Question about fiber requirements in diet

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beachbean24

beachbean24

Member Since 2012
Hello,

I have an 11-year-old Persian/Russian blue mix named Bebop who was diagnosed with FD in March. We haven't been able to regulate her BG and my vet wants to refer us to a specialist. I'm currently a student and it's been very difficult to keep up with all the additional expenses in the last few months. So before I head to the specialist, I decided to join this forum to see if I can find any useful information. Based on what I've read, it looks like I should change her diet from dry to wet food. She's currently on Hills' W/D dry food (prescribed by her vet), which has a very high carb %. I see that people have recommended Friskies and Fancy Feast canned food as affordable options. After looking at the nutritional information from Binky's page, it looks like the foods low in Carb % are also very low in Fiber. For example, the W/D has 2.4g while Fancy Feast ranges from only 0.1 to 0.2. I just wanted to confirm that the change in fiber will not negatively impact her diet.

Also if I am unable to test her BG regularly at home, do you recommend I still make the change in her diet? She's currently on a very high dose of PZI (4 units/2x per day). Thanks so much for any information!

Jane
 
Hi Jane,
First, about the "fiber" question. Here's a link to an awesome page of information about dietary needs of cats. According to Dr. Lisa, an expert in the field:
The subject of fiber is also widely discussed with respect to feline nutrition and diabetes. It was once thought that a high fiber diet would be beneficial for blood glucose control in the diabetic cat but this recommendation has since fallen out of favor. Please see Dr. Zoran's article for more details. A cat's natural diet is very low in fiber. Cows and horses are designed to eat a high fiber diet - not cats.
Click to expand...
She also discusses Hills W/D specifically on that page.
http://www.catinfo.org/?link=felinediabetes

About hometesting... are you unable to test because Bebop won't cooperate, or have you tried home testing yet? I understand completely about trying to get a handle on the expenses, but if that's why you haven't home-tested, it'll actually save you money in the long run. Vets charge a lot of money to do BG tests and curves, so doing it yourself at home is the inexpensive way to go. You can get a testing kit for the price of shipping if you click on the "Home testing kit" link at the top of the page.
Of course the primary reason we advocate home testing is "safety". Not only will the numbers you get at home be a more accurate representation of her blood glucose levels (eliminates the stress most cats experience from trips to the vet), but those numbers will help you determine the appropriate dose of insulin that Bebop needs. Changing to a low-carb canned diet usually has a pretty big and positive impact on BG numbers, and home-testing while changing diet is definitely the safest way to do so. 4u is a pretty high dose compared to what most cats need, and the dry food could be the biggest reason she needs that much insulin. Not true in every case, as my cat, Bob needed 4u a day at one point before he turned around and eventually went off the juice. He was only eating low carb FF classics at the time his dose was that high. But in general, most Prozinc kitties don't need that much if they are eating a diabetes appropriate diet.

What sort of BG numbers have you been seeing lately? And as far as the specialist, is the vet recommending an FD specialist, or does he suspect that something else is contributing to your difficulty with regulating Bebop's numbers?

Carl
 
Hi! Im pretty new here too. One thing i can tell you is to ditch the dry food. My kitty was on 6 units twice a day and after the change to only wet he's currently at half that dose, though we've still got some adjusting to do....
Good luck!
 
Just to add to what Carl wrote.

Changing the food from dry to wet (higher carb to low carb), may also mean you need to change the insulin dose. And something that should be done together - if you change the food and do not change the insulin dose, you could have a hypo situation and an emergency trip to the hospital.

Like Carl said, home testing is key to understanding what is the safe dose of insulin to use.

We typically recommend starting at 1 unit or even 1/2 unit twice a day when starting out. And with home testing, can determine when and if the dose needs to be adjusted.

Can we help you to get started home testing?

How did you arrive at 4 units of insulin?
 
Hello.
Welcome. You will get lots of help here.
I've only been here 21 days and because of this community, my cat may be in remission soon.

