Results of first At Home Curve

Hi,

I have completed my first at home blood glucose curve and before I send my results to the vets, I would love some advice on the results. (My spreadsheet has been updated).

After the first curve (at the vets), my vet said to raise the insulin units to 3. I decided to raise it to 2.5 after speaking with people on the forum as I didn't want to jump up so quickly (my vet does not know this ....yet).

Anyway, following the results and the extremely high numbers, I think I should increase the dosage to 3IU? What do you think?

Also, as most of his numbers are black - should I be really worried that they are so high? What could happen if they continue to stay high? Douglas sleeps a lot but there is really no change to his behaviour in the last 3 months.

Any advice/thoughts/happy vibes are very gratefully received

 

I cannot give dosing advice but wow you've really caught on to testing GOOD FOR YOU AND DOUGLAS! Way to go!
He sure is a handsome lil devil! Scritches to him!
Is that happy enough?
I think I do happy quite well

 

Absolutely, it actually bought a tear to my eye, but tears of joy! Thank you.

I seriously cannot believe how far Douglas and I have both come in such a short space. You guys are absolutely amazing with this support!

 

It is an amazing site. I found it back in 2008. and its still rollin stronger. Stronger than ever I think! Its every person who posts here. We are FAMILY!

 

Gosh yes, you seem to have mastered testing very quickly indeed, well done! That in itself is a huge step forward.

Those are very high numbers, yes, and the aim is to lower them in a sensible and safe way. Cats do seem to cope remarkably well with high bg but if numbers stay high for too long it can cause organ damage. That’s why people are so passionate about testing, dosing and getting numbers down.

I’m not a dosing expert either but it’s hard to say much without more bg data. Do you know what Douglas’s numbers were like when he had his first curve at the vet? What dose was he on then? It does look as if an increase is needed but it would be interesting to see what bg was like on a lower dose. Another thought also - has Douglas been checked for any kind of infection? That can raise bg, and diabetics are prone to infections of various kinds, such as UTIs (especially male cats). And has the vet looked at his teeth recently?

Maybe @Elizabeth and Bertie or @Critter Mom - both very experienced UKers - have some thoughts for you. Meanwhile, you’re right to increase in small increments - vets tend to suggest increases of 1u at a time quite quickly, but remember that insulin is a powerful substance and and although an increase of 1u doesn’t sound much, it is. Best to go slow and increase by 0.25u or 0.5u to stay safe and make sure you’re not skipping over the “ideal” dose. That said, you don’t want to hang around too long on one dose if numbers are stubbornly high.

See what the others say.

 

Thanks @Diana&Tom, the first line on my spreadsheet is the one taken from the vets.

Would it be an idea to do another curve sooner than 10 days (vet has said it takes about 7-10 days to know if the insulin is working)?

 

Sorry, I missed the dates on the ss. It doesn’t look as if much has changed so I’d be inclined to increase. Yes it can take several days for a change of dose to “settle” if that makes sense so try another curve a week or so after an increase. But I’d like to see what the others say - Eliz has many years’ experience treating two diabetic cats and Mogs too has a vast amount of knowledge.

 

Hi there,

Well-executed curve. Gold star. Top o' the Class!

Textbook response to Caninsulin (bucket-shaped curve).

Couple of questions:

1. What weight was Douglas? What is his ideal weight.

2. Do you know the carb values of the Royal Canin Diabetic Wet and Dry diets?

3. Was Douglas started on 2 units of Vetsulin?


Mogs
.

 

Hi Mogs,

1. He has been a steady 4.25kg (9.36lbs) for the last few months, but I've weighed him this morning and he has lost weight, he is now 3.81kg (8.4lbs). His ideal weight should be between 5-5.5kg (11-12lbs).

2. I don't know the carb content, it doesn't seem to show on the box. But I've just looked and protein only accounts for 9%?! Surely that can't be right. Ive attached a photo.

3. He started on 2IU on 24th July this year.

Any help would be much appreciated. I am now really concerned about his weight. Should I up his food? He has 2x 100g sachets and 40g dry of Royal Canin Diabetic in a 24 hour period. With a small plate of tuna during his shot (as a positive association). The royal canin he eats 20-30mins before his shot and smaller meals throughout the day.

Thank you!

 

If you can get the dry completely out of his diet, it will really help. The RC Glycobalance is very high carb. The ME profile comes out to be about 24% of calories from carbs. We want them eating less than 10% carbs.

The canned RC is better, but not much. It's about 12% if I remember right.

BUT, don't change the food quickly and be ready to test often. Lowering the carb percentage in the food can drastically lower the need for insulin.

 

Hi! Fellow Caninsulin user here!

