Timing Hannah's Food Around Her Insulin

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Blamethecats and Hannah

Blamethecats and Hannah

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I have had a terrible time getting my little girlie to eat. She has lost a lot of weight and is a very thin 7 pounds. Finally, with the help of a FDMB friend with a very similar issue, I have followed her good advice and gotten Hannah on Cyproheptadine, dosing at approx. 1/8 of a 4mg. tablet, twice per day. She is now eating better, but her numbers are now worse than ever, most likely as a result of her increased food intake. She currently gets 1 can of Fancy Feast pate in the AM. We start it prior to her morning insulin. She usually eats about 1/3 of the can, at that point. I then feed her the balance over the course of the morning and she nibbles away at it until about +4 hours. Then around +8 hours, I give her a small amount of about 2 teaspoons to keep her happy. Then prior to her PM insulin, it's another 1/3 can, with the balance fed over the course of the evening and overnight. She never has food 2 hours prior to her AMPS/PMPS.

Can anyone suggest a better feeding plan that won't have such a negative influence on her numbers and still put some weight back on my kitty? It would be nice if the food could work with the insulin, not against it. I am also thinking, now that she is eating better, I maybe should up her insulin doses? Increased her dose very slightly this morning, but it didn't help at all. It was likely too little, but I am a real chicken when it comes to increases. And perhaps I have to give it another couple of days? It seems like increasing sometimes makes the next preshot number even worse.

Just thought of one more thing to add, here. At our vet visit last week, we got a new bottle of ProZinc. It's probably my imagination, but it seems like the new bottle isn't as potent as the old bottle. Is that possible? Could the old bottle have worked better because it got less diluted over time? Am thinking about going back to the old bottle for a few days, just to see what happens? Would that be worth a try? Anyone else ever had this happen?

Advice, thoughts, and suggestions please... and thanks.
 
The typical glucose curve on insulin drops over the first 5-7 hours on long-acting insulins such as Lantus, ProZinc, Levemir, and BCP PZI, then comes back up.

If you feed most of the food in the first half of the period - maybe in 3 mini-meals at shot +2 and +4 - you help control the drop and don't accelerate the rise. That said, some cats do best grazing over the 10 hours after the shot. You want about 2 hours before the next shot without food so the pre-shot blood test shows how well the diabetes is being controlled.
 
Carole,

We have had a terrible time with weight loss and getting Tisha to eat. We find that it works best for us to let her free feed throughout the day and night, so she can eat any time she is hungry. That at least seems to stabilize her weight a bit when she's not actively sick. The cypro will help since it has an appetite stimulant, but it will also cause some sleepiness in cats. (It's really an antihistamine with an appetite stimulant side effect.) Just to warn you, Tisha decided that she would force herself to vomit when we gave the pills. We switched to a transdermal gel that we just rub on her ear.

FYI: We have recently discovered Wellness grain-free canned food. Tisha LOVES it, so she's eating more. The down side is that the cost is ridiculous, but since Tisha is down from 12 pounds to under 8 from her most recent illness, we really need to encourage all the food we can right now.

Good luck!

Lisa
 
Lisa, thanks so much for your response. Hannah seems to be eating better with 1/8 tab of Cypro, twice a day, and she is tolerating it quite well, too. At first, I gave her 1/4 of a 4 mg. tab, once a day, and it made her dizzy. That's when I cut back to the smaller dose, twice a day. After giving her the Cypro, she gets about a teaspoon of tuna water as a treat and forgets all about the pill. However, now that she is eating better, her numbers are way out of control. This has me very concerned and my head is just about spinning over it all. @-) Her numbers weren't that great before, but this is downright frightening.

I will check out the Wellness grain-free canned food. I assume it's low carb, high protein? I really don't care about the price if it helps my fur baby. Whatever it takes at this point. She isn't that crazy for the FF Classic pates or the Friskies pates, either. Hannah's numbers weren't this bad when she was eating her dry kibble (Purina Indoor Formula -- she loved the stuff). Guess an increase in insulin is likely the next step and will hopefully get those numbers down.

Thanks for your input and good luck to you and Tisha, as well. cat_pet_icon

Carole
 
I liked Wellness canned foods; I just can't afford it for 14 cats.

The 3 garage cats get a mix of canned Friskies and Evo Cat and Kitten dry because as it gets colder, wet food will freeze and not be edible, then in the summer it attracts lots of insects. This was a workable compromise for them.
 
BJM, I think it's great that you look after the garage cats, as well as your own. They are all so fur-tunate to have you feeding them and showing concern. 14 kitties is quite a responsibility, to say the least. Glad you have found an affordable and nutritious diet for them. Thanks for doing what you do! o:-)
 
Hi Carole,

The last few cycles haven't been too bad. The pmps last night was very nice and the amps today looks better. I wonder if she was feeling crummy and that affected her numbers and now they will improve. I like your doses - if the one unit on a black gave you a yellow preshot and an extended cycle (with the number dropping late) I think that's a pretty good dose for a black.

If I were you, I'd give her a few more cycles of eating well with the cypro and reevaluate.
 
Hi, Sue... so good to hear from you!

Yesterday was a pretty good day for my little girlie. Saw that black AMPS number and it was all I needed to finally try the 1 U dose, as knew I would be home all day to monitor. It worked pretty well, although it certainly was a very long cycle. I was also happy with her PMPS number. She doesn't often get yellow numbers at that point. Stayed up late to do a little monitoring after her evening dose. Was satisfied with her numbers, so finally went to bed. As you know, I am sometimes too conservative (chicken) with her doses, especially at night when I know I'm too exhausted to monitor.

