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Kristoph89

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Hello all!

My cat Casey was diagnosed last month with diabetes and I've been on and off the board regarding asking q's. Everyone has been such a great help here that I wanted to post a new question regarding his insulin dosage and eating.

So first off, Casey is doing great. He barely even notices me giving him his shot and I've got quite accustomed to giving it to him. Here is a little background before I get to my question on Casey's situation since he was diagnosed at the end of March:

Casey got diagnosed around the 3rd week of March with diabetes. He had a blood test (I suspected something was wrong when I noticed he was losing weight for no reason and drinking a lot more water than usual along with peeing more). When the results came in his blood sugar was 504. So my vet started him off at 3 units, twice daily of ProZinc Cat Insulin. At that time, after doing some home research, I switched Casey's food to a low carb, high protein diet. I chose Evo canned wet food and dry food. Since Casey always ate Iams dry food, I slowly made the switch to canned food.

After two weeks on insulin, I took him back to the vet for his first BG curve. According to the vet his #'s were still high (in the low 400's) so she bumped him up to 4 units, twice a day. At this point he was eating canned Evo in the a.m. and p.m. and I would leave a bit of dry Evo Weight Management in his food bowl during the day in case he got hungry.

After 3 weeks, I took him back in for his second BG curve. According to the vet this time, his #'s were still slightly (in the low 300's this time) and she bumped him up to 5 units, twice a day. At this point she said I don't need to bring him back for at least 6 months to a year unless I see a change in him.

Now at this point I changed him over to Wellness canned food along with Wellness Core dry food. I give him a can (5.5 oz) and a half a day and just keep a bit of dry food in his dish during the day in case he gets hungry.

Now my question here is: is 5 units, twice daily seem like a lot of insulin to be giving him? Seems to me that since he is on a high protein, low carb diet his insulin intake should be lower than that. Am I doing something wrong when I feed him? Is Evo or Wellness not a good brand?

I'm totally stumped! If anyone has any insight to give, it would be greatly appreciated confused_cat

Kristy and Casey
 
Well yes 5 units very well may be too much insulin. On the board, we use the start low and go slow - meaning starting at 1 unit or less.

However, it doesn't sound like you are home testing and that is vital for you to really know what is going on and how his BG's are.

When you take the cat to the vet, the BG's can be artificially inflated due to vet stress, car ride, etc. And can be upwards of 100 points or more off. The only way to know for sure if the dose is too much or just right is by home testing.

by not home testing, you risk the possibility of a hypo or DKA incident. http://www.felinediabetes.com/phorum5/r ... ?8,1700444


I can't stress enough the need for you now to learn how to home test.

You can do this fairly easily and use a human meter - you can get a cheap set up from walmart - relion brand and start testing immediately - you don't need the vet's permission to do this.

Think about it this way - would you shoot insulin into yourself or a child without testing? Why is it different because it's your cat?

viewtopic.php?f=14&t=287


We can help you learn how to home test - if you tell us your location, there may be a member local to you who can help.
 
I don't have exact #'s for the first BG curve. She said it dropped about 100 pts so since his first blood glucose levels were 504, he had to be around 404 for the first BG curve, then around 304 for after the second BG curve.

As for home testing, I have yet to do that. I already have the monitor and everything but have been a little reluctant to do it. I wanted to get him settled on his dosage first. And I do want to start monitoring him at home now especially since it seems like he may be getting too much insulin a day. I am going to do a few test runs at it this week and next weekend would like to test him a few times throughout the day to see what his levels look like.

If he is getting too much insulin, what are some of the signs? Would he start drinking more water or eating more? Possibly vomiting?

I don't even know what to look for since he seems completely fine and has not an any type of episode since he's been on insulin.

Kristy and Casey
 
We encourage new diabetics to start low and go slow. Low would be one unit twice daily. With PZI, you usually increase by .25 or .5 units, not a whole unit. You can easily go over his ideal dose and cause him to stay in high numbers because of rebound: Rebound

If you look at the spreadsheets of people posting on the PZI forum, you can see how they increase the dose and what kind of numbers they are seeing. Especially check out Callie Mae. She was on 9 units of insulin, dry food and vet curves on Friday. Today Callie is doing great on one unit and wet food. viewforum.php?f=24

As others have said, you just can't tell what is really happening until you test at home, where your kitty is not stressed out. Cats here routinely have tested 100-200 points higher at the vet.

I won't encourage you to stop the dry, because I am concerned about your high dose and the dry may be keeping him in safer numbers. After you are testing at home and know his numbers, you can free feed wet. I freeze it and leave it out to thaw or put it into an automatic feeder.

Unfortunately if he is in rebound, you will not see many symptoms other than the regular diabetic ones like urination and hunger because his body is fighting both the diabetes and the insulin. There is a real danger that he will crash at some point, however.

We have taught hundreds of people how to test over the internet. We would love to teach you.
 