Our numbers didn't budge for ages...see SS....but changing over to just wet food really made a huge difference. I had to wait a week or two to do it to make sure I was up to speed with the home testing. Our old vet would up by half units but our last half increase (from 4.5 to 5) by our new vet really shook something up and we are currently testing out 2 units and will only be increasing and decreasing by .25 units.

Congrats on the home test!!!!! It really is such an achievement!

 

I was about to say exactly this. Try to remove the dry completely and you should see a lowering of bg from that alone. Vets are very fond of prescribing “special” food but you should be able to get all the necessary nutrients from a good-quality commercial cat food. Many of us here in the UK use Zooplus, or something like Natures Menu from www.fetch.co.uk - that’s what I feed and I increase protein intake by adding small amounts of something like the shredded Applaws chicken or just human cooked chicken. As Chris says though, if you do cut out the dry do so over a period of a few days and make sure you’re testing enough to catch any surprising drops.

This is very much a learning curve, we’ve all been there, trust me! You’re doing really well, probably better than you think

As for the weight loss - if that’s due to Douglas eating less, by all means feed him more. Unregulated diabetics are often very hungry - don’t withhold food.

 

@Diana&Tom @KyraCat @Chris & China (GA)

Thanks guys! I think my next step will be to remove the dry food and have it completely on wet. Then look at changing the wet food to a lower carb. I didn't realise RC was so high in carb.

Is there an easy way to calculate what the carb % is? I can't seem to decipher it on the cat food which unlike human food seems to show the carb %.

@Critter Mom, do you think I should still increase the dosage to 3IU? I ideally want to go back to the vet with a plan in place and then get his advice on it as oppose to him dictating the next step (in the nicest possibly way, of course )

 

Hi Anna, yes, for those of us in Europe there is an easy way to calculate the percentage of calories from carbs. You can just use this little online calculator (link below).
(Calculating carbs is harder for people in the US because the data on their pet foods isn't as accurate as European data).
https://secure.balanceit.com/tools/_gaconverter/index.php

I did take look a the Royal Canin foods and the dry is around 26% calories from carbs, and the wet around 14.7% calories from carbs (using data from Animed).
We do recommend that diabetics have diets with less than 10%, and many cats do best on diets with no more than, say, 4 - 6%. There are lots of options in the UK. Do take a look at the list in my signature.

Well done for doing that curve. Excellent job!
The numbers are high. And there are two things you can do to try to bring that down at this point. You could increase insulin dosage. Or you could lower the carb content of the diet. But don't do both at once...

My suggestion would be that you first get more comfortable with testing on a routine basis, and then phase out the high carb food. You could, as I think you said above, start by phasing out the dry, and then lower the carb content of the wet food.
You 'do' need to be hometesting while you do this because it's not known how the change in diet would affect Douglas's blood glucose (and the dose may even need to be reduced). So, you'd need to get at least a couple of tests every day....
How do you feel about trying to get a test before every insulin shot..?
And might you be able to get another test at some point in the day, preferably in the first half of an insulin cycle? ...I know you're new to testing, so please don't feel under pressure. But this would be a really useful thing to aim to do...

And then, once the diet change is done, you could increase the insulin dosage - if that is still necessary.

Eliz

 

Yep. Just did the calculation based on the as-fed values for the wet RC food as shown in the photo above. It also yields 14.7% calories from carbs.

Natty little calculator BTW, Eliz!


Mogs
.

 

I think if I were where you are at the moment, I'd arrange a consult with the vet to say I wanted to remove the dry food from Douglas' diet and that for safety reasons I would prefer to hold off on the dose increase until the move to an all-wet, low carb food has been completed and the impact on Douglas' BG levels could be properly gauged. Then continue the discussion from there.


Mogs
.

 

PS: I agree with Diana: you need to give Douglas more food (preferably the lower carb wet variety). With the range his BG is running in he won't be getting the full benefit from his grub yet.

How much is he drinking and peeing at the moment?


Mogs
.

 

OMG what invaluable information, thank you! The carb calculator looks amazing and will definitely be using that. I have some Applaws food that I had bought in bulk prior to his diagnosis so will check that value of that. But agree to phase out dry, then change wet to lower carb.

I think I could do the test prior to his feeding prior to his shot. This weekend, I will try to do a few more tests throughout the day. Do I record this all on the spreadsheet? If I do some couple throughout the day are there any better times to do this (ie, not a full curve)

He actually decreased his water intake and outtake, although it has slightly increased recently.

By how much should I increase his food? Whats a safe amount or should I let him dictate to me?

I know I keep saying it but this is an absolute revelation and am feeling more and more confident going back to the vet!

 

I'd let him eat what he wants throughout the day. Just remember to remove all food for the two hours before AMPS and PMPS BG tests to make sure they're not food influenced. He needs to get back to ideal weight.

Thanks for the info about Douglas' fluid intake and output. Given that it seems to be increasing a little, I'd take that as a flag to get a bit of a motor on WRT the diet modifications - safely! He needs to get his BG under better control.

