My kitty LOVES Fancy Feast. When it’s time to eat he RUNS. Lol It’s the funniest/cutest thing. He is always hungry but I’m trying to be strict on his feeding schedule. My vet advised me he should be fed just twice a day and once he is regulated he will be fine. Any suggestions? Should I give him FF Classics during lunch? Half of the can or the whole thing? Would it increase his blood sugar? quick history about my kitty: My kitty used to weight about 15 pounds and we used to love him being soooo fluffy. Now he weighs about 7.8 pounds. I know he is always hungry because he is not regulated but it is frustrating seeing him like that. We used to give him FF Grilled Seafood and Medleys but realized they are high in carbs. Yesterday we switched over to FF Classics Poultry & Beef.
It's quite all right to feed Triton several meals a day or even to let him free feed. Some vets seem to still be stuck in the past and recommend feeding twice daily only especially with Vetsulin but current wisdom is that letting kitty eat more often is easier on the pancreas and also can help smooth out the BG cycles. The only time you should be withholding food is for 2 hours before pre-shot BG tests so you get a BG reading that is NOT food influenced. All other testing during the cycles, it doesn't matter if kitty just ate or not. Do you know what Triton's ideal weight is? You can calculate his normal caloric needs with this formula...... 13.6 X ideal weight in lbs. +70. That will give you a baseline however, it sounds like Triton may need to gain back some of his "fluff", so you can exceed that baseline amount to help him maintain and gain back the weight he has lost but do monitor his weight because you don't want him too "fluffy". Unregulated diabetics are not able to process the food they eat adequately so they need more calories. The vast majority of folks here feed their kitties 4 to 6 times per day, split up into 2 main meals at shot time and then 2 or 4 smaller snacks spread out across the 24 hour period. Not only is this better for Triton but also easier on your nerves as there is nothing worse than looking into those pleading eyes knowing they are hungry. Some folks feed at shot time and then leave food out until 2 hours before shot while others use timed feeders. Just an observation......Looks like you recently increased Triton's dose from 1u to 2u which is a big increase. We recommend increases of 0.25u or at most 0.5u at a time to ensure you don't skip over the right dose. It looks like Triton had a better cycle last night on the 2u and went quite high on 3u before that cycle so I definitely wouldn't increase the dose until you give the 2 units a good chance for a minimum of at least another 3 days. If numbers continue to hit lower blue range, I'd hold the dose for a couple more days. You've missed some pre-shot tests as well as mid cycle testing a couple of days and Triton could have dropped into better numbers then causing some bouncing which is a normal albeit frustrating phenomenon that causes higher numbers following the lows. Bounces happen when BG drops quickly or a lot or to levels kitty has become unaccustomed to. With time bouncing tends to level out but it takes patience. You are doing a great job of testing Triton. Vetsulin usually reaches peak action between +3 and +6 hours post shot so any random testing you can do in that time frame will help figure out dosing. Pre-shot tests tell you whether it is safe to give insulin while the mid cycle tests tell you how low BG is dropping on a dose and that is the critical information you need to get Triton regulated and to keep him safe. Keep the questions coming.