Please etch this in your head quickly because you are about to embark on a steep learning curve.
The diet change does make a big difference to many cats.
But Please get dosing advise before you make the complete switch to low carb canned because the change can be dramatic enough that your current dose of insulin might be too high .
That's how much the dry food affects their glucose level. We have many well experienced people here who will do that. I would put Carl right there with them ( and he may be one of the advisors , I don't know that )

And you definitely want to be home testing so you will know if that is happening. If you aren't home testing,
then it is the same as driving with a bag on your head. You don't want to give insulin without knowing how your cat is responding.

Your vet may or may not like home testing. But it will save you money, you'll have a more accurate picture of
your cats glucose levels, and it will keep your cat out of danger of overdoses of insulin which can be fatal.
Most here either convince their vet to support them or they find a new vet who will.

You will need to start reading ( and it sounds like you have been doing that already) up on how this all works.

I switched foods but I was already monitoring and was started on a low dose. Our numbers dropped really fast,
you can see it on my spreadsheet. We changed to low carb the day we started the insulin.
 
Hi Everyone,

Thank you so much for all the replies and useful information. I spent some more time yesterday researching how to do a home test and plan to go to the drug store to buy all the necessary items. Just curious, do most people prefer to use the lancet pens or "freehand" the lancet? Or rather, which method would you say is easier? After watching some youtube videos, I think I'd prefer the freehand, but thought I'd get some people's takes on it. I also will be calling my vet to let them know of my plans and hopefully get agreement from them. Just FYI, the vet wanted me to go to an FD specialist so they could do some additional testing (e.g. ultrasound, etc.). $$$!

Another question - How do you determine how to change the doses based on the glucometer readings?

Just to give you some more background info about Bebop. She has consistently been getting a blood glucose of about 390-400 and her doc has always said the ideal range for her was below 300. There was one time early on in the process when she was still at about 2 units/2x per day when she dropped to the upper 200's. However, shortly after she got a UTI and her BG shot back up. Since then, it's stayed in the 400 range even though we have progressively raised her insulin amounts over that time period. I've at least switched her over to the canned W/D food starting yesterday (and she LOVES canned food, so she must be thinking this is a treat for her). But I guess I'm not sure at what BG level I should start lowering her insulin amounts once I feel comfortable taking the tests and switching her to lower carb foods. Unfortunately I'm at work during the day so I can't stay with her throughout the day to do continuous checks. Any suggestions?

Thank you again for all the help! I was really at a breaking point this past weekend and am so happy I found this type of resource. It's given me hope that she can perhaps be better regulated.

Jane
 
Hi Jane,

We are so glad you have decided to test at home. It may be that her numbers are lower when you test than they are at the vet. Stress raises glucose levels and most cats are stressed at the vet. I would be careful about switching right to wet food. When we switched Oliver from dry to wet, his numbers went down 100 points overnight. We really needed to reduce our dose in the morning!

If I were you, I would get the testing down first and see what numbers you get. Here is a shopping list:

A human glucometer. Any one that sips and takes a tiny sample is fine. We do stay away from any meter with True in the name and the Freestyle meters. They have proven to be very unreliable and read lower than other meters. The meters are sometimes free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not

I used the lancet; others like to free hand. You'll have to see what is easiest for you.
 
Thanks Sue!

I am planning to go to the pharmacy to see if I can find these items so I can start today. Will keep you posted...
 
I really like my lancing device. I have an accu-chek softclix plus. ( don't get the fastclix, too fine a gauge)
the softclix is the right gauge.

While I like my meter, accuchek avia plus, i don't recommend it because the strips are higher cost.
I think the one every likes here is the relion. I don't know the specific name, ask and someone will tell you.

I tried freehand and my cat didn't like that. That really got her upset. I think she finds comfort in hearing the click to cock
the softclix and then click to stick. It's clean fast and easy. My vision isn't the greatest so maybe I just couldn't aim well enough
with freehand. ( especially at 2 am)

Good low carb treats are PureBites - come in shrimp , turkey, chicken, beef and liver. They have them at PetsMart.
Be wary, there aren't enough selections of treats that are no carb. But there are new ones getting released.
Freeze dried tends to be 100% protein. You can also make your own. I hear some boil chicken or turkey.