Thanks so much for your insight...it does seem like since he was bumped up to 5 units, twice daily that he seems to be hungry more and drinking more water. Other than that he is completely fine. I will definitely start home testing this week. I didn't realize that the stress level of him going to the vet could skew his curve by up to 200 pts. It makes sense that if you are stressed that would happen but it just didn't cross my mind...

When I get home from work tomorrow, I am going to try and test his BG level for the first time before I give him his shot of insulin. I will post my findings once I do so!

Kristy and Casey
 
Sounds good. Don't get discouraged. Very few people get it on the first try. The most important thing for us was to warm the ear with a rice sack. A bigger size lancet (25-27 gauge) and a double poke can also make a huge difference. We all have tricks that worked for us so just ask.
 
So I took Casey to the vet today because to me he seems a little "off" since they increased is dosage to 5 units, twice daily. They took a blood test when I was there and his BG was 422. I am beginning to get very frustrated by all of this. It seems like his BG keeps getting higher and higher and not lower. Now he is on 6 units, twice daily. I asked the vet about his #'s being skued because of the stress factor when he is there but because my cat Casey is mellow (he loves riding in the car, he seems calmed and relaxed when at the vet) that his #'s wouldn't be that off mark when he is there.

How can I get his BG down??? I am currently feeding him Wellness canned cat food and dry food. The vet said today to cut out the dry food completely. Only wet. He suggested I start feeding him Purina DM wet food. Does anyone have any suggestions on here as far as food goes???? When I changed Casey's food when he originally got diagnosed with diabetes to a low carb high protein diet I was using Evo. Then when his number's were still high after the second curve, I figured I'd try Wellness. That doesn't seem to be working. NOTHING seems to be working.

I got all the materials I need (I was originally missing some pieces to my kit) so I am going to start testing him at home tomorrow. I'm hoping by the weekend I'll be more comfortable and can do a curve on Saturday to get some at-home #'s.

Very frustrated,
Kristy and Casey
 
I would NOT change completely to wet until you are testing at home. Last week we had Callie Mae post - giving 9 units, feeding dry. Within a week, she is giving one unit, feeding all wet. But she had to be really careful watching her numbers and testing a lot. Changing over to all wet can drastically reduce insulin needs in some cats; you have to be aware of his numbers.

Purina wet isn't awful as far as carbs go; but it's expensive and heavily liver based. Lots of cats get tired of the taste. Most of us feed Fancy Feast, Merrick, Wellness, Friskies. A food your cat will eat, between 8-10% carbs.

We would really like you to start testing now - waiting means you are continually shooting blind. Do you want to start a new thread with your city and state? Maybe we have someone who lives nearby and could help you get that first test.

You can start messing with his ears so he will get used to it. Make the rice sack, heat it and get him used to that too.

We have taught hundreds of people how to test over the Internet; we would love to help you learn how.
 
How often do I have to test him? I hold a full-time job and don't have the luxury of sitting home to test him all day. The most I can do is once in the morning and once or twice at night. On the weekends I can test him all day if I need too which is what I want to do anyway to get a better reading and diary log as to what his #'s look like.

Do I test him before I give him his insulin shot? If so I can't do it tonight because I already gave him his shot an hour ago. I want to regulate his insulin but I'm just pretty frustrated at this point that what I see and read on here is not what the vet is telling me. He told me I can stop the dry food completely today after bumping him up to 6 units, twice daily. I just read on another post thread here that since they have been feeding their cat Wellness, their cats #'s have spiked up.

I just don't get why his #'s aren't decreasing. I changed his food diet upon diagnosis and have slowly been feeding him less and less dry food. Right now he eat 90% wet food. He eats wet food in the a.m., wet food in the p.m. The only dry food he eats is the little bit I put in his dish during the day which half the time he doesn't even finish. So he's not completely on 100% dry food like Callie Mae was.

The girl at the vet today actually showed me a pretty good technique on how to prick his ear so I'm confident I will catch on quick doing that plus he's a great cat so he should be easy to keep entertained while I do it...

Kristy & Casey
 
You picked good low carb foods. All the Vet DM's are higher in carbs than even the cheap Fancy Feasts, and many others. I laugh when I'm in the store looking at foods and carbs since none of the Science Diets are low carb either.
The high numbers could be from his body trying to cope with going too low and liver dumping.
 
It does sound pretty overwhelming at first, but the majority of people here work. They test when they can during the week - always before every shot (to be sure it is safe to give the amount of insulin you are planning on giving)

At first, it is most important to get that pre shot number and hopefully some mid cycle numbers(maybe a before bed check). Then on the weekend you can get more numbers.

The data will help us see how the insulin is working and when you need to adjust the dose.

If you have already given the shot tonight, you can see how it is working by getting a test 3-6 hours afterwards, if you can get a test in before bed.
 
