Newly diagnosed cat options

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It’s been about 24 mins since the karo gum rub and I just tested him at 79. So the big question is what to do tomorrow AM at around 630am when we leave for work. I can give fancy feast and dose 1U but I’m super concerned that if I can fancy feast and keto kibble with no dose and he was in the 50s, what will happen with just fancy feast and 1U? Am I making sense here? If I didn’t dose and gave ultra low carb and there was panic, What happens if I give low carb and low dose?
 
First of all you will need to test to see he is high enough to give insulin to in the morning.
If you read back on this thread you were advised by others who are familiar with Vetsulin to reduce to 1 unit and not give it unless the BG was over 225 or 250 @MrWorfMen's Mom
 
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Bron and Sheba (GA) said:
First of all you will need to test to see he is high enough to give insulin to.
If you read back on this thread you were advised by others who are familiar with Vetsulin to reduce to 1 unit and not give it unless the BG was over 225 or 250 @MrWorfMen's Mom
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To be clear, we’re not ignoring advice. We decided that after this morning we would start trying to follow a new plan as laid out here and abandon the plan given to us by the vet. If you look back, this afternoon I gave low carb food and did not give any vetsulin the food mixture was implemented because Ziggy didn’t seem to care at all for just wet food.

After feeding the very low carb mixture tonight, Ziggy’s BG was low. I tested just before feeding and he was in the high 40’s (after what we decided would be the last vet-instructed feeding of w/d food and 4u vetsulin). It seemed to be so low that I thought something was wrong with the machine, since he seemed totally normal. I supposed I’m still thinking of diabetic students and family members I’ve seen drop low, but I also had early issues getting readings and had to swap out the stock battery when I received it, so I thought maybe it was just off. In retrospect, it seems the prescribed feeding/dosing plan was just sugar loading and glucose depletion that was bringing Ziggy dangerously low. that’s part of my questioning.

Ziggys blood sugar was too low. You mentioned giving 1U of vetsulin, but I’m wondering how that wouldn’t still be problematic. To be clear, when I fed low carb this evening, I gave no units of vetsulin. Tomorrow morning I’ll feed just fancy feast. Is 1u too much even then?
 
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I suppose my question was more along the lines of whether or not this evenings results were tainted by this mornings vetsulin dosage.

To be clear, we only relied on this vet clinic because they’ve been treating our dogs for the last 6 years or so. When this diagnosis came along, the treatment came along, the treatment logic just seemed wrong. But, rejecting it and starting something contrary meant any harm to Ziggy because of that rejection would be our own doing. So, as I alluded to, we decided that we would follow the vet’s orders this morning and start testing based on this forums advice this evening.

Since 12 hours had passed since the last vetsulin dose, I assumed I could give low carb food and not dose vetsulin at all. It seems to me now that the dose was so high that basically Ziggys body was relying on carb loading from the crap w/d food to maintain and that the vetsulin has dropped him very low over those last 12 hours.

So, my concern is that we can feed tomorrow around 600am and we have to leave tomorrow around 700am. I’m guessing the best solution is to feed fancy feast and then test, only dosing if he seems high, but I’m worried about time constraints. My hope is that since by tomorrow at 6am he won’t have had insulin in almost 24 hours, he won’t be low before feeding and so we won’t run into tonight’s situation again.
 
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jgeeky said:
It seems to me now that the dose was so high that basically Ziggys body was relying on carb loading from the crap w/d food to maintain and that the vetsulin has dropped him very low over those last 12 hours.
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BINGO!! 4U is way too high a dose and it was probably the high carb junk you were feeding that kept him from crashing before this.

jgeeky said:
So, my concern is that we can feed tomorrow around 600am and we have to leave tomorrow around 700am. I’m guessing the best solution is to feed fancy feast and then test, only dosing if he seems high, but I’m worried about time constraints. My hope is that since by tomorrow at 6am he won’t have had insulin in almost 24 hours, he won’t be low before feeding and so we won’t run into tonight’s situation again.
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If he is below 250 in the morning, do not give him any insulin. It's better that he's too high for a day than too low for a moment.

If he is above 250 and you're concerned about giving 1U, you could always start a .5 until you get him completely off all the kibble and eating only the low carb canned food as well as getting some testing data to see how he's doing.
 
