Blackberry
Member Since 2019
Hello!
My 13-year-old Loki was just diagnosed. He's 14lbs, but only a little overweight; his target weight is probably more like 12lbs. Indoor kitty, very lazy. We have 5 cats at the moment, and we've been through FIV, cancer, urinary crystals, hyperthyroidism, asthma, heart disease, you name it, but this is our first sugar baby. Fortunately, both my husband and I work from home, so we can keep an eye on him almost 24/7.
Sorry, this post turned out really long. I'm writing it half for myself to just get it all straight in my head, put the important parts in bold. I'm just feeling a little lost: the more I read, the more I keep finding things I should have started doing yesterday!
Diagnosis
We started to suspect something was wrong late last year: his appetite had gone through the roof. The vet tested him for hyperthyroidism and diabetes in december, both negative (blood sugar was only 100, even though he gets VERY stressed at the vet). Then his appetite continued to get worse and he started drinking excessive amounts of water, so we insisted on another test April 1: blood sugar was in the 500's! They didn't do a urine test, but the jump was high enough that the vet felt it was a conclusive diagnosis.
Initial Treatment
The vet immediately put him on 3u of vetsulin and scheduled him for a checkup in 2 weeks. (I didn't know at the time that that was a bit reckless to start so high. I assume the vet did it because Loki's such a big cat and his reading was so high.) The vet encouraged us to do 'casual' home testing: he suggested we buy a meter, but said there was no point in testing immediately. He also prescribed a change in diet, both for the diabetes and weight loss: previously, Loki was on Friskies canned and Purina One dry, and they put him on W/D canned & dry.
We were completely overwhelmed! So much information, so much to worry about! I did my research and settled on the Alpha Track 2 meter, but I wasn't happy with the lancet, so we got a Softclix. We've had no trouble giving him the insulin shots: Loki's a pretty laid-back cat.
Early Results
After 2 weeks on 3u vetsulin, Loki tested again in the 500s at the vet. Also, his water consumption had increased. Vet was pleased that we were so gung-ho about the home testing. He increased Loki's dosage to 4u, and asked us to home test a few times a week and let him know how it goes.
Just after this appointment, I learned about 'bouncing' from you wonderful people. I decided to keep him at 3u for another day, and try a glucose curve to check for this 'bounce'. In hindsight, going straight from never-used-a-meter-before to full-glucose-curve was a bad idea, but we didn't have much choice: I was NOT about to start him at 4u without knowing if he's dropping to dangerous levels mid-day.
It. Was. HORRIBLE. Well, the pre-shot and +2 hour checks went okay, but on the +4, we just couldn't get any blood: we FINALLY got a reading, but the poor baby got stuck so many times that we gave up testing for a few days. Anyway, 3 readings isn't much of a 'curve', but I hoped it was enough to at least rule out that he was dropping into hypoglycemia territory: pre-shot was 587, +2 was 378, +4 was 431.
He's been on the 4u for almost a week now. Our priority right now is to just get both him and us used to the testing, and so far the blood tests have gotten MUCH easier. His spreadsheet is pretty spotty right now: we don't want to test more than once or twice a day for the moment, while we're all still new at it, and we're sort of trying to spot check how he looks at various times of day. Unfortunately, as you can see, his readings haven't improved at ALL. I think he's drinking a little less, and his appetite has improved (he's not so frantic about getting every last scrap). Husband thinks he may be a little lethargic, but its hard to tell: he's always been lazy, and it's hard to tell if we're overreacting. Still, he's very responsive to pets and talking to him, and he doesn't seem confused.
Moving Forward
Step 1) Ketone test! The ketostix are in the mail. Should have done that sooner. Vet never mentioned it, and I missed how important it was in the avalanche of information
Must...be...more...vigilant.
Step 2) Change his insulin dosage (with vet approval, of course). I don't know what the vet is going to recommend when we talk to him next. The gut reaction to his high readings would be "increase the dosage", but from what I've read, it would be better to start over at 1u and work up slowly, in case he's been bouncing. I dearly hope the vet agrees, because I don't know what I'm going to do if he pushes us to 5u or says that dropping to 1u is dangerous.