Vets are like gps; they have to know a little about a lot of diseases in a lot of species. They may see a few diabetic cats a year. We see hundreds. We live diabetes; thousands of cats have been regulated or gone into remission using the protocol of wet, lo carb food and insulin doses determined by testing at home. It works!
 
Ok I will test him tonight before I go to bed. I'll start keeping a log and keep you posted. If his #'s start going down I guess I will get used to how much insulin he needs from that. At least I know today he was at 422 at around 5:15 p.m. which was about 10 hrs after his shot in the a.m. I think I may switch back to Evo. Seems like his #'s were lower on that....

I will keep you posted!

Kristy & Casey
 
That sounds like a good plan. You will be amazed how much better you will feel once you gain a feeling of control over this thing - when you know how the insulin is working and how you can adjust it to help.

We have a great tool here - a color coded spreadsheet that will help you see trends and patterns, and help us see your history when you want dosing help. viewtopic.php?f=6&t=18207. It is slow to load and can be a little hard to figure out. If you need help, just ask.
 
kristy, i think if you read around on this site you'll find nearly everyone having the same experience that you're having with conflicting info between their vet and here. i know i had it. i educated myself by reading everything i could find, both on this site and elsewhere, and realized that my vet office has exactly 2 diabetic cats - mine and one other. there are 3 vets - so you know how much experience they could possibly have. here people "do" cats & diabetes 24/7.

my cat was diagnosed in december and i found this site and started home testing in february. since february i probably have seen at least 10 cats go off of insulin by following the advice here. my vet made several mistakes in advice, which i only realized after i was here, and while i'm still going to the vet, to manage punkin's diabetes i come here. i adore that vet, but the truth is he has a fraction as much experience with diabetes as folks here have - and i would say my vet gave the same kind of start to us that you have gotten. punkin ended up on 8+ units of lantus through the vet's mistake with the wrong needle size.

anyway, i just want to encourage you to bite the bullet and start home testing. it sucks for the first few days. i think 4 days was some kind of watershed for us when i finally got the testing down. it took about 2 weeks for the ears to bleed every single time i poked him. and now after 2+ months, i've got it down and can do it while i talk on the phone, even! take a look at a spreadsheet and you'll see how much a cat's blood sugar changes during the cycle between 2 shots. when you start getting the spread sheet info you'll understand more on what's going on with your kitter.

hang in there! it truly, truly, truly does get easier. information is power and you will be so glad when you have more information.
 
The good thing is your vet isn't totally off the mark

On the mark - changing to all wet diet. Prescription
Off the mark - not necessary
Off the mark - changing the dose based on one test at the vet office
Off the mark - changing the dose 1 unit at a time


As we've mentioned, we start low and go slow - starting at 1 unit and changing doses by .25 or .50 unit at a time.

We also don't change dose based off of one test. Especially one test taken at the vet. My Maui is a mellow cat and can handle a trip to the vet office. However, her BG's still go up when she is there, even though she doesn't mind the scenery or noises.

By home testing, you are in control and can better determine what is and isn't happening. You don't have to go crazy home testing. Just get tests in before shots, maybe once or twice while you are home during the week, one before you go to sleep and you can use your days off to test more frequently.
 
Kristoph89 said:
How often do I have to test him? I hold a full-time job and don't have the luxury of sitting home to test him all day. The most I can do is once in the morning and once or twice at night. On the weekends I can test him all day if I need too which is what I want to do anyway to get a better reading and diary log as to what his #'s look like.

Hi Kristy! I managed Bandit's diabetes working a full time job, a part time job and going to grad school, so you can definitely do this! Testing gets so much easier the more you do it, and only takes a minute to get one in. You can do what I did: Test before the morning shot, go to work, test before the evening shot, and test 6 hours after the evening shot. I also got another test in 4 hours after the evening shot. Then I would do a curve (testing every two hours for a 12 hour cycle) on the weekend when I was home. At first, the 6 hour test was a pain because I had to set an alarm to wake up for a few minutes and test, but after a few weeks I acclimated (I think a few times I literally did it in my sleep :razz: ).

The daily testing before shots and 6 hours after one of the shots are necessary to see how the insulin is working. The test 6 hours in is vital because that's the one that tells you what the dose should be. Because your cat's dose was raised so quickly, it's very possible the correct dose was missed and he's staying high because he's getting too much insulin. Too much and too little insulin look the same on BG unless you get that daily test 6 hours after insulin.

I know it seems overwhelming, but once you have that data things will be way less stressful for you, because you'll have the information to get Casey regulated. The recommendations here work and there's proof in the hundreds of cats in remission...my own cat has been in remission since last summer. I was fortunate in that my vet happened to recommend all of the same treatment that is recommended here, so I never had to make that leap of faith, but having people here on a daily basis to help you understand for yourself what those numbers you're collecting mean is invaluable, and I hope you consider setting up a spreadsheet!
 
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