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Eggburtsmom

Member Since 2014
Good Morning! I'm trying not to overreact to my sugar kittie's lack of appetite.
Newly diagnosed (started Lantus yesterday-BS in vet's office over 600). Glucometer should be arriving today. I'm a pediatric RN, so I know how important it is for kids to eat with insulin, but I don't want to stress out my boy forcing him to eat. I thought his appetite was better than it is-he has been showing up for meal times, but I guess not eating very much. We were a 3 cat house hold until Saturday (lost one to a stroke) and I thought empty food bowls meant everyone was eating. I should have gotten a clue from the pig-fat brother (feline vacuum).
Anyway, gave the Lantus this am with him only taking a few bites. Will observe for hypo, discreetly.
Feeding w/d from vet (wet and dry). He took a few bites of each. I did the no-no of a rapid food swtich (from ONE Urinary Tract Health dry) and the vet started him on Clavamox yesterday for a slight UTI. I fear all of these changes (along with my staring at him while he eats!) have thrown him for a loop.
I need a hug!!!
 
{{hugs}} as requested.

What dose? Many vets start too high. For Lantus, you take the lower of current weight or ideal weight, in kilograms (pounds/2.2), multiplied by 0.25, rounded down to nearest quarter unit (we eyeball 0.25 and 0.75 increments).

The prescription foods are generally too high in carbohydrate for an obligate carnivore. Since you're not testing yet, I wouldn't change the food. We've observed a 100 mg/dL drop in glucose by changing to over the counter canned low carb food, such as Friskies pates or Fancy Feast Classic pates. See Cat Info for more details and a printable food nutrition chart.

Vet stress can raise the glucose from 100 to 180 mg/dL, too so numbers may be substantially lower at home.

Also, pick up some urine ketone testiing strips and see my signature link Secondary Monitoring Tools for tips on using them, plus other assessments you may wish to make, such as weight and dehydration checks.
 
Thanks, BJM, for the hugs!
3.5u Lantus on an ideal weight of 15lbs. By your calculations he should be on 1.7 or 2u. Hmmmm...now I really can't wait until the glucometer gets here.
My initial question, lost in all my babbling, should I be very concerned about his lack of appetite and giving the insulin? Although, what I observed him eating this am may be his new "norm" due to the diabetes.
I will settle down, he seems fine except for an exasperated look on his face.
 
Hi Chris and sugarkitty Eggburt and welcome to the message board. Sending more hugs your way.

My initial question, lost in all my babbling, should I be very concerned about his lack of appetite and giving the insulin?
Click to expand...
With that high of a starting dose, I would be concerned. Vet stress can raise the BG levels 100-180 points (mg/dL) and an infection can also raise the BG levels. You are feeding a very high carb food, so that is probably helping to keep Eggburt's BG numbers artificially high.

Do not change the food until you are home testing! My sugardude Wink was on the Hills' W/d food and I slowly switched him to low carb food. His BG readings dropped rapidly and if I had not been home testing, I probably would have lost him to hypoglycemia.

Lantus is a depot type insulin, so only part of the dose goes to work right away, the other part goes into "storage" to be released slowly over time. It's not until the depot fills up, which usually can take 3-5 days, that you see the full impact of the dose you are giving. There's a fuller explanation of the depotover in the Lantus TR forum.

It's much safer to "start low and go slow" on the dose, since once it's in, you can't take it back out.

If you're concerned and have a drugstore nearby, you could pick up a human glucometer to test. We have reference ranges for the human vs pet glucometers and find the human glucometers accurate enough for our purposes. The test strips are so much less expensive than the pet meters too. You want to keep the numbers above 50 mg/dL on a human meter, over 80 on a pet meter. That gives you a built in margin of safety.

I use a Relion confirm meter from Wal-Mart. It only cost about $16 and test strips are $36/100. I started with an Alphatrak, but the test strips at $1-2 apiece were too expensive for my budget.

Having some karo syrup or another simple sugar on hand, plus some high carb wet food can help to raise the BG levels quickly. I'd go get some Fancy Feast gravy lovers food to have on hand, because you want to be able to get those numbers up quick without filling him up too fast and you can 'squeeze' the gravy out of the can to do that.
 
As Deb said, Lantus has a bit of a delay (about 2-4 hours after a shot) before it starts kicking in for that shot. Once you pass the 5-7 days after initially starting Lantus, you'll notice there's a bit of an overlap with the doses so as the last dose wears off, the next dose starts kicking in (one of the reasons Lantus is a preferred insulin for cats). What that all means is that as long as your cat is not having any appetite issues, they don't have to eat at shot time. It's actually better for them to eat around 5-7 hours after a shot (if necessary) when Lantus hits its peak/nadir and you're more likely to see low numbers.

I also agree with everyone else that that's a fairly high starting dose and I would suggest you to reduce the dose significantly (like around 1u) as well as start testing to make sure he's not dropping too low or staying too high. Especially because it sounds like he might have a lack of appetite (not enough food in means insulin needs are lowered).
 
Thank you, everyone.
What a difference 24hrs makes. After some fumbling this am checking his sugar-as I stuck myself more than him!!! (@0700 189 fasting on a 2u dose of Lantus given at 1700), we got it done!! He is SO patient. He was really hungry when I came home from work and ate rather well. I swear he already feels better and there is less urine in the litter pan.
I'll check him in 3 hrs and keep you posted!
Thanks again!
 