When I was using Caninsulin, for safety I tested every day at AMPS, AM+3, PMPS, PM+3 (before bed check). I'd then do additional spot checks at different times during the period when the Caninsulin was at its most active to check whether Saoirse might go lower than +3 (she tended to nadir early, but nadirs can move around) and also later in the cycle to check when the dose had pooped out. It worked well, and I'd recommend it as a test strategy. Note: +2 tests are also very valuable because they can give an early warning of bigger drops to come later in the cycle.


Mogs
.

 

TOTALLY AGREE with this!

 

Sorry, I might be a little dumb here but what does WRT mean?

I'm gonna start phasing out the dry from tomorrow over the course of 6 days with preshot tests and other tests when I can

 

WRT = "With respect to", a common internet abbreviation (but obviously not as common as I thought! )


Mogs
.

 

No, its me. Sometimes I have to Google even the simplest ones!

LOL (lots of love, right?! )

 

Oh this is a whole new thread! I sometimes use abbreviations like IDK thinking it’s obvious but nobody has a clue what I mean (SMH)

 

HA! I posted smh on another site and someone asked me why I was slapping my head...

 

Because removing dry food from a cat's diet can have such a big - and fast! - impact on a cat's insulin needs, I'd hang fire for a little bit longer before removing the dry food, Anna. Not too much longer, but to be safe it would be better if you had some more BG test data before starting. Again for safety, when you do start the transition to all low-carb wet food you'll need to be in a position to check how low Douglas goes on each cycle as more and more of the dry is removed from the diet because the insulin dose may very well need to be reduced alongside the reduction in dry foods.

At the following link there's good advice from vet Dr. Lisa Pierson on how to safely transition to an all low-carb wet diet:

catinfo.org - Feline Diabetes Page


Mogs
.

 

Do you hug huskies? Can I call you Dave?




Mogs
.

 

Mogs, you’re in a league of your own

 

Hi Douglas, Applaws is great to reduce the overall carb content of a whole day diet, but the pure meat pouch does not have any nutrient, so is not considered a viable diet substitute on its own.

 

I'm just badly sleep-deprived, Diana. Makes the brain go really skitty.


Mogs
.

 

But very entertainingly so

 

Nice to know I'm good for somethin'!

.

 

As indispensable as anyone here, my dear!

 

Thank you, that makes sense. I will collect some more BG data first.

Sometimes I can jump in head first wanting to make the change asap! Must remembe, slow and steady wins the race

 

You are right! I had the senior complete foord but the other was just complimentary, must bear that in mind

 

It's hard, Anna, because we all want to do everything we can to help our little ones, and we want everything to be all better - BY YESTERDAY!!!

Youse'll get there.


Mogs
.

 

So just an update, I emailed my vet the results and my plan of moving Douglas to low carb food before changing dosage.

He agreed but wants me to stay on diabetic food so has offered Hills and Purina as alternatives. Whilst I didn't say no, I did say that I would be doing some research on low carb food this weekend and will email him what I decide. This conversation was through his nurse (not direct with him) but they seemed adamant about sticking with Royal Canin, Hills or Purina diabetic. Im not convinced and will pick a low carb food.

Now I really want Douglas's numbers to drop from the change of food alone to show the vet that diabetic food isn't always the way!

 

Thats because they believe what the marketing person told them. They MAY even be getting kickbacks from Royal Canin.
You have one of the best defenses. COST.

 

Thank you, nice to know I'm not just being difficult!

 

Not at all. We can choose to feed our cats with whatever we like, according to our own research. Stick to what you believe to be best for Douglas. Vets don’t always know much about the content of foods and automatically think prescription stuff must be superior. If you don’t want to get into an argument you can always say that you simply can’t afford the expensive prescription stuff on top of insulin etc - say you can buy good quality food in bulk online which is just as good, end of

 

Exactly!

 

Glad it went well with the discussion re overall strategy, Anna.

WRT the insistence on the diabetic Rx diet choices, I suppose like all the rest of us vets probably like to stick to what's familiar and what has worked for other of their diabetic patients (in the sense that they stayed alive).

I have no idea how great a percentage of caregivers of diabetic cats are as proactive and hands-on as we are here at FDMB. Many caregivers don't home test, possibly because they're not educated about it - and are in many instances actively warned against it - by their vets. In such cases the only way to protect the cat as much as possible from hypos is to have it 'run hot' through dietary manipulation. A carbed-up cat may thus be kept at a fair distance from the hypo threshold but unfortunately it tends to push the cat toward the renal threshold. I think many in the veterinary profession - even some feline specialists - consider the gold standard of feline diabetic regulation to be a cat that doesn't hypo and who doesn't tip glucose into its urine. Hardly ambitious.

