Newly diagnosed in STL: questions on feeding, spikes in BG

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fearlessmom

fearlessmom

Member Since 2017
Hi everyone. Fearless, my nearly 12yo male tabby, was diagnosed diabetic last week. I was away for the month of February (my better half caring for Fearless and his two brothers), and when I picked him up I noticed right away he was lighter. Then noticed he was drinking and urinating more. Went straight to the vet; he had lost 1.5 lbs since last March, down to 6.5 lbs. Not sure how long this has been coming on, perhaps only a month or two (fingers crossed). Upon lab testing, BG was 432. No renal issues. Nothing else out of the ordinary except low levels of a few elements that are probably being depleted through excessive urination. Started on Lantus, 2U/2x/day. Didn't start testing until day 4. Counts were 508, 472, 431, 407, 415. Then this morning count was 49, though he showed no signs of being hypoglycemic and was still eating well. No dose this morning. Counts rose to 61, then 160 by noon, at which time vet suggested 1U insulin instead of 2U. Next two counts were 60 and 56. Very confused. All the while he's eating, but I have been feeding him low carb FF classic (3-5% carbs) (sorry, but on fixed income that's all I can afford) since first thinking he might be diabetic. But still had some of the higher carb (20-25%) version FF I purchased in Dec. to save $$ that the cats were probably eating all of Jan. and Feb. (maybe contributing to the onset of the diabetes??) , so gave that to him at 7:30. By 9:30 BG was up to 345! I feel I am doing him more harm than good trying to "guess" what food, how much, and when to feed. All this because all I have read (here and other forums) is that dry food is no good (even though my vet suggested self-feeding with prescription dietetic mgmt dry) because of grains, etc., cats don't need. I read with interest that many on this forum self-feed with wet food. My vet agreed that perhaps the fluctuations in counts is because I am not feeding enough, so I have segregated the cats tonight, leaving Fearless in a room with a full 3 oz can of food (he typically gets only 2 cans for the entire day), water and litter box to himself. Have to segregate because his brothers would eat up the food meant for him. If this works, and he will eat only as much as he needs to keep his counts from plummeting (he got 1U of insulin at bedtime) and his counts are good tomorrow morning, I will know that food (how much and when) is affecting his counts as much if not more than the insulin. I would love to get him regulated, not just for his health, but for my sanity. Husband and I are newly retired and would like to travel and have pet sitter come in and feed, give insulin, etc., 2x/day only. Knowing how much wet food to leave out would be great. Even better would be if someone out there would give me some direction as to what dry food could work as backup. (I know. I know. Not good. But in a pinch ...?) Maybe just to leave out overnight and then pick up in the morning. I also don't want to keep the three boys segregated forever but the other two had urinary tract issues (blockages) a year ago so I need something that would work for them AND the diabetic. Hope I provided all the info you need to give informed opinion on how I can proceed and if there is hope for me and my cats. Thanks to all.
 
Hi and welcome. Fancy Feast Classic is a fine food for your kitty, and having everybody on the same food is the easiest plan. As you said, dry food isn't the best, but some here swear by Young Again Zero Mature. It is low carb and can be bought online only. https://www.youngagainpetfood.com/zero-mature-health.html
If you can set up a spreadsheet that we use here and get a few tests in, we can help you figure things out. The 49 was too low and definitely earned a dose decrease, and he may be bouncing from that low. The SS will help you, your vet and us to determine that. If you need help, just ask and someone will set it up for you.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Good morning all, and thank you Sharon. I will check out the spreadsheet and ask for help if needed. The vet gave me a printed sheet that is OK for now but not the easiest to read. So overnight I separated Fearless from his brothers (BTW, that's him in the photo at left, in his younger days, admiring himself on the computer screen) and left him a full can of food. This morning it was almost all gone. He started to leave the room so I picked him up and put him in front of the food, and lo and behold, he started eating again! Ate all but a couple of bites. Guess it will take a while for him to get used to the new routine (of eating on his schedule instead of mine). Will probably keep him segregated at night for a while until I see how much he eats and pees without the addition of his brothers. BG first thing this morning was 303. Not the best, but much better than the 49 from yesterday or the 508 from the day before. Per the vet's instructions gave 1U Lantus. Will keep the food bowls full and continue testing throughout the day. Thanks for the dry food info. I'll check it out.

Back again. After reading the Young Again web page, I have one question: They say you should feed ONLY their product and nothing else. Does anyone feed canned food at regular meals and leave the dry out all the time for self feeding? Thanks again.
 