You said you switched foods yesterday.
You really need to start monitoring asap. The glucose number should go down right away, by as much as 100 less.
You said you aren't home during the day and 2 units could become too much suddenly because her numbers will drop after
the first few hours on Lantus.
Some here recommends "go low and go slow". It's good for getting familiar with all the new knowledge/experiences.
I can't tell you what dose you should be doing. There are more experienced here who will address that. But they are likely
to have you drop to 1 unit, maybe even less. You don't want to risk your cat having a hypo, especially if you aren't home.
You need to have a baseline of testing numbers to know your cat's pattern on the insulin. Hometesting will tell you when
the insulin is at it's peak performance ( often 3-4 hrs or 6 hrs after the shot)

Your question about the vet's happiness with numbers in the 200's, is a good one. Many vets don't expect you to learn enough
to really manage so they don't push for remission or even tight regulation.
You can achieve it on your own with the advise given here.
You have a steep learning curve and lots of reading. You will need to get the basics down and a spreadsheet so that everyone
here can see your numbers and start advising you how to do it. In a few weeks, if you are able to spend enough time learning,
you could start that path.

Keep asking questions. I'll ask someone who really knows her stuff to come look at your post.
 
I freehand, mainly because I couldn't figure out how to use the device. Plus I feel that I have more control by freehanding.

I suggest that you try both ways and use the way that is most comfortable for you. There is no right or wrong way.
 
I freehanded just because I found it to be easier, but try both ways and see which one works best for you.

I've at least switched her over to the canned W/D food starting yesterday (and she LOVES canned food,
Click to expand...

Good that you are switching to canned, but is there a particular reason why the W/D is needed? Good that it's canned, because overall canned food is much better than dry, but the W/D is still really high in carbs (26% according to Binky's), and I'm guessing it is pretty costly since it's prescription?

Carl
 
Thanks again for all the help!

I've been trying to compare prices between devices/strips/lancets and have ultimately come down to Bayer Contour and Relion. Although the Relion is cheaper (via Walmart website), the only lancets available are 30G, which I'm guessing stands for 30-gauge? I think someone had mentioned I should be looking for 26-28 gauge because it will be easier to draw blood. The Bayer Contour is pretty reasonably priced on Amazon, but I just had a question about the compatibility of lancets. I thought I had read somewhere that you don't have to buy the same brand. Is this true? Assuming I don't use the lancet device, will it matter as long as I get lancets that are 26-28G?

As for her food, her vet had put her on the w/d diet and that's all I've been giving her the last few months. I would occasionally give her some w/d canned food as a treat, but after yesterday's research and your comments, I am only giving her the W/D canned food since I haven't started home testing. I thought I wasn't supposed to move her to lower carb canned food until I have testing down? In the meantime, I am reducing the dry food and giving her more of the canned food (strictly w/d) until I have the home-testing part down. Once I am able to home test, I was going to switch to Friskies or Fancy Feast or any one of the lower carb foods. Please let me know if you suggest otherwise.
 
Hi Jane,
You are absolutely correct. Keep feeding the w/d canned until you are ready to home test, because switching to friskees or FF will lower her BGs, and it'll happen within the first day or two.

On the lancets - if you aren't going to use the device, and are just going to freehand the lancet, then you can buy any brand you can find. Odd that walmart only has the 30g online, because at the store here, they have 26, 28, 30 and 33 on the shelf. At first, I couldn't use the 33 or 30 gauge and get blood. I bought a box of 26's and started getting blood on the first poke every time. Over time, I got better, and Bob's ear started to bleed more easily, so eventually I used the 33g that I had bought at the start. But you'll find it much less frustrating as you are learning to poke if you use the 26g lancets.

If you do end up using the device, I don't believe brands are interchangeable, but since I never used the device, I can't say for sure.

Carl
 
Great, Thanks Carl! I'll keep giving her the W/D for now.

