New to the group + question about changing food safely

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Max and Brooke

Member Since 2022
Hello everyone!

I'm Brooke and my diabetic cat is Max [age 10]. This is my first post in the group but I've been reading the threads off and on (since adopting Max) to get answers to more straightforward questions and now my question isn't that straight forward, so it's time to dive into the wealth of knowledge you all have :).

TLDR version: I'm wondering how I transition from his current prescription dietetic diet that's a dry+wet food combo to all wet, low carb food while managing insulin and blood sugars, especially since I've made some mistakes with his insulin over the past few days and he's not as stable as he was.

Backstory:
Max was diagnosed with diabetes and diabetic neuropathy after being surrendered to his rescue in Feb 2020. He was stabilized by them on 2.5 units of Lantus twice per day and a diet of 1/4 cup Purina Dietetic DM dry with 1/4 can Purina Dietetic DM Savoury Select Wet food.

I adopted him in September of 2020 and have kept everything the same because I thought the vet's optimized his insulin and diet as much as they could and it would be best to keep the status quo. I would do the occasional glucose curve when needing to refill his insulin prescription and the odd test every now and then. [I did include these readings on my 2022 spreadsheet for extra info because I have been so sporadic with glucose testing]

In 2021, I spoke with Max's rescue vet, and the vet I took Max to for a second opinion regarding the readings and both stated his numbers were good as long as his symptoms have been stable and no change to insulin was needed. I also asked about switching his food at this time because I had learned (from here :)) that store wet food can be ok depending on carb amount but the vet recommended he stay on the prescription diet and wasn't much help outside of that. Because the prescription food was relatively affordable and I was overwhelmed by information I decided to keep everything as is.

Present day:
Now that the cost of his food has almost doubled my motivation to switch to an all wet low carbohydrate diet has been renewed [I'm paying close to what I did when I fed my Great Dane raw]. The problem is, I'm at a loss as to how to transition to wet while also being on insulin.

I have done a spreadsheet for the past few days of readings and have definitely thrown things out of whack by trying to phase out the dry food and go to the dietetic wet on day, which resulted in what I thought was a low reading (but actually wasn't) then held his insulin when I probably shouldn't have because I was worried about him dropping even more while I was at work.

And today I did everything wrong again because I read the stickied "how to handle a low" and other linked posts in the Lantus section after the fact, and held his insulin for a low reading but fed him his regular meal (I realize now I should have given him small amounts) So, now his sugar is super high.

Which leads me to my question:

How do I transition from his current prescription dietetic diet (dry+wet food combo) to all wet, low carb food while managing insulin and blood sugars, especially since I've mucked with his insulin over the past few days and he's not as stable as he was?

Thank you in advance for your help! I'm going to consult with his vet about this too but I'm not holding my breath that they be super helpful.
 
Welcome Max and Brooke I will tag a few members for you but I did notice
one thing on your spreadsheet those 2021 dates should be above your 2022 dates so if you can fix them that would be great
 
Max and Brooke said:
Hello everyone!

I'm Brooke and my diabetic cat is Max [age 10]. This is my first post in the group but I've been reading the threads off and on (since adopting Max) to get answers to more straightforward questions and now my question isn't that straight forward, so it's time to dive into the wealth of knowledge you all have :).

TLDR version: I'm wondering how I transition from his current prescription dietetic diet that's a dry+wet food combo to all wet, low carb food while managing insulin and blood sugars, especially since I've made some mistakes with his insulin over the past few days and he's not as stable as he was.

Backstory:
Max was diagnosed with diabetes and diabetic neuropathy after being surrendered to his rescue in Feb 2020. He was stabilized by them on 2.5 units of Lantus twice per day and a diet of 1/4 cup Purina Dietetic DM dry with 1/4 can Purina Dietetic DM Savoury Select Wet food.

I adopted him in September of 2020 and have kept everything the same because I thought the vet's optimized his insulin and diet as much as they could and it would be best to keep the status quo. I would do the occasional glucose curve when needing to refill his insulin prescription and the odd test every now and then. [I did include these readings on my 2022 spreadsheet for extra info because I have been so sporadic with glucose testing]

In 2021, I spoke with Max's rescue vet, and the vet I took Max to for a second opinion regarding the readings and both stated his numbers were good as long as his symptoms have been stable and no change to insulin was needed. I also asked about switching his food at this time because I had learned (from here :)) that store wet food can be ok depending on carb amount but the vet recommended he stay on the prescription diet and wasn't much help outside of that. Because the prescription food was relatively affordable and I was overwhelmed by information I decided to keep everything as is.