Ever since she started the Cypro, her numbers seem to be higher than usual, so it looks like that could be food related. Now, I am trying to feed a good amount of food right before and up to 4 hours after her AM and PM insulin. Maybe I should cut that back to 3 hours after? After that, I pull the food for a few hours, hoping to slow the rise, as she seems to usually nadir early. However, at night, I usually leave out 1/2 can, should she need it. That is usually gone before I pull the food 2 hours prior to her AMPS bloodwork. Does any of this sound workable and reasonable? I have never had to work around her eating, before, so I am experimenting and welcome suggestions.

For the most part, she acts pretty good. Some mornings when her numbers are in the black or red, she acts so good, I would never expect those colors. She is certainly a cute, "sweet", little puzzle!
 
Ever since she started the Cypro, her numbers seem to be higher than usual, so it looks like that could be food related. Now, I am trying to feed a good amount of food right before and up to 4 hours after her AM and PM insulin. Maybe I should cut that back to 3 hours after? After that, I pull the food for a few hours, hoping to slow the rise, as she seems to usually nadir early. However, at night, I usually leave out 1/2 can, should she need it. That is usually gone before I pull the food 2 hours prior to her AMPS bloodwork. Does any of this sound workable and reasonable? I have never had to work around her eating, before, so I am experimenting and welcome suggestions.
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I think you are doing fine with the food, Hannah. Since she has feeding issues, I would be careful changing too much in that department. The most important thing about food is that she eats. :-D
 
Insulin aside, Carole, if it's possible that Hannah has nausea problems then sometimes it can be better to feed smaller amounts more regularly (e.g. from a timed feeder). If excess stomach acid is the cause of the nausea, feeding smaller, more frequent meals might help Hannah since it reduces the build-up of stomach acid. Both Saoirse - and occasionally Lúnasa - bring up white, foamy vomitus if they fast too long. When Saoirse was first diagnosed I had to make sure she ate something every 2-3 hours. The combination of appetite stimulant + anti-nausea med (ondansetron or cerenia) and an occasional dose of famotidine really helped her. It took a good while on the meds but now she can go much longer without food in her tum. (Don't ask how I know this ... :oops: )
 
Hi, again, Áine,

As you might have noticed from Hannah's spreadsheet, her numbers for today finally did drop a bit, late in the cycle. As you suggested, gave her a smaller portion for her PMPS meal and will try to do the same throughout the rest of the evening and tomorrow. We don't have a timed feeder, but so many folks here use them with great success, I am thinking maybe we need to get one. What kind do you have? Nausea or not, I think that perhaps your advice to feed smaller, more frequent meals sounds good all the way around and might also be kinder to blood glucose levels. Heck... at this point in our dance, anything is worth a try.

Every now and then, but not too often since switching to wet food, Hannah does that foamy vomit thing. It was much more frequent when she was eating dry kibble and her food dish went empty before her appetite gave out. Am also going to get some famotidine, for now, just in case she needs it. Actually, she hasn't acted nauseated, of late -- knock on wood.

Got a chuckle out of your comment
It took a good while on the meds but now she can go much longer without food in her tum. (Don't ask how I know this ... :oops: )
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Now you really have got my curiosity going, but "NOPE", I'm not gonna ask. With my overactive imagination and experience with kitties, I think I might already know. :lol:
 
I found the timed feeders invaluable in managing both Saoirse's pancreatitis flare nausea/inappetence problems and her insulin therapy. I think the regular small meal feeds helped enormously to get her regulated (and I managed to get some sleep).

I've got 3 different types of feeder:

1. Petpods, which have digital timers and motorised lids (worked like a "Come 'n' get it!" prompt for Saoirse to eat.)

2. Cat Mate feeders - single and double models, both with mechanical timers.

Petpods enable precisely-timed feeds but they're not burgle-proof for a cat on cypro. The Cat mates are more burgle-proof, but the mechanical timer's not precise. I had reliability problems with two of the Catmate C20 double meal feeders. I've had them fail to open when I've been asleep (just one of the ways I found out that Saoirse could go longer between feeds without vomiting). The C10 single meal feeders have been very reliable thus far. reasons why I know about Saoirse's . . I've seen lots of recommendations on the forum for the Petsafe 5 feeder (one feed immediately plus 4 timed feeds).
 
Well, we did it -- finally ordered a PetSafe Eatwell 5-Meal auto feeder from Amazon.com. Now, as DH says, let's hope it doesn't close just as she's eating, or she'll freak out and never go near it again. Anyone here have that problem?? Hannah is one of those kitties who's afraid of her own shadow (and everything else). bcatrun_gif But it certainly is worth a try. Will set it to dispense smaller meals at appropriate times to see if it helps with her awful numbers. Hopefully, will also be able to set it to close 2 hours before her pre-shot blood work. That way, won't have to get up at 5:00 AM every morning to pull her food. Hope it arrives soon. Thanks to everyone here who offered advice.
 
You might be there the first few times. Set it and when it turns, call her and let her see the food. It will stay open till the next set time which can be several hours.

My cats figured it out pretty fast. Now when it turns, he comes running, even if he's in a different part of the house. Sometimes he sits and waits for it to turn - guess he can tell time!
 
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