I just got the Bayer Contour through Amazon because I would receive it by this Thursday and the sooner I can start the better. It ended being about the same price as Relion ($50 vs $54). So I guess I will see how it all goes starting this Thursday. This might be a good thing since over the weekend I can try to do a full day of tests (assuming I figure out how to do it all!). Sorry, still not familiar with the terminology, but I think trying to get a mini glucose curve or something like that... Will start tracking on a spreadsheet as well.
 
It sounds like you are getting this thing down, Jane. You can buy the strips For your Contour on EBay and save at least half the price in stores. Just be sure they have an expiration date that will work for you.
 
Bayer's microlet lances are 25 gauge (and nice and colorful!). So you could have used the ReliOn and freehanded with the microlet lancets. The thing about the Contour is the strips are expensive in the long run... they are nearly a dollar a piece. That is the most expensive part of diabetes.

I use a Bayer Contour with the pen device, and although it's kind of annoying to use, you get good at aiming it after a while. I tried freehanding a few times but it hurt Scooter and made him scratch me, so I stuck to the pen.
 
You can also check ebay for strips for the Contour. They are much cheaper but you need to be careful who you buy from. I buy only from top rated sellers and make sure the expiration date is pretty far out and the boxes have not been damaged in any way.
 
I'll be getting the home testing kit on Thursday, so keeping my fingers crossed! Will keep everyone posted. Thanks for the support!

Not sure if I should create a new post for this, but I wanted to see if anyone's cat had experienced recurring urinary tract infections. Bebop has had at least 3 or 4 since March and I continue to have to take her to the vet to get her antibiotics. Unfortunately, she gets sick with the oral antibiotics (vomiting), so they keep giving her Convenia injections instead, which don't seem to be working. Her most recent urinalysis (from this past weekend) has again shown positive for bacteria. According to the vet, the diabetes and UTI's go hand in hand, and it almost seems like a never-ending cyclical process. Does anyone have any information about this? I'm just looking for any other types of solutions or words of advice. It's been an extremely frustrating process and after joining this message board, I almost feel like her vets don't really know anything. I know once I can change her diet and get her BG down, the UTI's should most likely stop. I'm supposed to be talking to her vet today and I can almost guarantee they're going to ask her to come in so they can keep giving her these Convenia injections.

Thanks again!
 
Have you seen this vet website: http://www.catinfo.org/?link=urinarytracthealth

While you are waiting for the test kit, you might try getting her ready for hometesting:

First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give her lots of praise while you play with her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming
 
Once you start adding water to her food she will probably start having less of them. She is dehydrated from the dry food all the time- it would be like us eating peanut butter, all the time. Problems would occur.

Adding water to her canned food- mix in as much as you think she will take- my Sneakers gets equal amounts of half food and half water- makes it kind of soupy and she thinks it is 'gravy'.
 
Cats with uncontrolled diabetes have glucose in their urine, which makes the urine a breeding ground for bacteria, which is why many diabetic cats get UTIs. When you add the chronic dehydration caused by dry food into the mix, it's not uncommon for diabetic cats with uncontrolled blood sugar to get frequent UTIs.

Make sure you pick up some ketostix (urine testing strips) and are testing for ketones. Ketoacidosis is a potentially deadly complication of diabetes that is most likely to occur when a diabetic cat has the combination of infection, high blood glucose, and dehydration.

W/D is a completely inappropriate food for a diabetic cat (I am convinced the huge carb load caused my cat's diabetes). I'm very glad you're switching the food! There is no Hills (Prescription or Science Diet) food for cats that is appropriate for a diabetic cat, canned or otherwise. I find Hills infuriating--their food is made from the cheapest of the cheap ingredients, and they feed misinformation to vets about feline nutrition so that they can have a bigger profit margin on their very low quality foods (corn and cellulose [wood pulp] are far more profitable to put in cat food than meat, even though a cat should not eat corn or wood pulp). They are part of the reason many vets don't understand the connection between feline nutrition and all these diseases that show up because of inappropriate, high carb diets.

I just want to repeat (because it's very important!) that you need to lower the insulin dose when you do change the diet. Cats can see a 100-300 point drop in blood glucose immediately when the diet is changed, so you don't want to shoot 4u, because that could cause a deadly hypoglycemic incident.
 
