Newbie

Status
Not open for further replies.
Holtfam6

Holtfam6

Member Since 2022
Hello all-

just wanted to introduce myself. I’ll be working on a signature and spreadsheet over the next week. Things have been hectic. My college daughters cat lives with me and was diagnosed two days ago. Chance is 9 years old and came to us as a rescue. He had a feeding tube and a bad URI. We managed to nurse him back to health but it was a challenge. He refused to eat by mouth and it took a few months and lots of different cat foods. This was approximately 3 years ago. We finally got him to eat friskies gravy swillers and some fancy feast with gravy. We noticed he was losing weight the last month and took him in for a work up with now a diabetes diagnosis. He was 553 on original lab BS. He went in the following Monday to start insulin and was 515. We went with the Libre 2 and sensor and it seems to be working. He tests “high” in the morning despite two hours without food and before the evening dose. We managed to get him off the friskies dry. He does nibble a little on hill science DM dry but we’ve been successful at getting him on a low carb can. He is very underweight right now so it’s hard to judge how much he needs. I’d say it’s 3 cans of fancy feast a day. He started off 2.5 u pzt insulin twice a day but the lowest reading we got was 359 and 315 at approx 5-6 hours in. Vet increased him to 3 u twice a day which we started today to monitor closer. Better readings. We got down to 239-253. I’ve already learned so much from this group and look forward to learning more.

Kathy
 
You're doing a great job! I am heading to bed but wanted to quickly pop in to welcome you. Once that stuff is up and running I'll take a look, but right now it sounds like dose is ok (as in, safe, not over dosed - we see that sometimes with new cars here).

It would be best if you could eliminate the rest of that dry food - namely because its technically high in carbs and akes things a little unpredictable, so have to go slow and steady when that's in the picture.

Can you share what specific line and flavors of fancy feast you're feeding? Last I knew only the pates are considered truly low carb. We define low carb as anything under 10%, most of us aim for around 5% - https://catinfo.org/chart/index.php

I'm sure some others will be by to post some other helpful links - otherwise I'll be back around tomorrow.
 
Hi and welcome Kathy and Chance to the forum. :)
I would feed him whatever he wants, quantity wise, at the moment, if he is u nderweight, except for the two hours preshot.
Once his BG (blood glucose ) numbers ae more normal he will start to put the weight back on. At the moment he can’t use all the nutrients in the food. im going to ask @Bandit's Mom if she can look in and hel0 you with the spreadsheet and signature.
 
Thanks for the help and welcome! Chance is a very picky eater. I did manage to get him on the fancy feast pate. We are feeding him pretty much on demand and pushing the pate over the dry. Were spending a lot of time looking at different can cat food and figuring out carbs. tiki cat was a no go. fussie cat so far is also a no go. He pretty much gets the hills science dry diabetic out at night along with some pate to keep food assessable. We do stop feeding the two hours prior to insulin dose. He's currently down to 262. Talked to the vet today and he wants to increase him to 3.5 units ptz twice a day. Originally chance weighed around 11 pounds and is now down to 7.5 pounds. we feel horrible that we didn't catch this earlier! He does seem more peppy and like his old self when his sugar is down. we made a vet follow up in 12 days to change his libre sensor- still learning that part and a weight recheck. Im going to try to figure out the spreadsheet and signature.
 
ok my signature and spreadsheet should be here. would you go up to 3.5 units twice a day?
 
Holtfam6 said:
ok my signature and spreadsheet should be here. would you go up to 3.5 units twice a day?
Click to expand...
Thanks!

I would not. You will want to hold the 3U for at least 4-5 days, because he needs time to adjust to the dose. Technically since you're feeding dry, youd wait 7 days per our guidelines. If at any point she starts showing ketones (see link below) that changes things a bit so let us know.

I would remove the rest of the dry now, since his numbers are high enough that it should be safe to do so. Removing high carb food, especially dry, can have a big impact on BG. I'm not expecting much here because youd said he's grazing, but it will probably help with duration. The lower the numbers get, it gets a little "fun" trying to do diet transition and pin-the-tail-on-the-donkey proactively adjusting dose.

I know nobody likes to see the high numbers, but his nadirs weren't too bad today (relatively speaking, for a newly diagnosed diabetic) so I would be patient and wait.