Some caregivers are advised by their vets that all they need to do is get occasional curves done at the vet's surgery, feed a high-carb diet, or even an ultra-high-carb diet, dose blind every day, monitor water consumption, and hope that they can spot a hypo in time to administer honey.

The 'running hot' / minimal monitoring treatment approach may not be ideal but, rather ironically, it may be responsible for saving the lives of many animals whose owners would choose not to treat their diabetics at all if presented with a more demanding regimen at time of diagnosis.

Unfortunately I think sometimes problems arise when people with more ambitious treatment goals for their cats and who wish to be more hands-on as caregivers come up against vets who are reluctant or unwilling to deviate from practices that they are more familiar with. Vets also legally have a duty of care to their patients and may be nervous about more progressive treatment protocols. Fear of the new and different? We're all guilty of that to some degree.

Just my two penn'orth.


Mogs
.

 

@Critter Mom, definitely food for thought. And makes sense with regards to 'covering all bases', ie, higher carb food to avoid hypo.

As they say, sometimes ignorance is bliss. If I had not been wanting to find out more except what the vet told me then I would be in that category as I thought 'vets know best' and I wouldn't have thought I was doing anything wrong. By knowing more opens us up to a whole degree of consequences but also real rewards when things are going well.

Like you say, those that choose to find out more then those who don't (not in a bad way but could be restrictions on resources etc).

I just hope my vet doesn't think I am trying to 'outdo him' but to take more responsibility in the duty of care for Douglas. One way to convince will be the numbers and I hope I can

 

That’s an excellent summary of the situation, Mogs - would bear repeating in its entirety elsewhere every time the issue of prescription diets comes up.
“Carbed-up cat” though - I’ve never heard it put like that before and have to laugh!

 

My vet recommended Purina Pro Plan DM - she said it was much better than either Royal Canin or Hill's, and looking at the numbers I have to agree. By my calculation, Purina PP dry is 13.3% carb calories, which is nearly as good as the RC wet, and Purina PP wet is only 4.6%. We foolishly bought ours from the vet at full RRP, but you can get it much cheaper at ZooPlus. Also, ZooPlus has a discount club that costs something like £2.99 a year and gives you 3% off all orders, so if you're getting all your food, cat litter, etc from them it soon pays off the annual fee.

FWIW (for what it's worth), Maddie much prefers it to her old kibble, and I was able to transition her onto it in only a few days. I want to move her onto wet food, but that's more of an uphill struggle so we're taking it slowly. I've also ordered some other good-quality lower-carb foods from ZooPlus (Integra Protect diabetic, Feringa, Mac's, Porta 21 and Wild Freedom) to see which one she likes best.

Good luck with Douglas - getting an underweight diabetic cat onto a better diet is a bit of struggle, but we're in it together!

 

Oh wow, thank you. I was gonna assume that Purina and Hill's would've been the same carb content so glad I assumed wrong. Will definitely check it out.

Btw thank you for including the meaning of the abbreviation

 

No worries. I'm not completely certain about the numbers, as each manufacturer lists things differently and the RC percentages total more than 100%, but looking at the ingredients list on ZooPlus, RC dry has 18.8% starch whereas PP has 12.5%. Hill's is also lower in starch but has vegetable protein as its first listed ingredient, which is not good for cats - plus the last thing you need for an underweight diabetic cat is a formula designed for obesity management!

 

An excellent post, Mogs.
Edited to add: This actually reminds me of something that happened shortly after my first diabetic, Bertie, was diagnosed. I asked the vet how long a diabetic cat could expect to live. He cheerfully said that, "About two years is average". And when I asked if I should test blood glucose at home he said, "You shouldn't need to do that." ....Hmmm... ...My cat was 8 at the time. And I really hoped he'd have more than two years... I got online, found FD groups, and started learning. And the vet was amazed over the years that Bertie lived so long with diabetes...

 

Thanks to his wonderful mum, Bertie didn't spend half the time with his organs swimming in syrup.


Mogs
.

 

And diabetic No 2 is OTJ too!

 

Aw, that is sweet of you, Mogs.

She is indeed, Diana. ...Although I don't entirely trust it to last... Time will tell...

 

Kyewl!!! Way to go, Eliz. Fingers and paws crossed that it will hold.


Mogs

.

 

The typical approach of UK vets to feline diabetes is primarily to balance food intake with insulin, while trying to keep the cat out of the hypo zone. If the approach is to balance food and insulin then it really doesn't matter so much if the cat is on a high carb diet, because they may just need more insulin to balance that out...
But a big problem with this limited approach is that it vastly underestimates the proportion of cats that could go into remission and cease to need insulin at all; and this approach disadvantages those cats immensely.
There are definitely cats out there on insulin 'only' because they are on a high carb diet that needs to be balanced out with insulin. We know this because of the number of cats that go into remission after a change to a low carb diet. And even those cats who don't go into remission may need far less insulin than previously.
Just one example: When I adopted Bonbon in Feb of last year she was considered to be 'stable' on a dry prescription diet and 4 units of Caninsulin BID. Transitioning her to a low carb wet diet immediately reduced her insulin requirement by half. And she was much happier and healthier on the wet diet. ...I switched her to a longer lasting insulin. Then over the following months her insulin requirements also gradually reduced further and she went into remission last October.