Question about urinary tract infections

Just a quick update - Had a chat with Bebop's vet and with the 3 minutes she gave me, she basically was supportive of the home testing but wasn't a huge fan of changing the diet (shocking). She said if I really wanted to change her food, I should consider Purina or Royal Canine (spelling?) because they have food that's specifically labeled, "diabetic food." Yeah, right. Anyway, I'm still planning to switch Bebop to Friskies/FF.

As for her UTI, it sounds like they have no clue what to do about it since Bebop hasn't really responded to the Convenia and it seems to be the same bacteria as her previous infections. Is there a chance that the UTI will go away on its own after I change her diet AND increase her water intake? Or is there a possibility that once her diet has been changed, she will respond better to the oral antibiotics?
 
Most prescription diets "formulated" for diabetics are too high in carbs for diabetic cats. The only prescription diet that is suitable for a diabetic cat is Purina DM canned. That food is perfectly fine to feed at 3% carbs. However, it's pretty much the same thing as Fancy Feast (also made by Purina), but FAR more expensive because you're really just paying an inflated price for the prescription label. You can get a premium commercial cat food with better quality ingredients for less than you'll pay for the DM. Check out the ingredients of the DM and compare them to the ingredients for Fancy Feast. With a few very minor variations, it's exactly the same thing.

Dr. Pierson's section on prescription diets is very informative: http://www.catinfo.org/#Prescription_Diets_and_Marketing_Labels\

Remember that vet offices make money selling prescription diets, so there is a financial incentive for them to convince you to purchase them from their office.

The good thing is that you can feed whatever you want to feed your cat--the vet's recommendation is just that; a recommendation. I was very lucky when Bandit was diagnosed that my vet gave me a handout they compiled for their diabetic cats of low carb commercial foods in different price ranges (all under 10% carbs) and told me to pick the best food I could afford.

Was Convenia the only antibiotic given? If so, why was that given instead of an oral antibiotic? Did the vet run a culture to confirm there was bacteria in the urine?
 
Julia & Bandit said:
That food is perfectly fine to feed at 3% carbs. However, it's pretty much the same thing as Fancy Feast
Click to expand...

Hey Julia!

You're right about DM being OK (and just OK) to feed to a diabetic cat, but FF is actually a higher quality food than DM.

Here are the ingredients of Purina DM:

Liver, poultry by-products, meat by-products, water sufficient for processing, chicken, salmon, oat fiber, salmon meal
Click to expand...

Liver and low quality meats make up the majority of this food. Real meat comes farther down the list.

Here's FF Chicken:

Chicken, chicken broth, liver, meat by-products, fish, poultry by-products
Click to expand...

Real chicken meat is the first ingredient. It still contains liver and byproducts, but overall, Fancy Feast is actually a HIGHER QUALITY food than Purina DM and is a fraction of the price. Strange, huh? :lol:
 
Ry & Scooter said:
but FF is actually a higher quality food than DM.
Click to expand...

Depends on the flavor of Fancy Feast...the one I linked to above, Liver and Chicken, is nearly identical to DM. I like to use that particular flavor to compare the two in case people want to bring the ingredients list into their vets and say, "Hey, why are you saying I have to buy this super expensive food when this other food is pretty much the same thing? "

The ingredients for the FF Liver & Chicken are:
Liver, meat broth, meat by-products, chicken, poultry by-products,
Click to expand...

Some flavors of Fancy Feast are higher quality, but some are also lower quality than the DM, like Tender Beef & Chicken:

Meat by-products, beef broth, beef, chicken,
Click to expand...

So it's always good to label read! :smile: There can be a lot of variation even with the same line of food under the same brand.

(I try not to dis DM too hard because even though I wouldn't recommend it because it's super overpriced, at least it's appropriate for a diabetic and not full of wood pulp, unlike the WAY overpriced foods from Hills. :roll: )
 
Wood pulp? Hmmm, trying to recall the last time I saw Bob or Mullet chewing on a tree.... That must be why my guys turned up their noses at Hills M/D after two servings!