If we do drop from 4u to 1u, should we drop it abruptly, or taper him down slowly?
As for how quickly to increase it, I found the SLGS guidelines, http://www.felinediabetes.com/start-low-go-slow.htm, though I worry if 0.5 is too slow of an increase if he continues to test super-high at 1u.
Step 3) Reevaluate his diet. I went on a mathematics blitz the past couple days, and I am NOT happy with the W/D diet they put him on. It's actually no lower in calories or carbs than his previous diet, and the nutrition profile isn't good for diabetes: 40% calories from protein, 33% from fat, 27% from carbs. It's also much less calorically dense than his old diet, so the instructions on the bag have him eating a lot more food (by volume) than he's used to: we have to feed it to him spread out over 6 meals a day or he eats it all too fast and throws up, even when we take steps to slow him down.
Fortunately, Loki is not a picky eater. I've put together a new regimen that I plan to run past the vet tomorrow: canned Fancy Feast and a small amount of dry Blue Wilderness. This new diet has an appropriate number of calories (240 per day, as opposed to the 288 of his original diet and 267 of his new diet), only 15% of the calories are from carbs, is more heavily weighted towards canned food so he gets more water, and it's a smaller amount of food overall, closer to what he's used to, so hopefully we can go back to 2-3 meals a day.
Assuming the vet gives the okay, though, I'm not sure when to start phasing in his new diet. It's a pretty steep drop in carbs, and at 4u of insulin, that makes me nervous. Or perhaps we should keep his food as-is for now, and drop the insulin dosage first? Gah.
Overall, I'm just so worried that he's not responding to the insulin, and it seems like every choice we make is a knife's edge for things going wrong if we make the wrong move: raise vs. lower the insulin, test too much and stress him out or test too little and he'll crash, follow the vet's advice blindly vs. ignore the experts, etc. Did I mention that I take anxiety meds? I imagine it shows.
My 13-year-old Loki was just diagnosed. He's 14lbs, but only a little overweight; his target weight is probably more like 12lbs. Indoor kitty, very lazy. We have 5 cats at the moment, and we've been through FIV, cancer, urinary crystals, hyperthyroidism, asthma, heart disease, you name it, but this is our first sugar baby. Fortunately, both my husband and I work from home, so we can keep an eye on him almost 24/7.
Sorry, this post turned out really long. I'm writing it half for myself to just get it all straight in my head, put the important parts in bold. I'm just feeling a little lost: the more I read, the more I keep finding things I should have started doing yesterday!
Diagnosis
We started to suspect something was wrong late last year: his appetite had gone through the roof. The vet tested him for hyperthyroidism and diabetes in december, both negative (blood sugar was only 100, even though he gets VERY stressed at the vet). Then his appetite continued to get worse and he started drinking excessive amounts of water, so we insisted on another test April 1: blood sugar was in the 500's! They didn't do a urine test, but the jump was high enough that the vet felt it was a conclusive diagnosis.
Initial Treatment
The vet immediately put him on 3u of vetsulin and scheduled him for a checkup in 2 weeks. (I didn't know at the time that that was a bit reckless to start so high. I assume the vet did it because Loki's such a big cat and his reading was so high.) The vet encouraged us to do 'casual' home testing: he suggested we buy a meter, but said there was no point in testing immediately. He also prescribed a change in diet, both for the diabetes and weight loss: previously, Loki was on Friskies canned and Purina One dry, and they put him on W/D canned & dry.
We were completely overwhelmed! So much information, so much to worry about! I did my research and settled on the Alpha Track 2 meter, but I wasn't happy with the lancet, so we got a Softclix. We've had no trouble giving him the insulin shots: Loki's a pretty laid-back cat.
Early Results
After 2 weeks on 3u vetsulin, Loki tested again in the 500s at the vet. Also, his water consumption had increased. Vet was pleased that we were so gung-ho about the home testing. He increased Loki's dosage to 4u, and asked us to home test a few times a week and let him know how it goes.
