Question about "amount" to feed my cat

[shortbusruss]

My cat Coco is currently approximately 4kg and going up VERY slowly post diagnosis. (He used to be pretty severely obese when free fed dry food) He is currently on 1-1.25 units of ProZinc Insulin 2x per day. The 1.25 is mostly when he has 450+ in the morning, otherwise he gets 1 unit. He still has pretty serious dental issues that we are getting looked at starting the 8th of February.. I feel like this is causing a lot of stress-induced BG level rising, especially overnight, as he is often popping up with a 500+ BG in the morning, despite getting 1 pack of food around 8pm to 11pm (an hour or two before his nadir time). His nadir is around 90 or so. Not sure if it might be dipping a bit below this, as we need to do a curve this weekend after getting back from vacation.

I have been feeding him around 3 1/2 - 4 pouches of food per day (around 255-300g of low carb wet food per day). I "think" this is a proper amount of food per day for such a fairly small cat. I might be misguided on this, but I "intentionally" limit him to this amount, as I feel that feeding him more will drive his blood sugar higher, and make it harder to manage prior to getting his teeth fixed.

Should I feed him more, and just give him more insulin to offset the higher blood glucose, if it manifests? Does anyone think that the high BG in the morning is maybe due to being stressed from being super hungry, and that he will end up with an actual LOWER BG if we feed him more overnight? I do understand bouncing, and think that the high morning BG might be due to his BG dropping too low, then bouncing up, so maybe feeding him more right before we go to bed will prevent that? I know the general advice is to give your cat "as much as they want" until their BG is stabilized. We still haven't gotten to that point yet, and 5 pouches of food seems like a lot.

Any advice?

 

[Larry and Kitties]

How is Coc's weight doing? If you want to increase weight then feed more. If loose weight then feed less. If Coco is now at desired weight feed the same. I would weigh Coco at lease oncer a week at the same time.
One does not limit food to control BG. Yes feeding more may require more insulin.

 

[Sienne and Gabby (GA)]

As a generality, many cats experience higher numbers in the AM. It is referred to as "dawn phenomenon." Our bodies and our cats' bodies prepare for the stresses of the day with a rise in blood glucose levels due to the way corticosteroids wax and wane.

It would be really helpful though, if you could get some mid-cycle and PM tests. There's no way to know if your cat's numbers are dropping during the PM cycle and as a result, you're missing half of your data. You may have missed dose reductions.

 

[shortbusruss]

As a generality, many cats experience higher numbers in the AM. It is referred to as "dawn phenomenon." Our bodies and our cats' bodies prepare for the stresses of the day with a rise in blood glucose levels due to the way corticosteroids wax and wane.

It would be really helpful though, if you could get some mid-cycle and PM tests. There's no way to know if your cat's numbers are dropping during the PM cycle and as a result, you're missing half of your data. You may have missed dose reductions.

I think that may be the case. (Possible dose reductions..). He was in the 200s yesterday, and we gave him the "normal" 1 unit that has been prescribed, and his BG was super low all day, and we fed him much more than our normal amount, and gave him some honey as well. Took him nearly 24 hours to get back to 200s. We are trying .5 units tonight, and see what things look like in the morning. I was working from the presumption that his 400/500s in the morning were as a result of his dosage not being "enough" to deal with his BG levels, or maybe as a result of his mouth pain at night.

From today's results, it is making me realize he was probably consistently bouncing off of super low numbers, due to not getting as much food at night, combined with a dosage that is a little too high at this point. His numbers have actually looked a lot better when we started feeding him MORE, which is completely anti-intuitive to me.

The lack of PM data is due to the fact that I work nights, and my wife struggles to stay on schedule with me so we can have some time together in the mornings.. If I give him insulin right when I get home, I stay up for about 4-5 hours and then sleep, which means wife has to be in charge of PM insulin and dosing. Coco's numbers have been all over the place, and she is becoming resistant to doing multiple curves and not getting much to show for it. I am going to try to focus on getting Coco on a strict schedule where he gets insulin right as I get home, and she will take the "evening shift". This will all get a lot easier if we can get his numbers more consistent. My wife has severe anxiety, and she is really uncertain as to deciding on dosage, how much to feed, so I have been in charge of most of that, and still trying to figure it out. The bouncing has thrown me for a loop, and now that I realize that is what has been happening, I think I can get it dialed in.