Many vets still greatly underestimate the number of cats that have the potential to go into remission. A lot of caregivers are still being told by their vets that remission is something of a rare occurrence. But that is not our experience on FDMB. And the RVC's own remission research a few years ago (the largest ever randomised trial) found that around 30% of cats 'in the general population' can go into remission. And if conditions like acromegaly and pancreatitis are removed from the stats then it can be over 40%...
The RVC's own recommendations are for lower carb diets and longer lasting insulins. They also recognise the value of hometesting blood glucose. But many vets seem to be unaware of this, or else they are aware but are choosing - for whatever reason - to stick with what they were doing previously...

If the approach to feline diabetes includes that remission is definitely a possibility then that is a game-changer, and can radically affect how the caregiver treats their diabetic kitty. Things move beyond simply balancing food intake with insulin, and can include strategies that give cats the best chance of getting into remission.
Of course not all cats will go into remission. Even our very best efforts may not bring that about. There are a lot of factors that are simply out of our control in this regard. But the same approaches that give the best chance of remission also give the best chance of getting the kitty well regulated. And a well regulated kitty is likely to be healthier and happier (and indeed probably safer in terms of hypo) than a kitty that is on a high carb diet balanced by insulin.

Hometesting is also a game-changer. If we can 'see' what is happening with our kitty's blood glucose then we can have much greater scope for influencing it. We can see how foods affect our cat's blood glucose; how the insulin works in the cat's body; and how well - or otherwise - any particular insulin is working for our cat. It makes managing diabetes safer because we can more easily deal with low number and hypo situations. And - for the lucky cats that can achieve this - we can see if our kitty is going into remission.

Eliz

 

Awesome post Eliz.! Thank you

 

With our old vet I kept asking if changing to wet food would help and every time I got told it wouldn't make a difference. Once I got comfortable with home testing we changed fully to wet and after 3 weeks on wet food we got much improved (but not perfect) numbers and a huge decrease in the amount Kyra was drinking yet the vet still didn't think that the wet food could be helping. He also tried to make some excuse that it was only because of the wet food that Kyra was drinking less. He was completely ignoring the fact of how well the readings were coming down, and he had a copy of our SS. Funnily enough though, in the next breathe, he started to try and talk me in to some expensive prescription food and another fructose test (3 weeks after the last one). Safe to say we changed vets the following week.

Do what feels right to you and your cat

 

Aw, thank you, dear Jeanne. x

 

Ooh yes, those are looking better....

 

@KyraCat Those numbers do look much better and give me some hope that Douglas' numbers will drop. To see purple or even yellow colours on my spreadsheet would be amazing.

From yesterday he is only on wet food and once the new lower carb food arrives, we will transition onto that. I have decided to go with Purina DM Wet for the moment. I know it's not everyone's favourite but is definitely much better than Royal Canin Diabetic.

I went on a bit of a carb calculator frenzy at the weekend as still had some of his older food before I moved him to Applaws just before he was diagnosed. I am shamefully going to say that the Indoor Royal Canin food he as on was 45% carb

 

This is all going in the right direction, Anna, and I’m sure you will start to see different colours soon. As you’ve probably realised, this is a marathon not a sprint, and it’s much better to be patient and do things the right way.
That RC food is eye-wateringly high in carbs but don’t beat yourself up - we’ve all been there and how were we to know until we had reason to learn about carb values?
You’ve been working really hard on all this - I hope you’re remembering to give yourself a few treats too!

 

It's true that an awful lot of cats on a wet diet don't drink much, if any, water from their bowls; they don't need to because the food contains all the water they require. That said, depending on how high blood glucose levels are running, diabetic cats on a completely wet diet would need additional water over and above that contained in their food. For example, at time of diagnosis Saoirse was going through 1.5 litres per day.

What goes in eventually comes out. Perhaps next time point out to him that Kyra's also peeing a lot less.


Mogs
.

 

Great job on the food transition and dose management, Jemma.


Mogs
.

 

I.5 litres a day? Ye gods! Just shows what diabetes can do
It’s true that cats on an all-wet diet don’t always drink much water. There is always fresh water out for my civie Sapphire and she very rarely goes near it...only in very hot weather when I sometimes see her taking a little (and needless to say I start to panic and watch her like a hawk...)