Chris & China (GA) said:
BINGO!! 4U is way too high a dose and it was probably the high carb junk you were feeding that kept him from crashing before this.

If he is below 250 in the morning, do not give him any insulin. It's better that he's too high for a day than too low for a moment.

If he is above 250 and you're concerned about giving 1U, you could always start a .5 until you get him completely off all the kibble and eating only the low carb canned food as well as getting some testing data to see how he's doing.
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What’s strange is that we were always feeding him very high protein, high fat, high fiber, and very low carb food. When he was diagnosed and his slightly older sibling was fine, I just assumed it was genetic. When the vet gave us the w/d food and vetsulin it just seem so strange. It was like a human eating healthy and getting diabetes and a doctor saying “the cure is to just eat ice cream and dose insulin accordingly”.

I also thought it was so strange that the dosage and diagnosis were issued without any reference for when he had last eaten and without any ketone issues.

It seems like the dry kibble was too low carb as it didn’t have any real ability to counteract the remnants of the vetsulin. Am I wrong there?

Thanks for all of the help.
 
jgeeky said:
Just under 1 hour since karo on gums and ziggy is at 106
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Looks like he is on the way back up now. I'd test again in 30 minutes just to be sure as karo wears off.

Glad to see @Chris & China (GA).. :)

Moving forward, Chris has given you good advice for the morning.
There are a couple of things you can do to help us help you.
If you could add your signature, that would be very helpful as it will give us a lot of information which is often needed in a hurry and it will save having to keep asking you. Here is the link
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

The other thing that would be super helpful and would allow us to give you dosing advice if you need it....is to set up Ziggy spreadsheet. Put in all the tests you have done so far and any moving forward. Be sure to put in the numbers in the 40s and 50s.
Here's is the link
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
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jgeeky said:
It seems like the dry kibble was too low carb as it didn’t have any real ability to counteract the remnants of the vetsulin. Am I wrong there?
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which kibble?

But I think you've got it backwards....if it was W/D, it's very high in carbs....so when the insulin was "working", the high carb kibble kept him from dropping too low.

Carbohydrates break down into glucose very easily, so by feeding a high carb kibble, there was lots of glucose in his bloodstream so the insulin couldn't counter-act that much glucose

By changing to a low carb food like Fancy Feast Classics (NOT the "gravy" kind), there's less sugar in the bloodstream in the first place so you don't need as much insulin to work against it.
 
Using my fire example from above....if you've got a fire and you pour lots of gasoline (high carb food) on it, it's going to take a lot more water (insulin) to control it.

By lowering (or stopping) the gasoline, you need a lot less water (insulin) to control it
 
Chris & China (GA) said:
which kibble?

But I think you've got it backwards....if it was W/D, it's very high in carbs....so when the insulin was "working", the high carb kibble kept him from dropping too low.

Carbohydrates break down into glucose very easily, so by feeding a high carb kibble, there was lots of glucose in his bloodstream so the insulin couldn't counter-act that much glucose

By changing to a low carb food like Fancy Feast Classics (NOT the "gravy" kind), there's less sugar in the bloodstream in the first place so you don't need as much insulin to work against it.
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the kibble is called keto kibble. It’s a supposedly very low carb kibble. It’s advertised as zero carb but the percentages don’t account for about 7% so I’m guessing that’s the carb percentage and there’s some reporting threshold. I bought the gravy fancy feast on amazon as I wasn’t checking closely. But, we live in a large enough city that I can get new stuff tomorrow.
 
jgeeky said:
What’s strange is that we were always feeding him very high protein, high fat, high fiber, and very low carb food. When he was diagnosed and his slightly older sibling was fine, I just assumed it was genetic. When the vet gave us the w/d food and vetsulin it just seem so strange. It was like a human eating healthy and getting diabetes and a doctor saying “the cure is to just eat ice cream and dose insulin accordingly”.

I also thought it was so strange that the dosage and diagnosis were issued without any reference for when he had last eaten and without any ketone issues.

It seems like the dry kibble was too low carb as it didn’t have any real ability to counteract the remnants of the vetsulin. Am I wrong there?

Thanks for all of the help.
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Yes you are correct......it is like treating diabetes with ice cream, giving the w/d food.

