Regulation Help

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There is a recent thread in Health......Diet Change. It discusses the change from dry to wet -- good info!
 
There's a stickey for that. :lol: I hope this link works.

http://felinediabetes.com/TipsforTransi ... -18-09.pdf

I had to mix it at first, Harley was not a fan of canned food at the beginning, it took me MONTHS to convince him that the stuff in the can was really food. But other people open the can and the cat switches right over to it. You need to watch for tummy upsets switching fast.

As for the insulin while switching. I wouldn't do them both at once. I would start with the 1 unit and test to see how he does and go from there.
 
Robin, do you suggest I start over at 1u tomorrow? Also, I think I may need different syringes. Are there syringes that have quarter doses on them? I currently have U40 1/2cc syringes. Should I change his food before or after I start over at 1u?

Thanks for the input, Kim. I would probably feel most comfortable mixing it at first, mainly because I'm unsure he'll eat wet food by itself, and also because I'm worried his numbers will dip too low.
 
Yes I would start over at 1 unit tonight. Then tomorrow if you could get some mid cycle tests we can compare that to today.

Kim is absolutely right that you will need to start checking for ketones when you drop the dose. You may never see them but at least you will be on top of it if you do. It's easy to check and gives you one less thing to worry about.

When you want to do .25 unit doses we switch to U100 syringes with 1/2 unit markings and use a conversion chart, you can get those syringes at Walmart also.

Lower the insulin before switching the food. If his bg's drop from the food switch he will have less insulin in his system.
 
As far as checking for ketones, I just try to catch him in the act and stick the strip right in the stream, or do I need to collect a sample? What do I do if ketones show up? Do I test multiple times a day?
 
If he will let you, that's the easiest way. Oliver would not let anyone watch, so we put aquarium gravel in a clean box and left him alone in the room with it. He'd christen the box and we would have our sample.

Once a day should be okay for ketone testing, less if no changes and everything is going well.

If you get anything trace or above, it really needs a vet visit. One way to help keep ketones away is to add water to the wet food so they are more hydrated.
 
If you can stick the strip in the stream that would be great. Some people use a ladel and catch it.

Checking once a day is fine in the beginning. If the strip changes color showing that ketones are present you would need to take him to the vet for fluids to flush them out of his system or have the vet show you how to do it and you can do it at home. It's really pretty easy.

Untreated, ketones can lead to DKA (Ketoacidosis) which is extremely expensive to treat and can be deadly. Ask Kim, I think it cost her over $3000. to treat Ms. Kitty.
DKA is brought on by not enough insulin plus an infection like UTI, etc. Once they go into DKA they are more prone to getting ketones after.

So you can see why waving an inexpensive strip in his urine is the easy way to go and is just a safety net when dropping the dose. Some kitties are not prone to ketones.

Also when you get him switched to wet food you can add water to the food to keep him better hydrated.
 
I think the hardest part will just be trying to catch him to get any kind of sample. If he's already had a UTI, is he at great risk for ketones?
Also, just tested 315 +6.
 
No, the past UTI does not make him at greater risk for ketones.

I will try to explain ketones to the best of my understanding, which is very elementary at best..... insulin helps in the proper digestion of food. Glucose is what fuels the body--- but, with insufficient insulin, then the glucose cannot be broken down. We know that with diabetics, this is a problem. When insulin is insufficient, then the body does not digest food properly and the kitty's cannot get proper nutrition, thus the weight loss. To compensate for this, the body starts to break down the muscle and body fat--- ketones are a byproduct of the muscle breakdown. DKA, is a condition that develops when the ketones get at a high level and the body becomes too acidic. With DKA the electrolytes get out of balance. The acidic condition (ph level) is very hard and bad on the organs. DKA can happen very quickly. A BG does not have to be at "High" levels for ketones or DKA to develop-- I have seen cats in PZI go into DKA with BGs in the 200s. It is a good practice, to test all diabetic kitty's for ketones on a regular basis. The keys to warding off ketones are-- fluids, insulin, and food. Anytime a diabetic kitty starts eating less and becoming lethargic, I would immediately check for ketones.