 

As you know from my previous posts here, the vet completely dismissed all of my observations of something being really wrong with Saoirse first time round, including how much her water intake had increased. I asked the vet approximately how much a cat on a dry diet should be drinking each day and she couldn't answer me. I realise now that she didn't actually know.

After we were unceremoniously dismissed from that consult, I went home and I decided to measure exactly how much water Saoirse was drinking and search online for help. That's why I'm able to state her water intake with such certainty. In the space of less than a week her water consumption went from 1 litre to 1.5 litres. Thankfully the next vet I saw at the practice took me seriously (although she initially mistook an egregiously overfilled bladder for possible ascites).

BTW, that online search is what first brought me here. I thank the gods for that.


Mogs
.

 

As do we all, Mogs. You bring so much to the table when you’re here and you’re sorely missed when you aren’t. I hope you’ll be able to stick around for a long time now

 

Yikes, that is bad! Out of curiosity, earlier today I checked the numbers for both our standard go-to kibble (Arden Grange) and Go-Cat, which we only ever bought in an emergency, when we had forgotten to order more AG.

Using an estimate of 10% moisture for both, Arden Grange is 29% calories from carbs (about the same as a high-carb wet food like Gourmet Gold in gravy), whereas Go Cat is 40%! Not to mention that the first ingredient in Go-Cat is vegetable protein, whereas AG is all chicken. So yes, I do wish I'd fed Maddie wet food all along, but there are worse things out there...

 

Thank you for this, Diana. It means more to me than I can articulate.


Mogs
.

 

Yeah between Kyra, Maddox and Rupert over a litre was being drank a day (and I know the other 2 weren't the culprits) one morning I woke up and Kyra was screaming for the water bowls to filled up. I am still monitoring water in take everyday, even though it was come down to "normal" levels, bit of a habit now! Also means they get super fresh water every 12 hours instead of just topping up what they already have!

Good luck on the new food @Douglas_my ginger cat, the numbers will get there soon enough! If one thing in life is for sure it is that FD is a marathon!!

 

Awwwwwww (((((((((Mogs)))))))

 

((((((Diana))))))

.

 

@Douglas_my ginger cat

Hi Anna, it's good to see those numbers start to come down a bit.

I see from the notes on your SS that you are having some difficulty getting PM preshot tests.
Is there anything we can help with? What sort of problems are you having? Maybe someone can come up with some ideas to make things easier for you.

Eliz

 

@Critter Mom
Seconding what Diana said, Mogs.

 

Wooo in to the AM reds - that's exciting! I'm sure you'll be seeing pinks before you know it

 

Hi Eliz,

I wanted to post something about numbers already going down after taking Douglas off dry food, but didn't want to jinx it or get too excited prematurely.

I'm currently having a squirmy cat when it comes to taking blood. I am currently holding him between my side and arm while I take blood. Last night, it looked like his ear was a little sore so tried to it on the other ear this morning. Failed but managed to get blood this morning in his usual ear. Any tips would be good. I do use a warm flannel to warm up his ear but only manage probably about 1 minute before he starts moving away. I give Douglas a Thrive freeze dried chicken treat after each go (even failed)

I am also struggling to give his insulin. I say struggling, but he is just not interested and moves around. I think the needle might be hurting him. Although I have to say he doesn't not run away as I have a delicious plate of tuna waiting for him. After a few tries (can be up to 5 tries), he usually stands a bit still, although I can almost feel the stress and his body is stiff still.

Any pointers would be greatly appreciated!

 

I third it!

 

What needle gauge are you using? Maybe a finer needle is needed for Douglas. Sadly I cant remember the gauge I switched to but I'm SURE others will guide you.

 

(((All)))




Mogs
.

 

From what you've said there I do wonder if his moving around has meant that you've accidentally pricked the flesh by injecting too deep recently, and he's remembering that... If that's the case then he'll likely be fine once you've clocked up a few 'good' shots. But it can dent our confidence when this happens (and it's happened to many of us... Sometimes more than once... )

Are you using the 'tenting' technique for giving shots? Are you pulling up loose skin to make a sort of hollow tent and then injecting through the 'imaginary door' of that tent? Or are you using a different technique?

I couldn't get on with the tenting technique with Bertie. He was too much of a fidget and it meant that I sometimes pricked him when he suddenly moved. But I found there was another way that works much better for a fidgety cat.
I'd grab a handful of loose skin with fingers and thumb of my non-dominant hand, pull that up and sort of tip it up slightly, and then give the shot almost directly down into the skin that I was holding in my hand, about mid way between fingers and thumb. This had a couple of advantages. Firstly, I could still give the shot if he moved a bit, as long as I was holding onto that skin. Secondly, there was no risk of my accidentally pricking sensitive flesh because the depth of skin I was holding was greater than the length of the syringe needle.... ....If that makes sense...?