Feline diabetes treatments have advanced and improved in the last 10 or so years and many vets are sadly not up to the latest treatments. And the nutritional information they are taught is taught by the large pet food manufacturers that of course promote their products that are really not all that suitable.
There are several much better insulins than vetsulin which was originally made for dogs which have a slower metabolism to cats. Lantus, Levemir or Prozinc are much better choices for cats...they are gentler and longer lasting. If I were you, I would be asking to swap to one of those insulins.

Cats can be diagnosed with diabetes without having ketones.
 
Reading your post from above where you referenced “NOT the gravy kind”, the kibble comment about w/d was my exact thought. I know our communiques are oddly juxtaposed because of the posting delays, but I think you were confirming the equation that the w/d food was so carb rich that basically it was cutting through the vetsulin enough to last until the next w/d feeding. Looking at the fire analogy, the w/d food was like trick birthday candles or ultra hot embers where the douse from the vetsulin would really just keep the carbs at bay.
 
4u being a high dose I can see why karo and high carb food was used last night however if there has been no insulin given for 12 hours or more, and BG is sitting in normal range, then no high carb food or karo is needed. Vetsulin is an in and out insulin so any concern about low BG without insulin for over 12 hours is likely not warranted and low carb food should suffice if you are concerned and simply retest to see if kitty is holding normal BG.

A BG in the high 40s is not dangerous for a cat not on insulin. My girl (in remission) has tested in the 40s on her AT2 meter a few times. Low readings below 68 require immediate action IF there is exogenous insulin on board. That 68 warning number allows for a bit of cushion before hypo is likely to occur.

My big question is how was your cat diagnosed? Was a fructosamine done or just a BG test in the vet's office?

How is your cat this morning? What was BG?
 
still thinking, your vet recommended a dosage much more suited to a dog -- perhaps this vet hasn't had any diabetic cats in the practice before, only diabetic dogs

glad you found us, listen to the posters above ^ --- seriously they know exactly what they are talking about and they have been shepherding some of us newbies towards success ...
 
MrWorfMen's Mom said:
4u being a high dose I can see why karo and high carb food was used last night however if there has been no insulin given for 12 hours or more, and BG is sitting in normal range, then no high carb food or karo is needed. Vetsulin is an in and out insulin so any concern about low BG without insulin for over 12 hours is likely not warranted and low carb food should suffice if you are concerned and simply retest to see if kitty is holding normal BG.

A BG in the high 40s is not dangerous for a cat not on insulin. My girl (in remission) has tested in the 40s on her AT2 meter a few times. Low readings below 68 require immediate action IF there is exogenous insulin on board. That 68 warning number allows for a bit of cushion before hypo is likely to occur.

My big question is how was your cat diagnosed? Was a fructosamine done or just a BG test in the vet's office?

How is your cat this morning? What was BG?
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This morning I only tested post food because of non-cat related happenings. About 45 minutes afterward he was at 190 and I had to go to work. It was our real first test run with absolutely no insulin (yesterday was like 11 hrs since last insulin). My AT2 test strips got delayed (arriving tomorrow) so I stopped by walmart and picked up an AccuCheck Guide. I know Chris mentioned the ranges are different. It will be nice to have two on hand for caretakers or incidents like today, but I wondered if the AccuCheck Guide was suitable and if all human meters use the same range. It seems like a much solid unit physically and has phone-based logging, which I like.

I just got home from walmart and I haven't tested Ziggy. I left the laundry pantry open so he was asleep on all of our towels when I got home. Unappreciative twerp.

My wife was the one who took him to the vet and I don't know if we still have the results. Blood work was done to see if there was an infection of possibility of Lyme disease do to the leg issues (not often cases of lyme here in central California, but the dogs travel a lot). The only information really relayed to us was that his BG was somewhere around 400 and to immediately begin vetsulin + w/d immediately in the hopes of addressing the neuropathy while there was still a chance (though it sounds like maybe B12 and Folic acid for that).

We have never taken our cats to this vet, just our dogs. Always had good experiences, but like you said and like others have alluded to, they may be inexperienced and looking at antiquated material in this dept.
 
All human meter normal BG range is 50-120 whereas the alphatrak 2 meter normal BG range is 68-150.
The AccuChek is a good Meter. Most of us use human meters here as our dosing methods are based on the human Meter BG numbers. Human meters are also much cheaper to run.

When testing to see if it is safe to give the shot, the test always needs to be done before food is given otherwise the BG result will be food influenced because BG goes up after eating.