Now - what's your feeding schedule?

You'll want a hypo kit going. You'll want a mix of wet foods - medium carb 10-15%, high carb 16-20%, and I like to have a few small cans of something like 23% on hand as well (use the list I linked earlier).

And test ketones at home. If you think can get urine samples, most people do that a few times a week (daily if the cat is ketone-prone). Some reading about ketones and DKA
 
We do have a hypo (emergency) kit ready. Got it off this group actually. Also Karo syrup and some sos glucose pet tubes that I got off Amazon. That was one of my first things before I started the insulin. Right now, chance is kind off all over with the weight loss and just starting this journey. His biggest meals either a small can of fancy feast or 1/2 a larger can at 08 and 8pm. He munches off and on throughout the day. Maybe a teaspoon to a tablespoon. He has a feeding area and let’s us know. He’s used to having his dry friskies available at all times which he doesn’t anymore so we are a little more generous with the wet. At night we leave a can of wet out and a little bit of the DM dry just because we want free food available while we try to sleep.
 
Stupid question on buying keto strips, can you use the human one or is it better for the pet specific ketones sugar ones?
 
Holtfam6 said:
Stupid question on buying keto strips, can you use the human one or is it better for the pet specific ketones sugar ones?
Click to expand...
Sorry I usually specifically day, human ones are fine! If you think urine sample will be tok difficult they make blood ketone meters, but the strips are fairly expensive. I use a NovaMax Plus.

As for feeding - the reason I asked is because he isn't getting good enough duration from the ProZinc, you can see he fizzles out right around +9 or +10. Ideally it should last the full 13 hours or a little more. There's a few possible reasons, or combination of reasons -
  1. Dose isn't high enough yet (you'll get there). Duration often improves as dose gets closer to being "right"
  2. Feeding after nadir. The insulin is wearing off at this point, so any food - even low carb - essentially adds fuel to the BG fire. I know you are concerned about weight gain - it is much harder for them to gain weight while in high numbers/unregulated, because they cannot process food fully. I am not staying limit the amount of food or calories, I am simply saying shift the times you feed to hopefully add some duration
  3. ProZinc just isn't a good insulin for the cat. It's too early to make this call, we usually say give it 2-4 months and see.
Edit please excuse the typos and billion hyphens, my brain and fingers are tired :confused:
 
Youre fine. that makes perfect sense about the feeding. Im going to pay closer attention to his feeding. He's used to eating at 2 which is half way through his day dose so I'll have to figure out something there since its better to feed on the epicycle vs down cycle. He's having a much better day today sugar wise. I'll update my graph later. just checked his sugar and he is at 203 at 1pm. Much more active and like himself. He ate a little at 11 but hasn't wanted anything since so just letting things ride.
 
Glad to hear it! And rules.you are seeing why we say wait a bit as they adjust, even when you know the dose isnt right
 
So looking a little deeper, the hills science DMthe vet recommended is 13% carb. We are going to try to leave no dry out tonight. Only can and see what happens. My daughter just worries about him dropping during the night. I told her looking at his numbers I think we are pretty safe.
 
Hi and welcome to the Sugar Cat Team.

Chance is gorgeous! The experts here can help so much. I am pretty new so just wanted to say hi and welcome to the club. Glad you found us, we can be new at this together. See you around the forum!
 
Last night chance dropped down to 75. Was asymptomatic. It was 2 am so it was 1/2 way through his Lantus cycle. My daughter gave him a little of the hills science DM dry and of course he’s high this morning. She gave him a sample of dr elseys chicken dry and he ate that during the day. I see that's acceptable carb level. Of course, everyone is out of it. I did order the turkey which is a little higher but better than hills science. chance likes his dry and it will be our spring project to hopefully wean him off dry completely. problem is he's a very stubborn kitty!
 
Can you please confirm what specific insulin he is on? Based on your first post I assumed you had mistyped an abbreviation for ProZinc, but now that you've mentioned Lantus and SS is setup I want to confirm because it does make a difference.

Either way with a drop to 75 you need to reduce by 0.25U
 
prozinc. He's running high right now. usually drops around 11. we left wet out for him last night which he really didn't touch. I did order some of the Dr Elsey's dry turkey only 2.2 lb. everyone is out of the chicken. I'm going to return the hills this week and switch to that at night if acceptable and only leave out a little for him. thoughts?
 