Like anything else, ketones can be treated quickly and successsfully as long as you are testing! So, don't fear this......Just be vigilent, especially when you are lowering the dose. You have a cat that has been getting 8 units of insulin a day and eating lots of food. You are now considering going to 2 units a day and are not certain if he will eat as much. But, to get him regulated, he must get off of the dry food and in doing that he eventually will need less insulin.

You have a tremendous support system here, so just give everyone a heads up when you are going to start your reduction and food switch. AND, get your Ketostix!
 
The ketones make sense. While science was never my strong suit, you made it make sense :)

I am planning on going to 1u tonight and seeing what happens. I'll check for ketones tomorrow... hopefully. I'll be following him around all day trying to do so.
 
Would you consider starting, at least partially with low carb wet, when you reduce the dose?

The dry food can raise the bg levels 100 points, or more. So by lowering the insulin and continuing the dry, you are most likely to get high levels with less insulin to counter them. It is very possible than the dry food has been keeping him in high enough ranges to avoid a hypo with the previous high dose.

It would be good to make only one change at a time, but in my opinion, at this point, I would reduce the dose and feed low carb and monitor ketones and bg levels carefully.
 
It's fine to do that short term, but you would expect to see higher BG numbers on the lower dose without the diet change. It's okay though. You'll be establishing a "baseline" on the lower dose that you can use going forward to see how much improvement happens once the diet is switched. You just don't want to delay the switch for more than a day or two so that he's not hanging out in the higher numbers for long.

Kim, good job on explaining the ketones, by the way :-)

Carl
 
I can go along with starting the food switch right away since you are going to be mixing it together at first. I was thinking that we wouldn't know if the numbers were being influenced by the dose or food, but it doesn't matter, it's better to switch right away for his health.

As long as you reduce the insulin to 1 unit first.
 
What if I reduce to 1u tonight and tomorrow morning, then feed a mix of his dry and low-carb wet starting tomorrow night? I don't have any wet low-carb on hand yet. But if I should start that I'm the morning, I will run to Walmart tonight. Any recommendations for low-carb wet at Walmart? Also, I haven't been able to update his chart yet, but his most recent reading was 335 so he's headed back up.
 
Do it however works best for you, 1 unit tonight and AM, switch the food when you can. I hope he takes to it right away.

Special Kitty Pate's, Friskies Pate's, Fancy Feast Classic's are all low carb.
 
PMPS was 301, so he's going back down again... which I don't understand. I'll do the 1u tonight and tomorrow morning. Then with his PM shot, I'll try to mix low-carb wet with his dry and see if he takes to it. Do you suggest half and half?
Also, any advice for his poor ears? They look like they're taking a beating (mostly thanks to our inexperience in pricking them). I know it doesn't hurt him because he's not reacting, but he's got bruising for sure. I try to rub them a little bit, but he doesn't really let me all that much.
 
Half and half is okay. You can hold his ear for a few seconds after poking to help with bruising. Neosporin with pain relief will also help. Just a tiny smear.
 
Started at 389 this morning after 1u last night. Also, to the person who asked about his weight, I'm sorry I overlooked your post. He is 11 pounds.
 
Yes, I'm planning on every two hours today so I can stay on top of it with the dosage drop. Hoping to do a ketone test as well.

He'd like to have you believe he's an angel :) But he sure is a feisty little guy.
 
Oh, good on the testing, I'm sure he's feisty, he's still a youngster.

What canned food did you end up getting, or are you getting that today.
 
Good Morning!

I was reading some of your posts from late yesterday. I saw where you had a late cycle test of 335 and then a pmps of 301-- and you considered this as his BG going down. In the diabetic world of hometesting, these would be considered pretty much the same reading. We all kind of accept, that there is a 20 percent variance possibility in each test. So, I would say his readings were flat. I just wanted to give you some feedback regarding the test!

I am looking forward to seeing how he does today on the 1 unit. Did you start mixing the wet food in or are you going to do that tonight?

I also saw you asked about Low Carb food at Walmart. For what is is worth, Kitties seem to LOVE Fancy Feast! In fact, it is often referred to as Kitty Crack here! My crew loves it. It might prove to be a good choice, especially in trying to transition him.