You are better choosing either the human or the pet meter and generally sticking to the one type of meter otherwise it gets too confusing.
 
I recommend returning the AT2 and test strips. You'll needlessly go broke purchasing test strips. In two weeks, I've gone through almost 50 test strips and I don't even think I've tested all that much! That would be $50 for test strips alone. I think there's some good info on the internet if not here with a chart of cost of strips and how much blood is required. I haven't had any problems getting enough blood for the ReliOn Prime, but other people have had issues. There are human meters that require less blood but slightly higher cost of test strips.

You'll want to stick to one or the other so that you can easily look at trends over time in the spread sheet.
 
A little update. We've tried different fancy feast iterations and combinations and Ziggy has zero interest. If it were a dog and not about a blood sugar, I think there MIGHT be some logic in saying "well, he'll get hungry enough". BUT, he seems to really like the keto kibble. His blood sugar has been pretty stabilized for the last few days without a single insulin injection, but we are very much keeping in our minds that this could be part of the honeymoon transition phase.

We installed a cat door into the office with another circulating, filtered water fountain and a small bowl of keto kibble for snacking. This keeps the dogs out and offers a third fresh water source, as well as a cat den. The dogs love the cats, but the cats still want their seclusion.

Ziggy's BG was hovering around 115 with the keto kibble, but I worried that we didn't have much ability to check after 7:30am or before 3:30pm. And, after the 40-50 BG scare while we were still giving vetsulin that so many of you very helpfully responded to, I decided to add a little bit of the old kibble this morning, which spiked him up around 250 and then about 6 hours later he returned to around 120. So, lesson learned, I will not be adding that back in. Going to try again tonight after just keto kibble and see how he is maintaining. If we can get BG somewhat stable, I'd like tp start administering the b12/folic acid combo for addressing the neuropathy. I have all the necessary things on hand, I just want to try to stabilize one thing at a time.

I know it's all a very small snapshot and nothing is regulated, but I will say that he seems more like Ziggy. He's walking around, crying in the middle of the night, and wanting to drool on us: all of the things that perturbed us before but that we're happy to see again. When we were giving w/d and shooting the vetsulin, he seemed zombified. He would have moments of himself, but mostly moments of being prone and staring, even when his name was called.

We're definitely not ruling out the Fancy Feast and definitely not thinking we're out of the woods. Our other 12-year-old boy, Captain America, seemed to take to the water + ff slurry, even after years of having no interest. He doesn't currently show any signs of health issues, but our plan is to change them both over to a new diet. The two dogs and two cats in the house drink a lot of water from the running fountains, and I hope adding a third fountain will help. But, I really like the idea that wet food will support a reality when they stop showing that interest.
 
One of the things I noticed about BG testing is that the human meters seem to require a larger blood droplet. The AT2 and the strips that come with the unit require only a very small amount. The PetSure brand generic alternative is about half the price, but seems to require about 10-20% more blood. But, the Accucheck seemed to require just enough more blood that I would often get an error. Ziggy does not give a single thought to having his paw pads pricked, but has never liked his ears touched. The AT2 strips are more expensive, but the stress level is much lower for both Ziggy and me. And, if it means no vetsulin or 1 dose of vetsulin instead of 4, doing away with the w/d food, the cost of the strips is negligible.
 
Hi thanks for the update.
Do you think you would be able to set up your signature and spreadsheet? It would make things much easier for helpers and you would get a lot of feedback yourself from the SS. Thanks
Links are in one of the posts above.
 
Fancy feast is the most recommended food because most cats love it and it’s pretty cheap, but as Bron said it’s certainly not the only option. Any food under 10% carbs on the list she provided will work. Tiki cat and a lot of the weruva kinds are also good, and there’s options that aren’t pate if it’s the texture that he’s maybe not liking about it
 
one thing you might try is Meow Mix Tender Favorites seafood mixes (tuna/shrimp and salmon/crab) -- they're low carb but shredded in broth, often stocked at Walmart, comparable in price to Fancy Feast

Catcat does well also on 4Health grain free chicken/whitefish or turkey/giblets (available at Tractor Supply, variety pack is cheaper) and Blue Wilderness grain free chicken, turkey, or salmon (not the "healthy" or "gourmet" versions) -- I got lucky with a seasonal closeout price
 
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