Thanks for all your support! I am not sure what Triton ideal weight as he was given to me at 15 pounds. He is my first fur animal..I really want to make sure he is eating enough without overfeeding. How much calories should he have in 24 hours? Spreadsheet has been updated. Triton’s BG is high today. I left to work today so I couldn’t monitor his BG. He was given a whole can FF Classic in the morning then insulin then after 6 hours he was given FF Gravy Grilled (half a can). @MrWorfMen's Mom
Congrats on your 1st furry critter. Now that you're hooked, he won't be your last. Ideal weight is something you should discuss with your vet. Is he a big boy or a small one? Is he a mixed breed or purebred where you might be able to gain some insight on norms? Cats range from tiny to huge so there is no way to know without some idea of his size and if since you are new to kitty parenthood, you may not have a way to gauge. Has the vet ever told you Triton was overweight/underweight before his diagnosis? For a 15lb cat, the average caloric need would be roughly 275 calories per day. For an 8 lb. cat it would be about roughly 180. The FF Classics are about 80 to 100 calories per can depending on flavour. Not sure about calories in the Gravy Grilled, but the Gravy Grilled is definitely higher in carbs than you want to feed on a regular basis. Good to have some on hand for low BG handling but not for daily dietary needs. In any event, it sounds like Triton needs to put at least a lb. or two if not more back on due to the weight loss he's had so I wouldn't hesitate at this point in time to allow him up at least 3 cans of the FF Classic as his total daily intake but do check with your vet because you want him at a healthy weight....not too thin but not too "fluffy". Triton dropped into some nice blues last night and appears to be bouncing today. Bouncing happens when BG drops a lot, drops quickly or drops to numbers your kitty now assumes are too low simply because he has become use to the higher BG levels. Bouncing is normal and all you can do is ride it out. It can take up to 6 cycles (12 hours per cycle) for a bounce to clear. Bouncing is part of the cat's body's defense system and being a prey animal they have a remarkable ability to boost their BG quickly when they sense it is dropping too low. Triton's sense of what is too low is now off balance and has to get re-calibrated. That said, giving him the higher carb food around +6 post shot may also have contributed to those higher numbers you are now seeing. Better to stick with the low carb Classic flavours and with time you may find keeping most food intake in the first 6 hours post shot each cycle may help smooth out Triton's cycles but that is something you'll need a bit more data to determine.
Update! Numbers look better than yesterday but still high. He had 2.5 cans of FF Classics. At one time should I give him his second meal? Today I gave it to him after his +4 check. Also, he has been trying to eat on anything he can get his mouth on including bread and candy. Is that normal? How much water should he have a day? Triton is a dhs Breed. His ideal weight should be 10 pounds. thanks for all your help and support!! @MrWorfMen's Mom
If ideal weight is 10 lbs. he needs about 206 calories per day to maintain and more to gain back a little. I think 2.5 to 3 cans a day right now is fine spread out between meals and snacks. How about a can at each shot time and then split up the rest between the number of snacks you feed him? Some days he may be hungrier than others and when they are hungry they will chew on anything. We've seen some very smart cats doing some very interesting pilfering on this board. My girl once tried to eat my peanut butter sandwich! Better to give him more of the food that is good for him spread across the cycles to keep him more satisfied and less interested in going after your treats! You might want to try moving the snack back to +2.5 or +3 post shot to see if that slows the BG drop down a bit. Sometimes that helps keep them in lower numbers a little longer before the upswing toward the end of the cycle. Like that low blue today!
Ok 2.5 to 3 cans it is. Quick update: Today we were high again at AMPS but still lower than yesterday’s AMPS. I see a slight progress He had a one FF Classic this morning @ 7am and @ 7:30am it was insulin time. Snacks: +3 .5 of FF Classics +6 .25 of FF Classics Should I give him the other .25 of FF Classics at +9? His numbers look really good today. I hope we have a good PMPS! @MrWorfMen's Mom
I would try to avoid feeding after the 6 hour post shot mark if possible. If Triton is hungry, then keep that extra 1/4 can snack before the +8 point in time. Vetsulin has a second drop often sometime around +8. It's smaller than the earlier drop and barely noticeable for many kitties but since Vetsulin doesn't usually last the full 12 hours, I'd avoid feeding after +8 at most and preferably +6. Today's cycle is looking great. Feeding times are really a bit of an experiment to see what works for your kitty. Maybe tomorrow you could try the 1/2 can around +2 and the 1/4 can around +4 and another 1/4 around +6 and see if how that works. The other alternative would be to give him the extra 1/4 can with his main meal before his shot and then the 1/2 can at +2 and 1/4 can at +5/6. He may bounce a bit from those lower readings and be higher tonight and tomorrow but it's all normal so not to worry. He'll come back down. Liking what he's doing so far.
