Transitioning old diabetic cat from kibble to canned AND monitoring

[Kittenskitty]

Hello! The cat in question is around 16 years old, norwegian forest cat. I must mention that she is a granny's cat and doesn't live with us, so I almost have no opportunity to directly supervise her, but if needed I will do my best. Has been diagnosed with diabetes year and a hald ago after ketoacedosis episode (been in ER for a few days, stabilised then diagnosed with diabetes). Doctor prescribed lowest dose of lantus two times a day and Purina w/d dry food which she also eats two time a day after a shot. For about a year everything was great, she got a bit of weight back (she is an underweight cat which was a drastic change from how she was before diabetes), but then although she is brushed every day, her fur started to get constantly tangled and became more matt. She became thinner again. We thought food is the main reason why it happened so I've started reading abount maintenence of diabeitic cats and best food available. We decided to switch her from dry purina w/d to canned animonda carny as this is the best availiable food in our country from the standpoint of quality, proteine and carbohydrates. However, I need a correct algorythm to do so because of hypoglecimia danger.
Here I must also mention that granny skipped testing for mounths as it became increasingly hard for her, but again, if needed I will persuade her to do it. So now as we don't know her "basic working" glucose levels before and after lantus shots. I imagine it must go like this:
1. Keep feeding dry food only for 3 more days, test 3 times a day, in the morning before food and shot, 6 hours after, in the evening. To get her actual glucose curve applicible now (is this a needed step?)
2. Start giving wet food, one meal per day is dry, one is wet (or should I mix dry and wet, or should I just switch her to wet completely in an instant with no dry food at all?), test BEFORE shot and meal on the very first day of switching (but if all guides say that wet food affects glucose levels and it will be lower than after dry food shouldn't I test after wet meal to look how it is and then decide is it to safe to shot her or not?)
3. Keep feeding wet food and testing until levels are stabilised
I have a question abouth this too - since cat has always been on the lowest dose of lantus, how do I lower the dose if a correction will be needed (glucose levels drop after wet fod -> need to lower insuline intake -> she already takes the lowest possible dose, so how do I make it even lower? -> should I not shot her at all? Is it safe?)
I also need to bring granny honey and sugar powder with big needlless syringe, teach her how to act in case of emergency and write an coherent and easy-to-use instrunction for her on what and when to do

Sorry if there are any mistakes, english is not my first language so if it is hard to understand what I mean please ask me to clarify.

 

[Kris & Teasel]

Welcome! We can help you to help your grandmother and her kitty.

Doctor prescribed lowest dose of lantus two times a day

The starting dose is usually 1 unit twice a day. Is this the dose that was prescribed?

Purina w/d dry food

Almost every type of dry food is too high in carbohydrates for a diabetic cat, even those sold as prescription diets for diabetic cats. Purina makes a prescription type called DM that is available as a low carb wet food. The pate variety is about 6% carbs. It might not be available where you live but you can ask your vet. Otherwise, there are commercial wet foods that should be low enough in carbs to feed your kitty. There are online carb calculators you can use with the "guaranteed analysis" to give you an approximate carb level.

needed I will persuade her to do it.

This is essential to keep her kitty safe, see the effect of the food change and find the correct insulin dose.

Keep feeding dry food only for 3 more days, test 3 times a day, in the morning before food and shot, 6 hours after, in the evening. To get her actual glucose curve applicible now (is this a needed step?)

This will give you baseline data before you change anything. I think it's a good idea.

Start giving wet food, one meal per day is dry, one is wet

You must introduce the wet food slowly. This way you might avoid causing an upset stomach in the cat, you will get her accustomed to wet food slowly, and you won't cause a problem with blood glucose levels (we hope!). It's best to mix wet and dry in changing proportions over about a week. Testing of blood glucose will be very important because it can change quite a bit when a low carb diet is in place.

(but if all guides say that wet food affects glucose levels and it will be lower than after dry food shouldn't I test after wet meal to look how it is and then decide is it to safe to shot her or not?)

No, you need to know her blood glucose before you feed her and inject insulin. There should be no food for at least 2 hours before this test so the BG is not influenced by food. You need to know if the insulin dose is too high or not at her BG level. This has to happen before every dose of insulin: test (no food 2 hours before)/feed meal/inject insulin. It's very important all the time but especially during the food transition.

since cat has always been on the lowest dose of lantus, how do I lower the dose if a correction will be needed

If you have been giving 1 unit of Lantus twice a day, it's possible to give fractions of that. You would need U100 syringes with half unit marks so you can read half units directly or estimate 0.25 units or 0.75 units by eye. There are other techniques for even smaller fractions that we can help you with if you need that.

should I not shot her at all? Is it safe?)