If you think a smaller syringe needle would work better then there is the option of using U100 syringes with U40 insulin... The needles are a tad shorter and finer. But you do need to use the U100's with a conversion chart so that you measure the right amount of U40 insulin in them (we have a chart here on FDMB). ...Quick explanation: U40 insulin has 40 units of insulin per ml. U100 insulin has 100 units of insulin per ml. So, U100 insulin has 2.5 times the number of units per ml. What that means is that when measuring 1 unit of U40 in a U100 syringe you'd measure to 2.5 unit mark, etc, etc...

It's good that you're giving treats even for 'failed' tests. The kitties quite soon come to associate testing with treats.

Regarding sore ears, it can help to put the teensiest weensiest smear of Vaseline on the outer edge of the ear. I think this should stay there OK even if you're using a warm flannel to warm his ears. This helps the ear to heal as well as helping the blood to bead up above the fur.
And be sure to press on the test site afterwards for a couple of seconds with a piece of cotton wool or folded tissue, or just a clean finger and thumb. This helps to minimise bruising.
The ears do start to bleed more easily once we've been testing for a little while, and they also seem to become less sensitive and more able to handle the testing. I tested my first diabetic's ears every day for nearly 11 years and they were just fine, even after all that testing...

Are you using the lancing device to test or are you testing freehand (just the lancet)? Whichever method you're using it may be worth trying the other method to see if that works better for you.

Some cats really don't like being restrained, and neither of mine would tolerate it, so I've always used 'distraction' rather than restraint.
Bertie was very food motivated so I could crumble treats for him and test him while he was hoovering up the treat crumbs. Bonbon isn't particularly food motivated (and truly hated having her ears touched at first..) but I found she loves to be brushed, and so I sneak a test into a little brushing session and she hardly notices.

With both my diabetics I found it helpful to spend time desensitising them to the sensations and sounds involved in the test process. And this really is well worth doing...
Try to make ear touching very 'ordinary' and non-threatening. Every time you stroke or cuddle the kitty include some ear contact in that, just for a second or two.
And, at times when you are not trying to get a test, you can go to wherever the kitty is in the house, stroke them, hold or massage an ear for a second or two (not enough to stress the cat) then immediately reward with a treat.

Similarly, when you're not trying to get a test, you can rattle the test strip vial or click the lancing device if you're using that (it can be used a bit like a training clicker) and then immediately give the cat a treat. They come to associate the sound with rewards just the same as they recognise the sound of a can of food being opened...
I did these kinds of things with my diabetics about 6 or 7 times a day, every day at first. It only takes a couple of minutes each time, maybe only seconds. But it is the repetition that is key to success....

It's also often helpful to test in the same spot at first so as to establish a routine. I tested Bertie on a table top, and Bonbon gets tested in her favourite armchair.
With Bertie - again at times when I wasn't trying to test him - I'd pop him up on the table, then stroke him, hold or massage an ear for just a second or two, and then reward him with treats and praise. With Bonbon I'd sit on the floor next to her favourite armchair and call her over, while rattling the treat bag. Then when she got onto the chair I'd stroke her, hold or massage her ear, and then give the reward. Make the testing spot a place where nice things happen.
If you can get the cat to the testing spot, can hold or massage an ear for a second or two, and give a treat, then you really are most of the way to being able to test on a routine basis.

Eliz

 

I have very little to add to what (the vastly more experienced than me) Elizabeth says above, but consider consciously calming both yourself and Douglas... it’s very easy for both of you to start getting stressed, which of course you are already, this is all still very new. So I’d say try not to rush it... sit on the floor together and have a little play session perhaps... also (this may sound strange) sing or hum a tune, or play some soothing music... and/or have a glass of wine or cup of camomile tea (delete as appropriate lol)... basically, whatever you can do to relax yourself and therefore Douglas as well. Our kitties are very sensitive creatures and pick up on our feelings. You do seem to be doing extremely well, from what you post here, but we all know that it’s a different story when we’re sitting their on our own with a squirmy kitty...

Try to remember, these are still early days and it does get better

 

yes stress FEEDS on stress it goes BOTH ways.

 

Thank you for this. I struggled again this morning with the blood but last night's reading was 23.9. Gonna give the vaseline a go.

The needles I use are a 29G, are there thinner U40 ones available?
However I do think I was not using the 'imaginary door' on the tent so was more conscious this morning and Douglas was definitely a lot less squirmy.

I will try the desensitising and sit with him more, touching his ear. I use the corner of the sofa as the 'testing area' and he is slowly always looking for the treat when I take him to this area.

As you say, its a marathon not a sprint. I just need to keep remembering that!