Did you order a pet-specific meter? Those have really expensive test strips and at the recommended minimum of 4 tests a day (2 pre-shots, a midcycle, and a before bed so you can sleep ... or not) with a strip as much as $2 each, $8 per day, $240 a month, that can really bite the budget.

We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WallMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses. A tiny blood droplet and the cost is significantly lower for test strips (like $0.18 each).

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Thank you, BJM.
He was 137 about 3 hrs after his am dose, using a human glucometer (very familiar with them as I'm an RN). Tonight he was 389 before dinner, so he got his full dose tonight.
The chart is VERY helpful!
Can anyone describe to most effective technique for pricking the ear? It takes me at least 3 pokes each time.
 
Chris,

If you would include the brand of meter you are using for testing in your signature, that would be very helpful for us.
 
So. what a difference a week makes.
Eggie and I have settled into a pretty good routine. When I am good with being 12 hours apart, his BS are in the 70's. He is such a trooper about the glucose checks and the injections.
The only ongoing issue is his appetite-he really doesn't like the canned food-he does do a little better with chicken flavored. He will eat for about 3-4 minutes (approx. 3 oz twice a day).
Any recommendations for a dry food he can eat? I think Wellness makes a chicken kibble, was curious if anyone had any experience with it.
Thanks!
 
You might try sprinkling the food with:
grated Parmesan cheese
a little bit of Stella and Chewey's freeze-dried food
crushed, dehydrated shrimp (Halo liv a littles)
dried bonito flakes (check an Asian market or online)
a little crushed kibble

You might try baking the canned food spread out thinly on a baking sheet to dry or crisp it up as a transition method (keep refrigerated or frozen if not using right away)


After unsuccessfully trying the above, you might try:
Evo Cat and Kitten kibble (8% calories from carbohydrates)
Young Again 0 Carb (5% calories from carbohydrates)
 
Wink was a dry food addict when I first got him, so I tried lots of tricks to get him to eat.

1.Wink liked to have his wet food heated up a bit, so it was smelly and more tempting to eat.
2. crumble Halo Liv-a-little freeze dried chicken on top of the wet food. This was has absolute favorite and would get him to eat more.
3. pour a tablespoon of tuna juice over the wet food.
4. Fancy Feast Turkey & Giblets flavor was his hands down favorite flavor. He liked this even better than the chicken flavors.
5. Give him a selection of 2 different flavors, sort of a smorgasboard to eat. This would get him to eat a bit more.
6. Meal feed. This gets his natural appetite working in you favor. If your kitty is a bit hungry, they may eat a bit more.

My Wink eats a lot better now then he did in the beginning, but it was definitely a struggle to get him to eat the wet food and I had to be persistent. It took a good 6 weeks to get him transitioned over from the dry to the wet food. If I gave him a choice, he'd still be eating the high carb dry food. ohmygod_smile
 
Sounds like he is doing good - is he in the 70s all the time.. or what is his nadir?

I wonder if he is heading into remission..

1. if he ever drops under 50 ( typically at nadir 5-7 hours after shot and more likely at night!!) then drop the dose 0.25
2. if he stays 50-130 for a week - drop the dose 0.25

Many cats go into remission and you need to watch for it - you don't want to overdose when his insulin needs change.

Wendy
 
Thank you, everyone. I've been trying the suggestion. He was a nibbler as a dry food cat, so I think his biggest issue is eating a lot at one time. His fav does indeec seem the be the FF Turkey and giblets.
Where can I get the Halo treats you've mentioned. I didn't find them at my grocery store (no big surprise there), but I also looked at Pet Supermarket with no luck.
I haven't done any nadir testing yet. Have had a wicked work schedule. Planning on doing that this week. He goes back to the vet the following week.
thank you again for all of your help and support.
Chris and Eggie
 
On the Halo Liv-a-little treats, Petco carries them. I've also ordered them online from a couple of places, like Chewy.com.

Let us know how the testing goes this weekend.
 
Good Evening! We haven't been posting because things are going really well. His fructosamine level a few weeks ago showed him in tight control. He still is a "grazer", but we have had 99 % of pre meal BG levels in the 50-80 range-totally food dependant, higher levels when he had shared 1/4 cup WD dry over 12 hrs with my civie Puck. I'm trialing OTJ juice tonight, as he has been consistently in the 60's and even dropping into the 50's on 0.5 to 0.25u Lantus BID.
It's wonderful to see my old cat back-he's even been playing!!!
How long does he have to go to be considered OTJ?
Thank you for all of your support.
Not so "Newbie" Mom
 
If he can go 14 days with no insulin and keep his glucose level below 130 mg/dL, we consider him off the juice ... and throw a party!
 
Thank you, BJM and will do!!!
Oh, I think you left the BG level out. What should it be? Stupid question, continue to check pre meal BG's?
 
You want his blood to be between 40-130 without insulin for two weeks to be considered OTJ. You can help by giving him mini meals through the day instead of big ones which can stress a healing pancreas.

I would test him 1-2 a day at various points.
 
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