newly diagnosed and it's a big mess

Hi, my cat was recently diagnosed with FD. He is 10 yrs old and 17.5lbs. About 2 weeks ago I noticed him drinking and voiding more than normal. He has not seen a vet since he was a baby. He is inside only cat with no other indoor pets and no obvious health problems. Needless to say, getting him in a carrier and in a vet's office was extremely stressful for us both. He also had to be sedated for the exam and all other testing. Vet did labs and urinalysis (he did not have a UTI but glucose in urine was 1000mg/dl) and made diagnosis. He was diagnosed on 3/16/21. His glucose from his blood work was 477 and the ear prick at the vet's office was 546. Vet wanted to keep him and run glucose curve. Me and him were so stressed out from the dogs barking at the office that I refused to leave him and offered to do any glucose checks at home and manage this at home. So we were sent home with Vetsulin and instructed to check glucoses every 12 hrs and give 5 units of insulin every 12 hrs. His previous food was Pruina Pro Hairball Formula (which I now know is extremely high carb). The vet gave us Hills Science diet dry W/D (which I now know isn't much better). I had already started the new vet food and giving insulin injections before I found this site. I wish I had known SO much more before our trip to the vet. He ate the new food (Hills W/D) really good for a few days but basically is refusing it today and only ate about half yesterday. Vet wanted him swapped to completely Hill's on that day, so there was no slow transition of food.

Glucose levels have been as follows: (I will work on a spreadsheet but needed help quicker than I can figure that out)
3/16: 9PM 454 (5 units given)
3/17: 9AM 292 (5 units given) then 9PM was 306 (5 units given).
3/18: 8:30 AM 374 (5 units given)
[Previous readings were sent to vet's office who instructed me to increased to 7 units every 12 hrs]
Next glucose check at 7PM was 513 and I gave 7 units. I rechecked it at 10PM and it was 392.
3/19: 5:30 AM 239 (5 units given as this was my first day to leave him I wasn't comfortable giving 7). At 8:15 PM glucose was 405 and I gave 7 units.

3/20: Since I would be home today I wanted to try a glucose curve and see exactly what has been happening. I felt like he was probably dropping during the day and then "bouncing" as I have read from different posts.
9AM - 252
10AM - 7 units of vetsulin given (a little late bc he was hiding under my bed)
11AM - 303
1PM - 123
2PM - 65 (asymptomatic - karo syrup on purina food because he still won't eat Hill's)
2:30PM - 73
3PM - 96
4PM - 128 (He has now started eating some of the Hill's that I had left out)

I'm not sure how to fix this mess that we are in. I would like to switch him to low carb wet food but hate to make two different food swaps in such a short amount of time. Right now the only thing I know he will eat is his old purina food and may eat some of the Hill's. I can clearly see that this 7 units is way too high and I don't understand how the vet only wanted AM and PM readings to decide to increase his dose. I wish we could just start over but I'm not sure how. Please give any advice regarding how to manage from here - do I give any insulin tonight/tomorrow? When and how can I transition to a low carb food? I'm also not sure whether to tell the vet I won't be following his plan of find another vet.
I hope this posts right as I have never used any type of forum but am desperate for help and what I have read on here seems to be more knowledgeable than my vet. Thanks in advance for any advice!

 

My first vet prescribed Vetsulin and I had food issues as well, she doesn't like wet food much at all, but when we moved to a new city, the vet insisted we switch to glargine/lantus and Maggi has been on that ever since. I agree that you get much more help here than at the vet's office. We have since moved back to CA and have another new vet, but now with Covid we can't even be with her in the office. I share your frustration, all of this is very confusing and frustrating. I have tried the Freestyle Libre monitor but the new vets can't seem to figure out how to mount them properly, but even a few days gives more accurate readings than the disaster we had doing curves at the vet's when stress makes the numbers unreliable as well. It is a learning curve gauntlet but sounds as though you are doing all you can and others here will add more helpful information for you. Hang in there.

 

Thanks for the reply and encouragement!
I can't imagine doing curves at the vet's office. Luckily even with covid the vet I used still allowed owner's inside the clinic. I asked before I scheduled the appointment because I don't think I could handle all that being done and me sitting outside.

 

Agree, dose is WAY too high, even with the food in the mix.

Is there any history of ketones or DKA? Do you have supplies to test for ketones? Link here

Any other underlying health issues, possible infections?

If no history of ketones, DKA, or other issues - if it were me I'd drop to 1U and start the transition to low carb wet, slowly. I'd start it when you have a few days you can monitor throughout the cycle.

Great job getting started on the forum by the way, I just had a slight panic attack when I saw the dose!

 

Thanks for the reply! No history of ketones or DKA. At his appointment on 3/16 he had no ketones in the sample. I don't have supplies to test for ketones yet but will be looking into that. No other health issues. I messed up this mornings dose bc I've been sick and had to go to the doctor's office and he wouldn't come out of hiding for me to give his the AM dose. So I kinda started over tonight... with 1U. I'm trying the transition to low carb wet - he isn't interested and will lick it for 5 minutes or so and walk off. I may have to give him more of his old purina than I want to and I know that will cause these glucoses to be higher but I guess I just keep taking it slow. I tried putting some of his old purina in the wet and he didn't even look at it. As sick as I've been I had to call into work last week and will probably miss some days this week so I plan to do some extra glucose checks while I try to give him more of the wet. I'm also not sure if there are certain flavors of the wet that cats like more than others?

Several people have panicked at the dose. I wish I had known so much more when I started this. I could have questioned the vet more. I was hesitant when he increased us to 7U so quickly bc at that point I had read some information but was still learning. And didn't know what else to do bc his PM glucoses were so high - probably "bouncing" now that I know. Not sure if I will talk to them tomorrow bc they wanted a weekend update on Monday and I haven't done anything they said do this weekend.....

 

I wouldn't beat yourself up, so many of us did what the vet said and ended up with issues. They're supposed to be the expert, why would I doubt what they tell me? And then something happens and a Google search leads us here and we get an overwhelming crash course. Just breathe - Tuko is ok, you ended up here before anything bad happened, and you'll get the hang of it!

As for the flavors, all cats are just so different, some just really like their crunchies.

I saw your post in the Feline health forum, glad we all gave the same advice. I personally would look for a new vet, but I know that can be hard depending on where you live.