DM is appropriate, I think it's now 3% carbs? The biggest drawback besides cost is that it only comes in one flavor, and many kitties prefer variety. That's what's good about FF classics, Special Kitty, Friskee's Pates etc. They won't burn out on it, and the carbs are low.

Carl
 
Thanks Julia and to everyone else!

I just ordered the Friskies Pate variety pack. Finally got the home testing kit and just tried to draw blood for the first time in Bebop and she kind of flipped out. It seemed like the prick actually hurt her and she kept wanting to move her head away from me. It definitely did not go as smoothly as I thought it would because she's so good about getting the insulin shots (zero reaction). I'm guessing ears are more sensitive to pain? I'm going to try again in a little bit, but was going to try to find some more videos to watch people doing it. When you actually poke the lancet through the ear, is it a straight one shot where you actually puncture through the ear? I was able to get some blood but it was not enough.

As for her UTI, the vet did run some cultures and found bacteria in them. They want me to up her insulin to 4.5 units, 2x a day and to once again try giving her oral antibiotics (at a lower dosage). I tried to talk to them about the benefits of changing her diet and how I was hoping it would lead to a lower BG, but they basically ignored me. So I guess I will be doing this on my own because they don't really care to listen to anything I say. Wish me luck! I will probably get the antibiotics, but I also plan to change her diet as soon as I get testing down. When you first start, do you check her BG before feeding and insulin, and then determine how much insulin to use? Since she's at such a high dose, is it ok to start from scratch (i.e. 0.5 or 1 unit of insulin)?

Many thanks!
 
The ears are not supposed to have nerve endings in them. I think it is more likely that you are doing something different and unexpected to her. Do you have something behind the ear to poke against? Some people use folded kleenix. We used a small make up sponge. Did you warm the ear first? That made a huge difference for us.

We used the burrito with Oliver until he got used to it. We wrapped him in a towel with only his head showing. Once he realized a treat was coming after every poke, he decided it was fine and we quit using the towel.

I would start at one unit, test before feeding every am and pm and midcycle. Test for ketones since you are reducing. Within a few days, you should see any lowering of numbers from the food change. If he is over 300, you can raise by .25 or .50 and monitor a few more cycles. Our theroy is that if you start low, test and increase as the numbers lead you, that is much better than starting higher and getting numbers that are too low and then trying to guess how much you need to reduce. The UTI may keep the numbers higher than usual. You'll just have to see what the numbers are.

If he is ever under 200 at preshot, wait 20 minutes without feeding and test again. You want to make sure the number is above 200 and rising.

Have we given you the PZI document? It is really large but has a lot of info.
http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799
 
Hi Everyone,

Just wanted to give an update and post a question. I changed her diet to Friskies canned and started testing her blood. Her BG dropped about 130 after a day. I kept her on the same level of insulin yesterday (the first day), but this morning, she's still at about 264. I'm not sure if I should give her any insulin or give her a smaller amount (maybe 1 unit versus the 4) since her BG is at a level we want it to be. Or I'm wondering if I should not give her any at all and keep testing her BG.

Thanks Sue for the burrito idea. It's definitely helped, although she does meow and flinch every time I poke her with the lancet. This morning she flinched so hard that her ear ripped a little. I'm getting more comfortable doing it, but I still feel bad for her. I just keep telling myself this is for the best.

Thanks again to everyone! I'm so excited that so far things are looking up!
 
JAne,

It will be very helpful if you would put a spreadsheet together and link it to your signature. This way we can see all the test numbers you have gotten and it will be easier to give dosing recommendations.

Here are instructions on how to set up a spreadsheet.

http://felinediabetes.com/FDMB/viewtopi ... =6&t=18207

For your reference, here is a link to what is BG levels in pets: http://petdiabetes.wikia.com/wiki/Blood ... guidelines

264 is a diabetic number and one that requires insulin. However, how much insulin 1 unit or 4 units or somewhere in-between is difficult to say, without seeing the spreadsheet of tests.