Holtfam6 said:
prozinc. He's running high right now. usually drops around 11. we left wet out for him last night which he really didn't touch. I did order some of the Dr Elsey's dry turkey only 2.2 lb. everyone is out of the chicken. I'm going to return the hills this week and switch to that at night if acceptable and only leave out a little for him. thoughts?
Click to expand...
Yep that's good!
Can you do me a favor next time you're in the spreadsheet, change it to say ProZinc.

Whenever you switch out the night food you'll want to keep a close eye on him. Right now he's bouncing from that low number, very normal, may take a few cycles to clear...but usually on ProZinc it's quick.

I'd actually suggest reducing by 0.5U, for two reasons - (1) you don't know how low he was before that 75, he normally nadirs earlier and (2) if you're swapping food it's better to take a bigger reduction to be safe.

Numbers down to 50 are safe on a human meter, so I don't think he was in any real danger. Just with the dry/high carb in the picture we really don't want them below 90.

Do you have a handheld glucometer? If so, when the Libre reads HI can you do me a favor and just compare a few of those to a handheld? I am curious whether the HI is 400s, 500s, or more.
 
Yes. i can do that. i have both. i bought a relion and the libre can actually be used both ways. I need the practice with the blood. Haven't done it before and with chance, it should be fun. He's getting some of his spunk back. Reducing 0.5 twice a day or the nightly dose? I can't really switch the dry for a couple days until chewy delivers. He's always been the type of cat who prefers his dry. Im really surprised he's open to change. I do have a small sample of the turkey that i gave him a few pieces of today to see how he'd do.
 
Last edited:
Holtfam6 said:
Yes. i can do that. i have both. i bought a relion and the libre can actually be used both ways. I need the practice with the blood. Haven't done it before and with chance, it should be fun. He's getting some of his spunk back. Reducing 0.5 twice a day or the nightly dose? I can't really switch the dry for a couple days until chewy delivers. He's always been the type of cat who prefers his dry. Im really surprised he's open to change. I do have a small sample of the turkey that i gave him a few pieces of today to see how he'd do.
Click to expand...
I would start with twice a day, consistency is usually best. If it'll be a few days - reduce 0.25U for now, then another 0.25U beginning with the shot before you give the new food. So if new food will start Tuesday night, Tuesday's PM shot should be reduced by 0.25U.

Last night could have just been due to the food, but better safe than sorry

Now if ketones start to show up we'll rethink that.
 
Did a couple manual readings. His 8pm before insulin was 401. I decreased it 0.5. My daughter does have a couple samples of the Dr. Elsey's so going to put a serving of that out tonight. part of the problem last night was he didn't eat any of the wet food that was left out. I'm hoping for better results this way tonight.. It sure is hard to get used to this ear thing for blood. Both chance and I don't like it. My daughter had to help hold him while he was wrapped like a burrito. I printed out a diagram showing the "sweet spot" Took a couple sticks. Even warmed a rice sock. I'm hoping it gets easier.
 
So I just found out I obviously missed Chance's am insulin dose. I could've sworn it went in. I felt it (I'm a nurse) and when i checked the fur (always double check myself that way) didn't feel anything wet. His libre kept reading high so I knew something was up. I waited for someone to get home to hold him for a manual (this cat has fight). His blood sugar is 510. Just double checking, just ride this out and give him the 3 units at 8pm right?
 
You're gonna wanna stab me (well, the meters) for this - I suspect it did go in, all of it. The human meters tend to read lower, and the pet meters tend to read higher (and it seems to get worse the higher you go).

Yes 3U at normal time, although if food change again I'd go 2.75U (the 2.5U last night didn't seem to cut it)
 
Yeah. This is definitely a new learning thing. It could have gone in. Knock on wood—I’ve been pretty good at making sure it in place.
 
Much, much better day today. this morning was hard and wondering if I could do this. It breaks my heart when I have to poke his ear multiple times to get blood. I warmed his ear this morning with a rice pack and it took 3 pokes to get a drop out of the right ear. The left ear does not want to bleed. Once we got past that, he has been in the 100s since noon. His food came in today so going to stay 3 units in the am and 2.75 in the evening dose for a few days and see what happens. Hopefully, its the beginning of better things not the calm before the storm.
 