Good Luck!
 
Thanks for clarifying about last night's numbers. I was baffled as to why he'd be going "down," but that makes more sense now.

I'm planning to get some wet food today for him and start mixing that in tonight with his dry. I'll probably grab a couple different kinds just in case. Sounds like Fancy Feast Classics and Friskies Pate are the top choices for low-carb.
 
394 +2
Little sneaker tried to outwit me, but I caught him just in time to get a ketone test. Negative!
 
Just curious, has anyone ever used the foot pad to test? I'm starting to feel terrible pricking him in the ears so much. Plus, he doesn't exactly sit still, which makes it even harder. I'm thinking if I can scratch him into submission, the foot pads might be easier, but I'm hesitant to try.
 
Some people do but there are concerns about them having wounds on their pads and the Litter Box, etc.

The brusing on his ear will get better as you perfect your technique. You can switch ears, move up and down the side of the ear, etc.

And apply pressure for a few seconds after the test using a tissue or gauze pad, that will cut down on the bruising too.

We are aiming for the capilary blood between the vein and the edge of the ear. Harley mostly bruised when I accidently hit the vein.
 
That's good to know because I have accidentally hit the vein several times. I'll just stick with the ear.
 
Not yet. He eats at 8p CT. So just under a couple hours to go. Should I test him after he eats?
 
Good. I was hoping that was the answer I'd get. He's getting pretty angry/frustrated with us. Hopefully he comes around with the testing part. As far as the canned food, he took to it like I couldn't believe. I did do half and half, but he snarfed it down. He was still really hungry, so I threw a few extra pieces of dry down and he wanted nothing to do with it... so I gave him a few treats instead :) The switch might be easier than I thought!
 
Good, lucky you. I hope he's smart enough to like the canned food better and switch right over.

Low carb treats, Bonito Flakes, Freeze Dried Jerkey, etc. is the key to testing, they get a treat for every poke, sucessful or not, so if it takes you 3 pokes to get a test they get 3 treats. Soon they associate the pokes with the treats and will come running to be tested.
 
He's getting pretty angry/frustrated with us. Hopefully he comes around with the testing part. As far as the canned food, he took to it like I couldn't believe.
Click to expand...

What I became convinced of with Bob was that time went by, the testing and the shots got a lot easier. I think my technique improving had a little to do with it, but what I really believe is that as the cat starts feeling better, they are smart enough to associate the "routine" with actually feeling better. I think they put up with it, and with us, because they figure out that it's helping. Your boy will "come around" too.

As far as the canned food, he took to it like I couldn't believe.
Click to expand...
Both my diabetic, Bob, and my civvie, Mullet, took to canned food like fish to water. I'm not sure if they'd eat dry again after a year and a half of not having any, and I know I'm sure not going to try. But I'd be willing to bet that if I stuck a bowl of dry and a bowl of canned side by side for them, they'd clean the canned food bowl before touching the dry food.

Carl
 
I guess I should look at it kind of like his shot. Before we were testing, when he was first diagnosed, he did not like his shots. Eventually he got to the point where he didn't care, and I could even do it while he was sleeping. Like you said, because he knew it made him feel better.
One thing I need to change is a treat for every shot. I've been giving him treats at the end, but I should stop to give one every time I prick him. I have also found out that NOT using the lancet pen is a bad idea. I thought I'd be more accurate, but it turns out I just prick too hard that way. Hopefully he comes around soon and will be less squirmy.
Also, will the canned food keep him filled up longer? Seems one of the hardest parts about testing AMPS/PMPS is he's soooo hungry, he doesn't want to sit still at all... just eat.
 
AMPS at 289 this morning! Since he's eating the wet food with dry mixed in, should I go ahead and switch straight to the wet? I already fed him this AM with the mix. Also, how often should I test over the next few days with new food? I don't want to overdo it and stress him out more than necessary.
 
The trick to the testing thing is to figure how it will work best for the two of you. Everyone does it a little differently. You could give him a few treats while you are poking, and then lots of praise and a few more when you are done. (you have low carb treats, right?) And anytime he is squirming, you can get a drop on your fingernail and test it from there.