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I know it may not feel like it right now, but I think you and fearless are doing great!!!!!

My suspicion is that the change in food to the low-carb FF has had a big effect already on his insulin needs. He's high now from a phenomenon called "bouncing" (reaction of the body to the too-low numbers yesterday), but he's definitely showing a strong response to the insulin and/or diet, which is great! I would very strongly urge you to try to get some tests in during the day in between shots. We refer to times in notation "+2,", "+4", etc. where the numbers are the number of hours since the most recent shot. I'd start trying to get something between +4 and +7 in addition to around shot times, in order to get an idea of how low the Lantus is taking him on a typical day. (though, he may be bouncing all day today, and even longer!).

fearlessmom said:
Back again. After reading the Young Again web page, I have one question: They say you should feed ONLY their product and nothing else. Does anyone feed canned food at regular meals and leave the dry out all the time for self feeding? Thanks again.
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I do that-- my diabetic kitty likes Young Again, but her main meals are Fancy Feast, the YA is just for snacking. It might depend on your cat(s) preferences-- if they are serious kibble fans, it might be hard to get them to primarily eat the wet food (which is much better for them than a dry diet) when there is the kibble available. I don't recommend going all YA, just because of the disadvantages to dry food (see this post for a recent discussion), but I think it's a good option to have around as a backup, especially in the beginning when you are still figuring out the right dosage and are worried that your cat might be going too low when you are asleep or out of the house.
 
Fearless and his brothers have always eaten both wet and dry, but when Squeaky and Paulie had urinary issues last year I stopped leaving dry (store bought cheap cat chow) out all day and now only use it as treats. I always thought cats would overeat if allowed but maybe mine do not have addictive personalities! Good to know another cat eats both FF wet and YA dry. How long does a 4 lb (or whatever size you buy) bag of YA last your kitty? Do you have others and do they eat it too?

On the testing, we've been using the meter since Tuesday. Took 5 readings on day 1 (every 3 hrs) and 6 readings yesterday (every 2-3 hrs, because of the lower counts). Since Fearless is on low dose of long-acting Lantus 2x/day, we don't adjust dose except at those times and only under advice of vet (who, BTW, is the best! He was out of the office this week but took our calls from 7 a.m. to 10 p.m.) Thanks for reminding me about the "bouncing" effect. I had read about that over the weekend but had forgotten. So much to learn!
 
Love your avatar! :cat:. A lot of cats are natural grazers when they know food is available. I also still feed my boy Friskies canned for meals and I leave about 1/4 cup of YA out for in between and take any food left 2 hours before pre-test so the reading is not food influenced. As for how long the bag of YA will last, I found this calculator on their website: http://www.youngagainpetfood.com/tools/consumptionCalculator.php
They don't have estimate for the 4lb bag but split the results from 8lb in half :)
 
Good to know. According to the calculator an 8 lb bag would last 40 days. Not sure if it fits into my budget, but will certainly consider it. Anyone know of any coupons available for Young Again Zero Mature?

Yong, I see you use Free Style Lite strips with your AT2 meter. I've read they are cheaper than the AT2 strips ($30 vs $46 for 50 on Amazon) but want to be sure they can be used with the AT2 meter. Any other deals for testing supplies out there?
 
Just posted this for someone else! lol, recently discussed alternate strips for AT2.
http://www.felinediabetes.com/FDMB/threads/test-strips-and-best-time.175494/#post-1928011

But I did end up getting a ReliOn Confirm for daily testing ($0.27 per strip online). I just use the AT2 with FSL strips for curves and occasional test when he's low. My meters seem to vary more than others :confused:

For YA, there are usually 10% off codes on retailmenot.com, I think that's where JanetNJ said to find them. When I got my free sample they sent me a coupon code too for 10% off :)
 
Thanks, Nan and Yong. I plan to check with my vet about the test strips cause my better half is insistent. He's afraid, since we just started this journey, that we won't get an accurate curve with the non-AT2 strips. But if our vet says it's OK, perhaps we'll do it. With the extra expense of the YA dry, trying to save $$ wherever we can.
 
As mentioned, the important thing when using FSL strips in AT2 meter is to do multiple comparisons. Like Tuxedo Mom wrote: "When I first started using the FS Lite strips I did about 50+ side by side same blood drop comparison using the AT2 strip with the AT2 meter and the FS Lite strip with the AT2 meter."
 