Good!

He might just drop below 90 on you today...if he does, both doses should be 2.75U.

I would note in the remarks column why you're doing the different AM/PM doses so you don't get a ton of questions. Realistically I think 2.75U is good both cycles but up to you
 
ok sounds good. trying to figure out my groove. yesterday was hard because he was so high and I was questioning if I gave the shot right. I'm hoping to figure out and get a good balance for him. I know he must feel rough yo-yo ing. Thanks for all your help. Ive already learned a lot from you. Then I get nervous and think if this is working, I don't want to rock the boat too much.
 
so my novamax plus came ketones 6pm tonight 1.7. blood glucose 452. received 3 units prozinc 0800 this morning. yesterday was rough blood sugar wise. kept high on libre. gave chance a chance to destress and didn't poke him. He was hissing when I gave insulin. great appetite. did a home weight and appears he gained a little over a pound in a week. the day he had excellent blood sugars, we fed him stella and chewys pate. tried it today and it looked like he was going to be good but didn't quite turn out that way. going to try again tomorrow. question is what to do about the ketones?
 
Only thing to do about ketones is keep him eating, and as much water as possible. Make his food soupy, etc.

It's a little higher than I'd like to see, need to keep an eye. I'd test again in the morning. If he starts acting off or lethargic I'd take him to ER vet.

Ok what's the high carb dry food situation? Is he still getting it, or you have the Dr Elsey's now?
 
He's got the Dr Elseys turkey (chicken unavailable. checked again tonight on chewy) we give 1/2 cup. My daughter says he "pigs out" at night. I told her to put out 1/4 cup when she goes to bed and have another 1/4 bowl to put out later in the night when he gets obnoxious for food. He sleeps in her room at night with the door closed otherwise dog and other cats would eat his food. He has a cat water fountain in the room. During the day, low carb food. maybe 2 cans a day. Do you think I should just do 3 units twice a day for a bit?
 
Last edited:
@Wendy&Neko what are your thoughts here? Chance is on low carb diet, but does have Dr Elsey's in the mix. The ketones are climbing a little higher than I'd like to see on the blood meter, I'm waffling between holding the 3U for another 3 cycles, or doing a 0.25U increase. That 75 a few nights ago was a Libre which I always question a bit when they get lower.

He was originally on high carb dry at night, the first night they swapped for Dr Elsey's was the 75. She was a little worried about more drops so was doing lower doses at night, so there was some back and forth about dosing.

If it weren't for ketones where they are, I'd say hold another 2 days ish
 
Holtfam6 said:
so my novamax plus came ketones 6pm tonight 1.7. blood glucose 452. received 3 units prozinc 0800 this morning. yesterday was rough blood sugar wise. kept high on libre. gave chance a chance to destress and didn't poke him. He was hissing when I gave insulin. great appetite. did a home weight and appears he gained a little over a pound in a week. the day he had excellent blood sugars, we fed him stella and chewys pate. tried it today and it looked like he was going to be good but didn't quite turn out that way. going to try again tomorrow. question is what to do about the ketones?
Click to expand...
I personally would not worry about 1.7. My boy lived with numbers in that range for a long time. Agree with Melissa about the food/water. As long as he has a good appetite, all should be well. Just watch out for vomiting or lack of appetite and excessive lethargy. You know your cat best and will know if something is not right.
 
Now that you have the blood ketone meter, you will be able to test daily and see whether they go up or down. When my cat hit 1.7 or 1.6 that was down quite a bit from where he had been before (and he was at 14 units of insulin at that time - but he was a high dose cat).
 
I sometimes do my best thinking at 3 am. My question is regarding the ketones, could this be resolving/improving ketoacidosis? Chance's blood sugars were over 500 at the vet and he was/ is very underweight. He was 11 poundish before diabetis. when we went to the vet, he was 7.5 pounds. His blood sugars are improved a tad. He's gaining weight. I know we still need to watch him close as he's still brittle right now. Just a thought, when I was trying to analyze clinically. I'm much better with humans than cats. I do agree holding insulin where it is might be good. I do find when I feed him the stella and chewys pate foods, his blood sugar is better compared to other foods with low to no carbs. We are on day 2 and his night blood sugars improved also. He gets the Elseys at night. Any thoughts on that food?
 