Thank you sooooo much for your help. You have no idea how happy I am to have this support. Triton's BG at PMPS today was 314. I really like where this is going. I hope it gets better ☺ I did not give the extra 1/4 snack before +8. Should I give it to him at pm post shot +2 ? @MrWorfMen's Mom
You don't need to worry about that missed snack today. Include the extra snack portion with pre-shot meal if you like. I'd keep the post shot snacks at 1/2 and 1/4 can portions. While you want to slow down the drop, you don't want to stop it.
I ran out of test strips!! So I only tested before his shot and 2 hours after. Numbers were looking good and he seems fine now too. Snoring and sleeping away Yesterday I emailed my vet to provide her with some updates on Triton’s progress since our last visit (11/4/2019). I would like to share her comments and would also like feedback. “ 1.doing blood glucose checks every day is stressful for cats and this will cause an artificially high blood glucose reading. In practice we only ever do curves every 3-4 weeks, or if their dose seems to not control their symptoms. So let’s give Triton a break from glucose monitoring for now. 2.Triton’s blood sugar in the morning and evening will never be below 200. That is how insulin works – it lasts in the body for 8-10 hours, so first thing in the morning before he gets his AM dose, the PM dose is wearing off, allowing his blood sugar to rise. Same thing in the PM, the morning dose is wearing off and the glucose is coming back up. That’s why it’s a glucose “curve.” The goal is to have Triton’s blood sugar in the 150-250 range for as long as possible, but it will always be high right before dosing. 3.Glucose monitor – to be as accurate as possible, you can use an AlphaTrax glucose monitor. This is about $50 on amazon, and is specific for dogs and cats and will give us a more comparable value to the glucometer we have at the clinic, allowing me to interpret his curves more accurately. 4.Glucose curve – it is best to do these every 3-4 weeks as I mentioned and we’d need to do readings every 2 hours to get the most out of a curve. 3 and 6 hour values are great, but we are not seeing the whole picture, we can miss changes in glucose over that long of a period that can make it look like he’s well controlled, but in reality he is having a spike or overswing reaction. 5.Triton’s weight – as long as his blood sugar is being well controlled, he should stop losing weight and his symptoms should improve – he should not be eating ravenously or drinking/urinating as much as he did before he started insulin. If he is still losing weight and his dose is controlling his diabetes, we have to consider there may be something else underlying causing weight loss. He had one mildly elevated kidney value, otherwise everything was normal. It is possible that by controlling his diabetes, this has allowed kidney disease to be unmasked.” @MrWorfMen's Mom
You are free to share any vet comments anytime. Your vet may have another opinion but we won't tell her we saw them! All I can say is MEADOW MUFFINS to keep it polite. Doing daily testing is not stressful for the cat and doesn't cause artificially high BG. Doing a curve every 3 to 4 weeks means you are getting information for one day out of 21 or 28 which may or may not be representative of what has been going on daily. If kitty happens to be in a bounce on curve day the results will show high and make you think kitty needs a dose increase. If kitty is having a good day, it could give you a false sense of having kitty regulated or needing a dose reduction. Daily testing lets you know immediately if there is a sign of needing a dose adjustment. BG changes and so do insulin requirements so waiting to test once a month is only going to slow down progress and potentially prevent making progress or worse, result in a hypoglycemic event. What you do testing wise at home is your business and yours alone. It's not endangering Triton.....quite the opposite. More meadow muffins. Yes with a kitty on insulin we expect to see a curve with highest values at the front and back of the cycles however BG can be below 200 on either end and BG can be below 150 mid cycle even on the AT2 meter. With a human meter, normal BG range is 50 to 120 so the goal would be to get kitty at least down to high double digit BGs mid cycle. If the vet looked at a curve done with an AT2 meter and one with a human meter for the same cat, same time frame for comparison, the curves would look very similar....like a smile with higher BG at either end and lower numbers in the mid part of the cycle. With your human meter you can initially aim to get BG down to a low of 90. With time and lots of data, you can aim to get those lows down a little more. The human meter is just as accurate as the AT2. The difference is that the AT2 is reading in accordance with animal lab equivalents and is programmed to read animal blood. The human meter is programmed to read human blood so it does generally read lower than the AT2 with the difference in the readings getting larger the higher the BG. Human meters have been used for pets far longer than pet ones and there is far more research done with human meters than pet meters because of this. All our dosing methods here are based on established human meter readings. See first comment. I agree with the vet's comments on this point. Best to ensure you always have a good supply of strips available. I always left an extra vial of strips in my Hypo kit and every time I bought more strips, I swapped out the hypo kit vial so it was always fresh and there was always an extra supply of strips available if I didn't get more in a timely fashion.