Nice amps! Yes, I'd go with the wet and ditch the dry. For now, unless you get a number that makes you nervous, you could do the preshots and somewhere in that +5 - +7 range. Put on the Neosporin and give his ears a while to look less ragged. :mrgreen:

You two are doing great!
 
Thank you so much! I seriously could not believe he was at 289 this morning... just from food! Is it likely to go down more after we completely kick the dry and it's all out of his system? Also, when should I start changing his dose? Should I wait until he's just on wet for for a while to think about that?
 
It's one of those "every cat is different" things. Some react right away to the low carb (for Oliver 100 points overnight) some gradually go down, some take a week or more. I'd just watch and see. As long as you monitor and he is on one unit, he should be okay.

You would lower the dose if you get a midcycle number in the 40-50 range or a preshot too low to shoot. (remember that waiting 20 minutes without feeding and retest thing). It may take awhile for the insulin and food to work together, or you may see differences in a few days. The trick is just to stay on top of it.
 
Nicer AMPS.

Yes, if he will switch to the wet right away go for it. You can donate the left over dry food to a local shelter.

Unregulated Diabetics can not process their food properly so they are literally starving, for now feed him as much as he wants, when he becomes more regulated his appetite will go back to normal. We also suggest more frequent smaller meals throughout the day to support his pancreas.

Always test pre injection, somewhere between +4 & +7 at a minimum.

A +4 will tell you where he is headed for the day or if he is dropping faster than normal. You are going to want to experiment with tests at different times to find out when his nadir is, usually between + 4 and +8.

Also test anytime something seems off with him.
 
Well, I did three smaller meals yesterday, starting with all wet in the afternoon. He was at 309 last night and 335 this morning. Am I needing a dose increase, or does he still need time to adjust to the wet food?
 
Good Morning- I can't pull up your SS due to firewalls at work! Imagine that! So, do you have any tests during the cycle or just the amps and the pmps?

It normally takes longer than 24 hours for the dry to totally leave his system- so I would wait another day before increasing. And, once I started increasing, I would go up in small increments. Be sure you are testing for Ketones!!!!
 
Yesterday AMPS was 289, 239 +4, 298 +8 and PMPS was 309. The last time he had dry was yesterday morning when I mixed it half and half with his wet. I just ordered some U100 syringes yesterday because I couldn't find any at Walmart, so I guess I kind of have to wait to increase until I get those anyway, right?
 
I Never used the U100s. I always used the U40s and just "eyeballed" the increase-- but, my Kitty loved insulin and .1units was like water to her! I never had any problem increasing by .5 units and using the U40. I even used the U40s when dosing Chewy, who was sensitive to insulin. You will hear many here say they gave a Fat 1 unit-- just meaning that they made sure the unit mark was showing when pulling back the dose. People that are increasing by .1 units might need the U100s, but I think you can increase and dose without them-- Be SURE to use the conversion chart if you decide to use the U100s. Prozinc is a U40 insulin and anytime you use a U100 syringe with it, You MUST use the conversion chart. Do you have it?

They should have U100 syringes at any Pharmacy. They are normally behind the counter. I buy U100 syringes for Sally, My Diabetic Dog (yes, I know.......) from Walmart.

Good Luck
 
I do have the conversion chart. And I guess since I already bought the U100s, I'll be using them :) I guess I should have asked the pharmacist at Walmart. Oh, well. Lesson learned! I think I'll see how he does today, and maybe start an increase tomorrow. I think he's going to need it regardless, but it would be nice to see how he does on a full day of wet food.

Diabetic dog and cat? How did you get so lucky?? ;-)
 
~O) Morning,

Here is the conversion Chart, I printed it out and hung it on the side of the fridge and checked it twice when drawing the insulin, you can never be too careful. Did you order the U100 syringes with the half unit markings?

http://www.felinediabetes.com/insulin-conversions.htm

When I get home tonight I will get you the information on the Walmart syringes, so you can take it with you, they often told me they didn't have them when I knew they did.
 
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