 

If its the tenting you are having issues with think of it this way. ( I always think things down to their lowest common denominator)
Think how a mama cat carries her young. She scruffs them. Make that scruff while administering insulin. Scruff first then tent. (You dont even have to pick Douglas up by the scruff just the motion) Once I did that a couple of times to Trouble he got a lot less squirmy.
Good luck! You will find the right method for Douglas. Sooner than later it will be just another part of his day.

 

Hi Anna, no, all U40 syringes in the UK seem to be 29G....
Which U40 syringes are you using...? Many UK folks use the VetUK generic syringes. But some people report that the Sol-Vet U40's are sharper and have clearer markings. (I 'think' there are links to where you can buy both of those in the UK info in my signature).
But....if you do want to try a finer needle then that would mean switching to U100 syringes and using FDMB's 'conversion chart'.
The U100's that many of us in the UK use (BD 0.3ml '+ demi') have 30G needles, which probably doesn't sound a lot different to 29G, but these are very definitely finer, and they are a smidge shorter, I think... If you wish I can post you a pack of 10 syringes so that you can see how they compare? If you'd like me to do this just PM me an address to send them to.

Eliz

 

Mine are the VetUk syringes so maybe I'll order some Sol-vet ones and see how I get on.

Thank you for the offer of the U100 syringes, I will DM you.

Douglas has been a bit better the last few shots, I think I may have been poking a chunkier bit of skin then then 'imaginary door' however he does still flinch a little.

 

Just throwing it out there and don't want to get too excited but took a random blood test at +5 after AM shot, read at 8.3 (shriek!!). I'm doing a curve on Thursday but just needed to tell someone as none of my family would understand if I called them and shouted 8.3!

 

Woot! Kissing the top of the normal range. Go Douglas!!!

That was some drop from AMPS today. I see in the spreadsheet notes that you first transitioned off the dry and now you're transitioning to Purina DM wet food. What have you been feeding 'in the middle', if you get my meaning. I ask because you may need to reduce the Caninsulin dose if there's a big difference in the carb loads. Can you start getting more mid-cycle tests?

Mogs
.

 

Hi Mogs, I am actually thinking that I will move Douglas off of Purina DM. It looks and smells disgusting, and also Douglas is not a fan and not eating much of it anyway so may look at other low carb foods. I have some Applaws Jelly tins which are complimentary food so have been bolsting up the food with this.

I am planning a curve on Thursday so we will get a better idea. I will post the results on here for advice

 

Haha, I can imagine your feelings when you got that 8.3, it must have been quite a shock! Sometimes they do throw us these random unexpected numbers. Sometimes there’s no definite explanation and sometimes there is - re-test if it really doesn’t seem right, there’s always the outside possibility of a “bad” strip.

I would definitely get on the case of finding appropriate foods that Douglas likes, so you can start to establish some consistency in what you feed. It doesn’t have to be the same thing every single mealtime, in fact it can be good to have maybe two or three (with similar carb content of course) that you rotate. When you’re trying to get a diabetic kitty regulated you do need to keep things consistent (ie same dose of same insulin with same food) so you can see from your bg readings how they interact. But even then, some people find that different varieties or even flavours within the same brand cause bg spikes. I think Felix AGAIL (As Good As It Looks) was noted for causing spikes in some kitties even though the regular Felix brands didn’t.

Have you looked at the UK food list recently? There are some good suggestions there. It is a bit bewildering I know trying to find the “right” foods. I had an email from Zooplus last week promoting their trial packs of foods so you can buy in small amounts before you stock up. Zooplus is also much cheaper for things like Thrive/Cosma treats. I don’t use Zooplus much these days but the website is useful to look at nutritional values of many different foods before you buy. I tend to use Fetch now (www.fetch.co.uk) - very quick free delivery over a certain spend, useful if you suddenly run low. They sell other pet supplies too, not just food. For supermarket foods, I think Sainsbury’s Delicious is pretty good (and actually looks like real food, not mush!)

Good luck and bon appetit, Douglas

 

I am currently looking at other options. Thrive Complete and Bozita are the two I am looking at. I really want ones with minimal ingredients.

Have you tried Bozita, its seems incredibly cheap. Almost too good to be true? Any thoughts?

 

I haven’t fed this personally but it’s Swedish and probably pretty good. I expect @Elizabeth and Bertie has tried it and can give you an opinion.

 

Someone posted this the other day which I have found really useful for checking the food content https://secure.balanceit.com/tools/_gaconverter/index.php

You just have to then hope whatever you do get Douglas likes it!!

Thanks for your well wishes for Kyra, he started eating as soon as we came home from the vets after paying for blood tests - typical!! Better safe than sorry though!

 

Bozita used to be a very popular food with UKers, especially before Zooplus came on the scene with all the many foods that they sell.
But you can only get single flavour packs of Bozita, not mixed, so it's a lot of a single flavour if your kitty doesn't happen to like 'Elk' or whatever....