@MrWorfMen's Mom, thank you for your input! The AT2 is quite expensive for me. I am still trying to make sure that I can treat Triton on a very small budget. Triton has an appointment on the 25th to check his kidney values. I am hoping all is well. By the way, I am located in Charlotte, North Carolina. Should I look for a friendly feline diabetes vet in the local area?
Your choice of vet is up to you. To be honest, most of us don't use our vets for the diabetes.... just for other stuff like yearly checkups, shots and if there is another medical concern. If you are happy with your vet for everything else, I see no reason to change. If you think the vet is going to give you a hard time about the diabetes, then a change may be necessary. My personal view and that of many people here, is that your vet should be your partner in Triton's care. Not a dictator and they can't have total control because they aren't going to be available to you 24/7 and diabetes is definitely a 24/7 proposition. You are obviously going to have to have a relationship with a vet you trust and can work with for prescriptions of insulin so if the vet is unwilling to work with you in a partner role rather than as a dictator, then change may be the best option. Whether that is a feline only practice or not is not a given. You need to interview the vets and see how they handle their feline diabetes patients. HERE are some interview questions you might want to use to track down another vet for Triton if need be.
Hi @MrWorfMen's Mom! I apologize for the late response. I have test strips again! I bought 100 and saved 50 in my hypo kit. Thanks for the tip! Thank you for you input on my vet’s comments! It looks like I will be treating Triton at home and with the guidance of this group. I have been in contact with DCIN due to my financial situation and they are suggesting to change my insulin to Lantus or Levemir.
Lantus and Levemir are excellent insulins for kitties. Vetsulin can work for some cats but it often doesn't last for the full 12 hours each cycle and can cause a lot of bouncing due to sharp drops in BG. The Lantus forum here has a lot of members and it's a great group with tons of experience and everyone is ready willing and able to help you get Triton regulated.
Any ideas how I can get a prescription on Lantus? Seems like vets are using ProZinc or Vetsulin in my area. I am still looking...
I think DCIN often has Lantus or Levemir available so perhaps you could tell the vet that DCIN is helping and that is what they are offering to provide but you need a script. If that doesn't work, perhaps whoever you spoke with at DCIN can recommend a vet who does prescribe Lantus or Levemir in your area. The other option would be to post in the Lantus forum and see if anyone there is in your area and can recommend a vet. I know of at least one member in NC but unfortunately she is over on the east coast so too far off for your needs.
Thanks Linda! My closest vet clinic gave me the Lantus prescription!! In 2-3 weeks, I will get it. In the meantime, can you please let me know if it’s time for a dose increase? Thanks! @MrWorfMen's Mom
Yes it looks like Triton could use a wee bit more juice so you can raise the dose to 2.25u but I would recommend waiting till tomorrow AM to do so, as you want to monitor a cycle when you make a dose change and I'm pretty sure you don't want to be sitting up late with Triton tonight. I think he's bouncing again but his BG still has some room for movement in the middle of the cycle so let's see how he does on the new dose. You will have to eyeball that 2.25u dose as best you can but it helps to draw up a sample with coloured water or coffee in a used syringe for future reference just to make sure dosing is consistent which is more important than accuracy. If per chance you are using the vet pen, then you can increase to 2.5u but the smaller dose adjustments of 0.25u are preferable.