Sometimes, a shot will have to be skipped because the BG is too low. We can help you with that.

I also need to bring granny honey and sugar powder with big needlless syringe, teach her how to act in case of emergency and write an coherent and easy-to-use instrunction for her on what and when to do

We recommend that a supply of higher carb wet food is kept for occasions when the BG is going too low. Canned food that has sauce or gravy usually works or honey can be added to regular low carb wet food. Knowing when and how to do this is something to learn about.

I hope this has helped you. Please ask if anything I said isn't clear. Here's what we recommend to/need to know from all new people here so we can help you as quickly and as well as possible:

• tell us your country or time zone because we're all over the world and need an idea of when you're available here
• insulin dose
• what BG meter you use (human or pet) - BG ranges are different but we understand both
• what food is fed now and what you'll switch to
• whether you can set up a testing routine to get all the BG data needed to help your grandmother help her kitty
• are you willing to set up the spreadsheet we use here to log all the BG data? It's an online Google doc and can be seen by all members. It's the first thing we look at before we offer advice. You could maintain it for your grandmother. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

This is a really good place for help and support. Unfortunately, feline diabetes is a disease that needs constant monitoring or you risk a serious complication like ketoacidosis. The insulin dose often needs frequent adjustments to keep kitty safe and healthy. A good testing routine is the essential tool.

 

[Kittenskitty]

The starting dose is usually 1 unit twice a day. Is this the dose that was prescribed?

Yes, this is the dose that was prescribed by vet. One dose at 8 a.m and one 12 hour after, at 8 p.m respectively. I think that I must clarify here that before vet prescribed it we did glucose curve testing and journal for two weeks so vet would have an idea of cat's glucose levels. Vet also prescribed purina w/d food.

Almost every type of dry food is too high in carbohydrates for a diabetic cat, even those sold as prescription diets for diabetic cats. Purina makes a prescription type called DM that is available as a low carb wet food. The pate variety is about 6% carbs. It might not be available where you live but you can ask your vet. Otherwise, there are commercial wet foods that should be low enough in carbs to feed your kitty. There are online carb calculators you can use with the "guaranteed analysis" to give you an approximate carb level.

According to this calculator Animonda Carny wet food is 3% carbs in dry matter, I suppose it's quite good for a diabetic cat, am I right? Plus we we gave it to her from time to time before diabetes so we know that she likes it and transition shouldn't be a problem.

This is essential to keep her kitty safe, see the effect of the food change and find the correct insulin dose.

She did tests before, when we had to make a glucose journal to show the vet, so she will surely do that!

This will give you baseline data before you change anything. I think it's a good idea.

Should We do it for three days only a as I've written before or should we continue this without changing her food to a never one for a longer period of time?

You must introduce the wet food slowly. This way you might avoid causing an upset stomach in the cat, you will get her accustomed to wet food slowly, and you won't cause a problem with blood glucose levels (we hope!). It's best to mix wet and dry in changing proportions over about a week. Testing of blood glucose will be very important because it can change quite a bit when a low carb diet is in place.

Sorry if there are going to be stupid questions, but I want to make sure that I understood everything perdectly before I do something:
Wet and dry food should be mixed in one bowl at the same time, for example 80% dry and 20% wet blended together? It's just I've read so much that mixing dry and wet food at the same time can cause digestion problems so I'm a bit afraid of that.

No, you need to know her blood glucose before you feed her and inject insulin. There should be no food for at least 2 hours before this test so the BG is not influenced by food. You need to know if the insulin dose is too high or not at her BG level. This has to happen before every dose of insulin: test (no food 2 hours before)/feed meal/inject insulin. It's very important all the time but especially during the food transition.

As I understood it from your message, glucose levels won't suddenly drop after feeding her with new wet food (as I thought before), so it won't be that I tested her -> glucose is high -> I fed her wet food -> glucose suddenly dropped and I don't know about that because I've tested her before meal -> I inject insulin while not knowing -> it's dangerous for a cat. Rather then suddenly dropping after feeding there should be a tendency for her base glucose levels to slowly get lower and lower thus the change in isulin intake and I will see the right glucose levels even when I test her when she's hungry.