Holtfam6 said:
I sometimes do my best thinking at 3 am. My question is regarding the ketones, could this be resolving/improving ketoacidosis? Chance's blood sugars were over 500 at the vet and he was/ is very underweight. He was 11 poundish before diabetis. when we went to the vet, he was 7.5 pounds. His blood sugars are improved a tad. He's gaining weight. I know we still need to watch him close as he's still brittle right now. Just a thought, when I was trying to analyze clinically. I'm much better with humans than cats. I do agree holding insulin where it is might be good. I do find when I feed him the stella and chewys pate foods, his blood sugar is better compared to other foods with low to no carbs. We are on day 2 and his night blood sugars improved also. He gets the Elseys at night. Any thoughts on that food?
Click to expand...
It could be that he started higher, yes. The ranges on the ketone urine strips are all different, but it's possible he's been floating right below trace on those strips and is coming down.

Lot of people here feed the Dr Elsey's, one of very few low carb kibbles out there
 
so basically chance's body is trying to expel the excess sugar or his body is trying to revert to homeostasis or a more balance and normalizing blood sugar. His body was "adjusted" to high sugars so now he has to readjust to insulin and lower blood sugars is what you mean by bouncing right?
 
Did he have DKA or ketones on his diabetes diagnosis? If so, please put that on the signature. Gaining weight is excellent!
 
no, no official diagnosis on ketones. Just tested for first time yesterday. I'm just assuming that maybe he had ketones with the weight loss and muscle wasting.
 
followed up. ketones 0.8 the other day so are dropping. Questioning if I should increase the prozinc to 3.5 units twice a day. thoughts? Happy Easter and thanks for all the help and support! You are so appreciated.
 
How much of the Elsey's is he getting now? The rest is low carb wet food right?

Technically with the dry you will need to hold the 3.25U for a week, but if the dry is more like "treat frequency/amount" you have a little more flexibility. It just takes them a little longer to settle into a dose with the dry food as actual meals
 
He gets 1/2 cup total at night. 1/4 when we go to bed and 1/4 when he wakes us up in the night. He boycotts the wet at night. The rest of the time is low carb wet.
 
FrostD said:
How much of the Elsey's is he getting now? The rest is low carb wet food right?

Technically with the dry you will need to hold the 3.25U for a week, but if the dry is more like "treat frequency/amount" you have a little more flexibility. It just takes them a little longer to settle into a dose with the dry food as actual meals
Click to expand...
@FrostD Chance is so high right now, what do you think about an increase soon? Even with the kibble, for now he’s only seeing high blues for nadirs. Maybe at least in the next day or so?
 
Suzanne & Darcy said:
@FrostD Chance is so high right now, what do you think about an increase soon? Even with the kibble, for now he’s only seeing high blues for nadirs. Maybe at least in the next day or so?
Click to expand...
This is where I usually say the dosing methods say this, but I also think this would be ok, your choice lol

So - because of the dry food the dosing method says to hold a dose for a week. Additionally, if nadirs are below 150 it also says to hold. That said, you test/scan enough that a 0.25U increase should be ok. He only had one nadir below 150, and he's so high overall, an increase at some point soon is warranted.
 
FrostD said:
This is where I usually say the dosing methods say this, but I also think this would be ok, your choice lol

So - because of the dry food the dosing method says to hold a dose for a week. Additionally, if nadirs are below 150 it also says to hold. That said, you test/scan enough that a 0.25U increase should be ok. He only had one nadir below 150, and he's so high overall, an increase at some point soon is warranted.
Click to expand...
Exactly. I think, for now, that he is so high that an earlier increase may be warranted- and most importantly, I think will be safe. Later on when he is in lower numbers, if the dry food is still a factor, then the doses can be held for longer.
 
today was an off day, I did miss skin on his am insulin so he was high all day on his sugars. I didn't do a manual as I had two vet appointments today. One for my son's dog who is stationed in Germany right now with military. The afternoon for chance. He has gained slightly over a pound in two weeks. Vet says he looks 100% better. Much more active and alert. I did give him a print out on his sugars for the past two weeks and he suggested 3.5 units prozinc twice a day. I do think we are on the right path thanks to the support here.
 
Status
Not open for further replies.
Back
Top