. Wait 30 minutes (for the food to be in the system), then shoot.

 

i looked at some of the spreadsheets and i cant make hide nor hair of iiit, just the 12 hrs increments. i also dont know how you got the sheet online. i made paper copies

 

Tagging @Bandit's Mom for you. She's a spreadsheet wiz.

 

Hello and welcome to FDMB!
I can help set up your spreadsheet and signature. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

 

You're doing great! Sometimes when speaking in text format there can be miscommunication. I'm happy were all clarified and honestly you're doing an amazing job with kitty! When I first came here I was no where even close to where your at! @Bandit's Mom made my spreadsheet while I cried onto my newly diagnosed cat lol!

 

It’s a shared goggle sheet. @Bandit's Mom will help you!

 

So true!!!

 

2 1/2 hrs into cycle Apache has barfed. how long shoukld i wait to feed, i was going to give a snack at 3 hrs. i checked her BG 429 at preshot,,,, 2 1/2 ---293

 

i dont know if this has anything to do with it but,,,,seems the barfing started yesterday amd today when i started waiting 30 mins after eating to give shot. previous to about 2 weeks ago , i used to give shot when she was almost done eating as i didnt know about the waiting period. i did call MERCK with a few questions and they never mentioned the waiting period

 

I'd try to get her to eat again. Vetsulin is strong. Did your kitty get any bloodwork at diagnosis? Vomiting and diabetes can be pancreatitis or dka. She eats so little (but she is a small girl) I'd want food on deck and a ketone check. Do you have ketostiks or a ketone meter?

 

i am not familiar with keytones. where do i get the meter and which one please ? im calling for a copy of her bloodwork now

 

You can get test strips at any pharmacy. Ketostix is one brand. You need to get a urine sample and then you dip the strip in the sample. I use a dedicated ladle that I hold over the litter to catch the stream while she pees.

 

Ketones are essentially kitties body burning up protein and fat instead of sugar. Makes their blood acidic. Usually happens from uncontrolled diabetes, infection, &/or lack of food. In my cats case it was all 3 at once! You can get ketostiks at any pharmacy. You get a sample of kitty pee and dip it in. Wait the 15 seconds (or 30 I don't remember lol) and it'll give you a ketone reading. For a meter they sell them on Amazon. I use KetoBM. I think I got mine same day delivered?

It won't hurt to have these things on hand if a longer-standing member thinks i may be jumping the gun? I'm fairly new here, only 2 years but I just dealt with DKA so I may have some ptsd @Diane Tyler's Mom what do you think?

 

unfortunately Apache doesnt let you get near when she is doing her business

 

Here's the link to my meter

The thing to remember, thr urine test is a buildup of the ketones for however long it took for kitty to pee so the number could be higher or lower at the actual minute she goes. The blood meter is the ketone level right now. That's why I'd rather spend the $1 per strip and know for sure (but if you havent noticed im a huge worry wart)

 

Ah sounds like the blood meter will be easiest for you it's expensive, but in my opinion worth it to catch DKA early.

 

And if getting a blood sample is easier than getting a urine sample, that’s another reason to go with a blood test.

 

https://1drv.ms/b/s!AoTrzzWmVnRAsylofKYKFQMgHJAu?e=RkQKfU Apaches bloodwork

 

Oh my ok so she did have ketones present at that time and a possible positive for pancreatitis. Was she started on insulin at the time of this bloodwork?

 

Oh was this in 2022?

 

she was not on insulin. for the test. that was the initial diagnosis and was then placed on insulin

 

Apache is eating. i gave her a small snack, should i give her all she wants to eat ??

 

That's good!

I would yes, sugar cats don't process food properly so they feel starved when they're in the higher bg #s. Just pick up the food 2 hours before preshot

 

Until the experts here get your Spreadsheet please remember I am not an expert. I'm just going off what I learned so far and what has worked for me and my cats there are people here that have been doing this for like 10 years! That being said, if I were you I'd let her eat all she wants and id check ketones because of the vomiting when a longstanding member chimes in definitely take their advice if it contradicts mine 100%

 

wow here we go again with meters !!!!!!!! can anyone suggest the best/ economical ketone meter. if its anything like the BG meter, i assume the strips are expensive. in that case ill need the one with the cheapest strips

 

All the ketone meters have strips about $1 per. What normal blood sugar meter do you use?