If cost is a concern, you might also consider using a human meter. The numbers aren't comparable with the pet meters, but many of us use human meters because the test strips are significantly less expensive, and we go through a lot of them. The scales and protocols on here work for either approach. My vet fussed a little about me using a human meter at first, but as he's grown to see how well I've been able to manage FD with it, he's warmed to the idea.
 
fearlessmom said:
With the extra expense of the YA dry, trying to save $$ wherever we can.
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My thought for this was, I had heard lots of good things about YA helping BG numbers so decided to buy the food rather than having to give more insulin and need another vial sooner, which is more expensive. Decided to spend money on good food and keep insulin at a "normal" dose. :). I've been doing this all on ZERO income so I'm always looking for money saving tips. Can you still *save* when you are not making any? LOL
 
Update on Fearless and his spiking BG levels: Today is day 6 of testing (every 3 hours), day 10 on insulin. Vet started him on Lantus 2U 2x/day. On day 1 of testing his BG never dropped below 400. The next day it was down to 49, so vet lowered dose to 1U. Day 2 BG went up and down before a spike to 345 end of day. Day 3 was 303, 141, 93, then spiked to 515, at which time vet increased dose to 1.5U. Day 4 started at 131 so lowered dose to .75U. Count dropped to 45, 47, then up to 151, and spike to 332 end of day, at which time vet suggested only giving .5U and staying there. However, yesterday started at 549 so I gave 1U. Counts dropped to 346, 168, then spiked back up to 483 and 556 end of day. Today started at 321 so stayed with 1U. Counts dropped to 273 and 165 before spiking again at 585. How long must we wait before we see a more stable reaction to the insulin? How much does his low carb food affect his reading? We keep wet food (FF, 3-5% carb variety) out all the time so he can feed at will, at the vet's suggestion. However, he seems to eat the most in the morning, when he gobbles up 3-6 ounces (1 to 2 cans) before lunch, then appears to get full and only snacks after that. But the spikes in his BG are happening mid- to late-afternoon to evening. How long does it take for food to be metabolized in a 6.5 pound cat? Should I be feeding him less? Is the insulin just not working after 8 hrs? Not only is it supposed to be long-acting (12 hours) but the vet said the affects may carry over longer. That could explain the really low numbers on testing day 2, after 5 days of 2U 2x/day, and maybe on Day 4 when counts dipped midday, but the rest of the results are a mystery to me. If it is rebound (and not a result of when food is given) how long will this last? Has anyone seen results like this before? Vet says he'd rather see highs rather than low counts, but Fearless shows no signs of hypoglycemia when he is in 40-60 range. I worry what the highs are doing to his internal organs. Afraid to raise the dose above 1U until I next speak to vet. Any advice?
 
Have you posted this over on the Lantus forum? There are some very wise people over there that know this insulin and can help you unravel what's going on.
 
It would help to have those numbers on our spreadsheet....I'd be more than happy to set one up for you if you like! It only takes me about 30 seconds once I have some information

If you'd like some help, please just click on my name and choose "Start Conversation" so we can get you set up!!
 
fearlessmom said:
Good to know. According to the calculator an 8 lb bag would last 40 days. Not sure if it fits into my budget, but will certainly consider it. Anyone know of any coupons available for Young Again Zero Mature?

Yong, I see you use Free Style Lite strips with your AT2 meter. I've read they are cheaper than the AT2 strips ($30 vs $46 for 50 on Amazon) but want to be sure they can be used with the AT2 meter. Any other deals for testing supplies out there?
Click to expand...
An 8 lb bag lasts me 3 1/2 weeks with about 5 cats eating it in addition to wet food.
 
Hi again all. Have been posting to the Lantus forum but reached an impasse because the consensus of most is no to any dry, even Young Again Zero Mature. But my question now is not about what kind of food, but HOW MUCH food. My vet wasn't really explicit in his instructions except to say I should wait until Fearless has "some food on board" before shooting. I understood that, but in my mind I equated low BG tests with feeding more and high BG tests with feeding less. Then I saw a video on shooting insulin where the person said make sure kitty eats at least 3/4 of normal feeding before shooting That got me thinking that I didn't understand the science of how insulin works in conjunction with food. So I started feeding much more than normal (Fearless is underweight so no worries about gaining), about a full 3 oz can before shooting and more after if he wants it. And he is eating it. And the results appear to be better. Am I on the right track? Still getting bounces but now not until closer to 8-9 hrs. And I really like the numbers I've been getting at 6 hrs the last 3 days. Of course, this might also be due to raising the dose to 1.5U from 1U. Can someone speak to the effect of WHEN food is given, how it works with the insulin, etc.? Thanks.
 
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