Just after this appointment, I learned about 'bouncing' from you wonderful people. I decided to keep him at 3u for another day, and try a glucose curve to check for this 'bounce'. In hindsight, going straight from never-used-a-meter-before to full-glucose-curve was a bad idea, but we didn't have much choice: I was NOT about to start him at 4u without knowing if he's dropping to dangerous levels mid-day.
It. Was. HORRIBLE. Well, the pre-shot and +2 hour checks went okay, but on the +4, we just couldn't get any blood: we FINALLY got a reading, but the poor baby got stuck so many times that we gave up testing for a few days. Anyway, 3 readings isn't much of a 'curve', but I hoped it was enough to at least rule out that he was dropping into hypoglycemia territory: pre-shot was 587, +2 was 378, +4 was 431.
He's been on the 4u for almost a week now. Our priority right now is to just get both him and us used to the testing, and so far the blood tests have gotten MUCH easier. His spreadsheet is pretty spotty right now: we don't want to test more than once or twice a day for the moment, while we're all still new at it, and we're sort of trying to spot check how he looks at various times of day. Unfortunately, as you can see, his readings haven't improved at ALL. I think he's drinking a little less, and his appetite has improved (he's not so frantic about getting every last scrap). Husband thinks he may be a little lethargic, but its hard to tell: he's always been lazy, and it's hard to tell if we're overreacting. Still, he's very responsive to pets and talking to him, and he doesn't seem confused.
Moving Forward
Step 1) Ketone test! The ketostix are in the mail. Should have done that sooner. Vet never mentioned it, and I missed how important it was in the avalanche of information
Must...be...more...vigilant.Step 2) Change his insulin dosage (with vet approval, of course). I don't know what the vet is going to recommend when we talk to him next. The gut reaction to his high readings would be "increase the dosage", but from what I've read, it would be better to start over at 1u and work up slowly, in case he's been bouncing. I dearly hope the vet agrees, because I don't know what I'm going to do if he pushes us to 5u or says that dropping to 1u is dangerous.
If we do drop from 4u to 1u, should we drop it abruptly, or taper him down slowly?
As for how quickly to increase it, I found the SLGS guidelines, http://www.felinediabetes.com/start-low-go-slow.htm, though I worry if 0.5 is too slow of an increase if he continues to test super-high at 1u.
Step 3) Reevaluate his diet. I went on a mathematics blitz the past couple days, and I am NOT happy with the W/D diet they put him on. It's actually no lower in calories or carbs than his previous diet, and the nutrition profile isn't good for diabetes: 40% calories from protein, 33% from fat, 27% from carbs. It's also much less calorically dense than his old diet, so the instructions on the bag have him eating a lot more food (by volume) than he's used to: we have to feed it to him spread out over 6 meals a day or he eats it all too fast and throws up, even when we take steps to slow him down.
Fortunately, Loki is not a picky eater. I've put together a new regimen that I plan to run past the vet tomorrow: canned Fancy Feast and a small amount of dry Blue Wilderness. This new diet has an appropriate number of calories (240 per day, as opposed to the 288 of his original diet and 267 of his new diet), only 15% of the calories are from carbs, is more heavily weighted towards canned food so he gets more water, and it's a smaller amount of food overall, closer to what he's used to, so hopefully we can go back to 2-3 meals a day.
Assuming the vet gives the okay, though, I'm not sure when to start phasing in his new diet. It's a pretty steep drop in carbs, and at 4u of insulin, that makes me nervous. Or perhaps we should keep his food as-is for now, and drop the insulin dosage first? Gah.
Overall, I'm just so worried that he's not responding to the insulin, and it seems like every choice we make is a knife's edge for things going wrong if we make the wrong move: raise vs. lower the insulin, test too much and stress him out or test too little and he'll crash, follow the vet's advice blindly vs. ignore the experts, etc. Did I mention that I take anxiety meds? I imagine it shows.
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Right now he's getting W/D treats, but I'll see if I can find something lower carb like one of your suggestions.