 

[Sienne and Gabby (GA)]

Bouncing is certainly a possibility.

We generally don't suggest adjusting the dose based on the pre-shot numbers. If you've not had a chance to read the information we have on Caninsulin, this is the link to the sticky note on dosing. There's also an introduction with general info on Caninsulin. The dosing method we use has you hold the dose for a week before increasing. A dose reduction would be warranted if Coco's numbers drop below 90. We also adjust doses in 0.25u increments. It may be easier for your wife if she is using the guidelines so making dose-related decisions doesn't seem quite so random.

It's always a challenge when you have to work and manage your cat's diabetes. I was my cat's sole caregiver so I understand. I set her shot schedule (5:00) so I have time to get tests in before I left for work in the AM and still had time to get tests at night.

I assume you're giving Coco treats for all of the tests?

 

[shortbusruss]

Bouncing is certainly a possibility.

We generally don't suggest adjusting the dose based on the pre-shot numbers. If you've not had a chance to read the information we have on Caninsulin, this is the link to the sticky note on dosing. There's also an introduction with general info on Caninsulin. The dosing method we use has you hold the dose for a week before increasing. A dose reduction would be warranted if Coco's numbers drop below 90. We also adjust doses in 0.25u increments. It may be easier for your wife if she is using the guidelines so making dose-related decisions doesn't seem quite so random.

It's always a challenge when you have to work and manage your cat's diabetes. I was my cat's sole caregiver so I understand. I set her shot schedule (5:00) so I have time to get tests in before I left for work in the AM and still had time to get tests at night.

I assume you're giving Coco treats for all of the tests?

Coco is currently on ProZinc, not Caninsulin. He was changed to ProZinc about a month ago, due to us not being able to come even close to good numbers in the second half of his 12 hour cycle. He has been on 1-1.25 units ProZinc 2x daily, and has been consistently above 500 in the mornings, despite getting 1-1.25 units at night, and not eating a lot of food at night. He has been on this dosage for at least a month now.

Yesterday, he got off his 12 hour cycle a bit after we dosed him 1 unit in AM, with a 222 (or so) BG. We had to completely skip his PM insulin dose due to a sub 60 PMPS. He did not get back up to 200 for nearly 24 hours. Yesterday was the first time he has ever maintained numbers all day under 100 since he was diagnosed. His numbers were actually going dangerously low (sub 50) despite us giving him MUCH more food than he is accustomed to, which led me to the idea that 1 unit 2x per day is too much insulin. Based on how much we have been feeding him (generally not more than 340grams per day), him being constantly hungry even with that amount of food (at 4kg body weight), plus his reaction to the 1 unit yesterday with at least 200-250grams more food than normal, is all kind of pointing to us overdosing him even at 1 unit 2x per day, and his body reacting to that overdose by his liver dumping glucose at night, driving his blood sugar through the roof in the mornings. I understand that an AM BG spike can be a thing, but him ending up with 500+ BG in the morning with maybe 120grams of food overnight, was telling me something else was going on rather than a steady decline to a decent nadir, then rocketing up to 500+. Him having too much insulin and then bouncing off his low number with his liver overproducing glucose starts to make a lot more sense.

His initial ProZinc dose was based on his previous Caninsulin dose, which we gave him for about 2 weeks prior to going on vacation and leaving him with a pet sitter. And he was never really anywhere close to being controlled on that 1 unit 2x of Caninsulin. I am trialing a .5 dose starting this evening (about 2 hours ago), based on a 200-ish PMPS, and I am going to see how it goes. Please let me know if you think my methodology is off on this. I am just thinking an entire 24 hour period of sub-100 BG from 1 unit at about a 222 PS reading, after months of him ping ponging between low and high.. It might be time to consider the dose was never right in the first place. I am trying to do a reset, start with a lower dose, feed him a bit more, and treat it as if he were just diagnosed. If things look a little more positive, we will try to get a AM glucose curve this weekend, plus some PM numbers to go with it..

What do you all think?

(Note: I am at work right now, and cannot access his spreadsheet to give accurate reading numbers at this time..)