Present day:
Now that the cost of his food has almost doubled my motivation to switch to an all wet low carbohydrate diet has been renewed [I'm paying close to what I did when I fed my Great Dane raw]. The problem is, I'm at a loss as to how to transition to wet while also being on insulin.

I have done a spreadsheet for the past few days of readings and have definitely thrown things out of whack by trying to phase out the dry food and go to the dietetic wet on day, which resulted in what I thought was a low reading (but actually wasn't) then held his insulin when I probably shouldn't have because I was worried about him dropping even more while I was at work.

And today I did everything wrong again because I read the stickied "how to handle a low" and other linked posts in the Lantus section after the fact, and held his insulin for a low reading but fed him his regular meal (I realize now I should have given him small amounts) So, now his sugar is super high.

Which leads me to my question:

How do I transition from his current prescription dietetic diet (dry+wet food combo) to all wet, low carb food while managing insulin and blood sugars, especially since I've mucked with his insulin over the past few days and he's not as stable as he was?

Thank you in advance for your help! I'm going to consult with his vet about this too but I'm not holding my breath that they be super helpful.
Click to expand...
@tiffmaxee

@Wendy&Neko

@Suzanne & Darcy

@Bandit's Mom
 
If that 34 this morning was accurate, 2.5 units is too much insulin. Try 2.25 unit tonight. Any time they go under 50, the insulin dose is too much and needs to be reducecd.

Have you started the food transition yet? If not, do it very slowly, maybe a 10% of his food per day. Since you are home testing, you'll be able to see if his dose needs change by him going low again.
 
Wendy&Neko said:
If that 34 this morning was accurate, 2.5 units is too much insulin. Try 2.25 unit tonight. Any time they go under 50, the insulin dose is too much and needs to be reducecd.

Have you started the food transition yet? If not, do it very slowly, maybe a 10% of his food per day. Since you are home testing, you'll be able to see if his dose needs change by him going low again.
Click to expand...

Thanks for the feedback! I'll try the 2.25u tonight and add the readings to the spread sheet. I was concerned when I saw him climb to 350-380's after his meal but he's come back down to 16.1 before insulin so, I'm starting to think the 2.5 is too much as well.

I haven't started the transitioning yet because I wanted to see what his sugars were doing first, so I'm planning to start the switch with his evening meal tomorrow since I'll be home to test him that evening and next day. The 10% slow route definitely gives me a good starting point for where to even begin.

Question:
When I start, should I lower his insulin further from the 2.25 (if results are in a normal range) to account for the 10% less DM food or test him for the night (with a moderate-high carb gravy to bring his sugar up if needed) to see how the readings look and make changes to his morning dose? The prescription wet food is 6% carbohydrate and dry 18%, I'm switching to Fancy Feast Pate which has between 2-3% carb so, I'm wondering if going slow means it'll take a day or 2 of less DM to start affecting his glucose readings enough to maybe lower insulin?
 
Are you still doing custom dosing? If so what’s your reduction number? I would not reduce until The bg falls under that number provided you test and monitor. I’d try following SLGS until the dry is out of the picture and then decide if you want to do TR. That means reduction under 90 but you won’t need hc unless under 50. If falling rapidly early in the cycle try mc (about 10-15%) .
 
tiffmaxee said:
Are you still doing custom dosing? If so what’s your reduction number? I would not reduce until The bg falls under that number provided you test and monitor. I’d try following SLGS until the dry is out of the picture and then decide if you want to do TR. That means reduction under 90 but you won’t need hc unless under 50. If falling rapidly early in the cycle try mc (about 10-15%) .
Click to expand...

I have been using a "custom" dose but it was based on what his vet stabilized him on and wasn't given a specific number to watch for/ insulin adjustments to make outside of watching for change to symptoms [like increased thirst and urination] and to call if that happens. On the odd occasion he's had lower readings I would either hold the dose if I had to work or decrease it by a random amount and test him to make sure he didn't go too low. So, after learning there's a structured way to deal with adjustments through the TR vs SLGS protocols I'm both relieved it doesn't have to be so half hazard and mad that if I knew about this earlier, and the diet stuff earlier, I could have been on top of this much sooner.

Long story short, I was leaning towards using the SLGS method moving forward and, if needed, switch to the TR method (vs. TR then SLGS) so your recommendation helps confirm my intuitive pull to SLGS. So, I'll start that tomorrow morning.
 
I’m happy you will follow a method. It makes it a lot easier and remember nothing is set in stone. You can switch at any time. Please change your signature and spreadsheet to show you are following SLGS.
 
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