Where can I find a some spreadshit or info with guidelines about needed insulin dosage in relation to glucose levels? Should we take her to the vet (although it will be stressful for her because she hates riding) and ask him for this information?

If you have been giving 1 unit of Lantus twice a day, it's possible to give fractions of that. You would need U100 syringes with half unit marks so you can read half units directly or estimate 0.25 units or 0.75 units by eye. There are other techniques for even smaller fractions that we can help you with if you need that.

Right now we use lantus with Micro-fine demi plus U100 0,33 ml syringes, they do have half a unit marks

We recommend that a supply of higher carb wet food is kept for occasions when the BG is going too low. Canned food that has sauce or gravy usually works or honey can be added to regular low carb wet food. Knowing when and how to do this is something to learn about.

I hope this has helped you. Please ask if anything I said isn't clear. Here's what we recommend to/need to know from all new people here so we can help you as quickly and as well as possible:

• tell us your country or time zone because we're all over the world and need an idea of when you're available here
• insulin dose
• what BG meter you use (human or pet) - BG ranges are different but we understand both
• what food is fed now and what you'll switch to
• whether you can set up a testing routine to get all the BG data needed to help your grandmother help her kitty
• are you willing to set up the spreadsheet we use here to log all the BG data? It's an online Google doc and can be seen by all members. It's the first thing we look at before we offer advice. You could maintain it for your grandmother. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

I'd like to know what is better, adding honey to low carb food or having a supply of high carb food? Should I keep both just to make sure?

My time zone is UTC+03:00
Insulin dose is one unit in the morning and one unit in the evening
BG meter is human
Food that we feed her now is Purina w/d dry food and we're switching to Animonda Carny adult (beef) wet food
Testing routine will be set up, as we'll do that I'll log in all her data

 

[Kris & Teasel]

Yes, this is the dose that was prescribed by vet. One dose at 8 a.m and one 12 hour after, at 8 p.m respectively. I think that I must clarify here that before vet prescribed it we did glucose curve testing and journal for two weeks so vet would have an idea of cat's glucose levels. Vet also prescribed purina w/d food.

Good. This is a the usual starting dose and it was good that your vet had you test at home.

According to this calculator Animonda Carny wet food is 3% carbs in dry matter,

That seems to be a good low carb food.

Should We do it for three days only a as I've written before

I think three days should give you a good idea of how she's doing right now.

Sorry if there are going to be stupid questions, but I want to make sure that I understood everything perdectly before I do something:
Wet and dry food should be mixed in one bowl at the same time, for example 80% dry and 20% wet blended together? It's just I've read so much that mixing dry and wet food at the same time can cause digestion problems so I'm a bit afraid of that.

There are NO stupid questions! Yes, do the food transition by slowly increasing the proportion of wet food in each meal until there is no more dry. Maybe keep the meals small and more frequent if you worry about GI upset?

As I understood it from your message, glucose levels won't suddenly drop after feeding her with new wet food (as I thought before),

That's correct.

Rather then suddenly dropping after feeding there should be a tendency for her base glucose levels to slowly get lower and lower thus the change in isulin intake and I will see the right glucose levels even when I test her when she's hungry.

Yes, you've understood this correctly. The testing is needed to monitor this lowering over the week or so needed to change the food.

Right now we use lantus with Micro-fine demi plus U100 0,33 ml syringes, they do have half a unit marks

These will be good if/when you need a fractional dose.

I'd like to know what is better, adding honey to low carb food or having a supply of high carb food? Should I keep both just to make sure?

It can depend on the cat. For example, my cat gets an upset stomach from the gravy in high carb food but tolerates honey in low carb food with no problem. It might be a good idea to have both though. In an emergency, a small amount of the gravy can work very well to raise BG for a short time and the cat might like it more.

My time zone is UTC+03:00

I'm sorry but I still use the old GMT time zone system. I'm in the part of Canada which is Eastern Standard Time. I don't understand UTC + 3:00.

You're well prepared to help your grandmother's kitty. Will you set up a spreadsheet? It so much easier for us to advise if things are changing quickly or if there's an emergency.

 

[Yong & Maury GA]

I think UTC +3 is East Europe / East Africa what we refer to as EET or EEST which should mean Kittenskitty is 7 hours ahead of Eastern Standard Time.
I'm going to throw in Signature setup instructions too: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/