 

vQpet H

 

Oh yeah all the pet meters are way expensive. Most of us here use relion. The meter is like $10 and I get a 50 pack of strips for $9 all at walmart

 

If your vet is anti human meter tell them to do the math. Some vets think that pet meters are a percentage off of human meters. If he thinks that then it should be simple math for him to get the #s he wants lol. I test almost every other hour and my curves are every hour. Im not paying a dollar an hour for BG checks.

 

you can get the vQpet meter strips for about $11 for 50 strips. plus this meter is the closest readings to an Alpha trac2

 

You test, the. Feed the main meal then wait 30 minutes before giving the vetsulin. Sorry if I did not explain it properly.

As Apache had ketones at diagnosis it is really important that she eats more than twice a day. I’m glad you have ordered a timed automatic feeder…that great. And it’s fine to just feed the food you are feeding at the moment.
It is food and insulin that keeps ketones away. And encourage fluids.
If you can get a blood ketones meter that would be ideal.

When you have time, I’ll get you to set up your instructions to do that are in the link I gave you in post 2 above called help us help you. Make sure you add she had ketones at diagnosis in the signature please.
Keep asking questions.

 

should i feed her at 3hs and 5hrs a snack or can, half can (3oz)??? she can eat alot if i give it to her. she was eating almost twice as much but started gaining weight so i cut back to what she used to eat

 

We don’t want her to get fat but she needs those snacks.
With vetsulin, I would give a snack at +2 and +4 or +5 depending on when her nadir is. Might be a bit of trial and error in the beginning. The reason I say +2 is because of the earlier onset of insulin of vetsulin.
I would feed a can at each the main meals as you are doing and then divide another can into the 4 snacks over the 2 cycles. So 3 cans in total for the day. How does that sound.?

 

It’s good that she’s gained weight. Most unregulated diabetic cats eat and lose weight since they can’t process the nutrients in food well and burn calories just be peeing out the sugar in their urine.

 

sounds like a good plan !! her nadir is 5hr

 

when Dre was on vetsulin he would drop like a rock at +3 then start climbing back up

 

I have filled in a few weeks of previous on my spreadsheet if anyone wants to take a look

 

You are doing a good job with testing the BGs!
Any time the BG drops under 90 you must reduce the dose by 0.25 units. That means you don’t go back up again the the previous dose next time. The new dose is the reduced one.
I can see several times where you have dropped under 90 but have not taken a reduction.
So if you gave a 2 unit dose and the BG dropped under 90, you need to reduce the dose to 1.75 units and you should not give a higher dose than that again unless the BGs tell you the dose is not high enough…and that will take a few days and I would recommend you post and ask for guidance with that.
With all the drops under 90 you have got…I think the sliding scale the vet gave is is not going to work.
I would give 1.75 units dose moving forward each preshot BG regardless of the preshot…unless the preshot is too low of course.
You need to get some consistency. I’m going to tag @Suzanne & Darcy again to ask her view on the dosing as she is a Prozinc user.

 

Would you mind starting a new thread as this one is getting too long and link this thread to the new one…thanks

 

Thanks for all the help. The vet dud not give me the sliding scale. I determined that on my own. I had no help and did what I thought would work. I will give a 1.75 dose beginning today

 

3 blues today!!

 

I do like that nice string of blues today. This gives me real hope that Apache would be able to do very well on a Lantus generic like Semglee or glargine. You would not only have better numbers (like those blues) but you would have much flatter cycles without the higher numbers like you are seeing now for the morning and evening pre-shot tests. Did you have any luck with your vet prescribing new insulin today? Paws crossed for you and Apache!

 

Waiting for vet to get back to me for prescription