Another suggestion, in order to get more attention, going forward, start a new post with your specific questions. This one is getting a bit long and is asking about fiber requirements rather than dosing and BG advice.

Also, if you can list the insulin you are using in your signature as well, that will make it easier for anyone who comes to visit.

Finally, once you get the spreadsheet up, you may want to start posting in the forum for the insulin you are using. You will certainly get more specific dosing recommendations and guidance from the people using the same insulin.
 
I'm a Lantus user, so I can't give you specific dosing advice for PZI, but I would strongly advise against stopping insulin completely. Too little insulin, dehydration, and infection are a recipe for diabetic ketoacidosis, so I would use caution in lowering right now because of the UTI. I would at least continue with 1u and get some mid-cycle checks to make sure she doesn't drop too low. Can you set up a spreadsheet with your numbers and put it in your signature? That way the experienced PZI users can give you more specific dosing advice.
 
If you have trouble with the spreadsheet, just send me a private message and I will get it set up for you. (The small PM button at the bottom LH side of this post.)

Is the 246 your first test? And it is after 4 units yesterday? There are two ways to do this, if that is the case. We certainly would not recommend 4 units for a 246 amps. It is clear that 4 units is a pretty high dose, if she is in the 200s at preshot. Since we have no overnight numbers, we can't be sure how the insulin really worked. You can restart at one unit and monitor in case it is not enough, or reduce to 2 or 3 units and monitor carefully in case those amounts take her too low.

With the infection and IF YOU CAN MONITOR, I might suggest one unit for a cycle or two. Anytime you can get midcycle numbers, that will be helpful - during the day or settting up the alarm at night. If the one unit is not enough, we will probably be able to see that pretty fast and can raise the dose by .5 units every few cycles until she gets good numbers. If you only reduce to say, 2 units or 3 units, it may still be too high and then, instead of slowly increasing as the numbers indicate, you are running the risk of getting low numbers and trying to guess how much to reduce. It is why we suggest starting low and going slow.

If you do this, I would also start testing for ketones daily. Reducing the insulin while she has an infection and if she stops eating is the recipe for ketones. So you would want to watching carefully for those. Here is some info on ketones: ketones

You have the syringe. You decide. All we can do is give you alternatives and the best advice we can.
 
I would drop the dose but not stop it. PZI doesn't have a 'shed'- when it is gone it is gone so missing a shot could raise her numbers back up.

Reduce by 50% to 2u but check for ketones daily. Test when you can over-night if you are at work during the day. After you start getting numbers we can see if that dose is still too much.

And the testing will get easier- it is still new and she won't like it. Just give treats and pets and she will realize that it is all worth it for the TREAT!!!
 
Hi Jane,

Sounds like you are having a time trying to get a good blood sample? I just wanted to post this pic so you are sure that you are poking the right place:


Next - if you can get a SS set up, it would be great! It will help you, and it will help us to be able to help you. It seems that with Prozinc, many vets base the dose just on the numbers you get at shot-time (preshot tests). My vet did the same thing, which is the primary reason that Bob went all the way up to 4u twice a day when in reality, he probably never needed that much insulin. Once I figured that out (from reading on this board), I started reducing his dose, and about a month later, he went into remission.
Dosage - I "think" that Bebop's dose is too high, but we need mid-cycle test numbers to be able to prove that. With Prozinc, the only way to evaluate the dosage is to know what the highest and the lowest numbers are during a cycle. You have to know how low he goes in order to figure out if the dose is too much, too little, or just right. If possible, test before the shots, and try to get another test or two in between the two shots. The low point (nadir) should be between 5-7 hours after the shot is given.

If you can get some mid-cycle tests today, tonight, or tomorrow, you should get a good indication that the dose may need adjusting, and then we can help you to figure out if a reduction should be made, and how far to reduce. I definitely would say NOT to increase to 4.5u like they told you to. But whether it should be 1u, 2u, or whatever, it would be easiest to tell you that if you can get some tests in around "nadir" time.

Oh, and since the subject matter of this thread is no longer about fiber requirements, starting a new thread would be a great idea like others have said. :smile:

Carl
 

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