? Up and down today; PM = 218 did not dose per vet

AEHawkeye

AEHawkeye

Member Since 2019
I’m new to the world diabetes, let alone in cats. I’ve only had Velcro home for not quite 48 hours after 4 days in the hospital. We’ve been doing the AM and PM BG testing before his meals and then insulin and then 3-4 hours out. I’m still adjusting to this new normal, so I don’t have a lot of behavioral clues to look for changes with him. Anyhow, you can see his spreadsheet, and his numbers aren’t on the surface very concerning. But, since he’s been gone, I’ve never had a reading as low as 106 (+3.5 from am). As I understand, the Lantus he is one brings it down after a couple of hours and then it’ll likely trend back up (all true in the short time we’ve done this). My concern is about behavior. He is meowing a lot at me, it sounds like his hungry meow and he can’t eat for another 8 hours. He did get his appetite stimulant this morning (every 3 days). He is also moving around a lot, but I’m not really sure if that is restless or not. All I can do it wait and retest right? Anything sound concerning?
 
First of all, you are doing great getting tests! I am new to this too, so I am not as experienced as many fine folks on this board. But I would say it might be good to test again at +4.5 or +5. His nadir--when the insulin peaks and BGs are lowest--might be later than the spot checks you are getting now.

The meowing sounds like hunger based on your description. Does he get set meals? Has your feeding routine changed since before the hospital?
 
taking a guess, it was the vet who told you to feed only at shot time?
more recent research suggests that small meals periodically during the day and night, is a better way to deal with feline diabetes
just as that's the procedure for humans with type 2 diabetes
at least at the beginning, it's good practice to feed primarily in the first half (6 hours) after the shot

I notice when Catcat is the lowest values of BG, he gets more energetic -- he is ALWAYS looking for food, clawing at cabinet or whatever, and occasionally meowing, but that's normal for him at this point

I wonder if that's what's going on with you
 
Hi! Why can't Velcro eat for 8 hours? We find many sugar cats do well on multiple small meals. When a cat is still unregulated they're hungry because some of those calories are going into the litterbox in their urine. Maybe he has some other condition that means he can't eat between meals?

Once I took Cyclone to a prestigious vet clinic and the vet there told me not to feed him between meals. I asked why and she just looked annoyed, so IMO some vets are taught this but it has little basis in fact.
 
Figaro's Liz said:
The meowing sounds like hunger based on your description. Does he get set meals? Has your feeding routine changed since before the hospital?
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Thank you!
He does get set meals, right before insulin twice a day. His eating has changed tremendously from before the hospital but not in timing, diet and method. But he has mouth sores (stomatitis) so I was largely syringe feeding him before the hospital and being diagnosed with diabetes (also twice a day 12 hours apart) to get him calories. He is eating on his own now, but doesn’t always eat as much as the vet would like so I supplement with syringe feeding if he doesn’t eat enough calories before insulin. He got about 75 calories this morning which should be fine. However, when he was feeling well before the stomatitis and diabetes, he prefers 4-6 small meals a day so I know he wants to eat. I know we are still in the timeframe where we are trying to establish and understand patterns.
 
CandyH and Catcat said:
taking a guess, it was the vet who told you to feed only at shot time?
more recent research suggests that small meals periodically during the day and night, is a better way to deal with feline diabetes
just as that's the procedure for humans with type 2 diabetes
at least at the beginning, it's good practice to feed primarily in the first half (6 hours) after the shot

I notice when Catcat is the lowest values of BG, he gets more energetic -- he is ALWAYS looking for food, clawing at cabinet or whatever, and occasionally meowing, but that's normal for him at this point

I wonder if that's what's going on with you
Click to expand...
Yes it was the vet that said to have this schedule. He goes back next week for a glucose cure and I am definitely going to check on adjusting his feeding times. But right now is a bit of an anomaly with how much I’m able to be home. I think if I wasn’t here he may just rest and watch birds and cry for food when I get home from work.
 
Camille and Cyclone said:
Hi! Why can't Velcro eat for 8 hours? We find many sugar cats do well on multiple small meals. When a cat is still unregulated they're hungry because some of those calories are going into the litterbox in their urine. Maybe he has some other condition that means he can't eat between meals?

Once I took Cyclone to a prestigious vet clinic and the vet there told me not to feed him between meals. I asked why and she just looked annoyed, so IMO some vets are taught this but it has little basis in fact.
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It’s just the feeding schedule the vet gave us. I’m definitely going to talk about this at his follow up appointment next week.
 
if I were you, I'd fudge -- obviously vet is one of the "old school" thinkers, even the veterinary associations are now recommending frequent meals

the stress of being hungry and begging for food, probably increases his BG as well
 
You don’t need to wait to talk to the vet to feed him. Here at FDMB, we feed small low carb meals throughout the day, the majority of it done in the beginning of the cycle.

We do this for a variety of reasons: to feed the numbers if they’re dropping, to keep kitties satisfied, and in extreme cases, to keep kitties safe from hypoglycaemia.

What food are you currently feeding?
 
There are lots of people here that use times feeders to get those smaller meals in. Works for when your home or not home.

Eating is a natural reaction to lowering bgs. Just like us peeps.

Jones was free fed and there were times I noticed he was extra hungry and that seemed to be the times his numbers were a little lower.

My vet encouraged small meals.
 
Crista & Ming said:
We do this for a variety of reasons: to feed the numbers if they’re dropping, to keep kitties satisfied, and in extreme cases, to keep kitties safe from hypoglycaemia.

What food are you currently feeding?
Click to expand...

Ya, the dropping part is my concern. Since I’m so new to this, 106 is low (though typically this would be considered good). He is eating Friskies pate. I think I’ll set out the little bit he left from the can this morning.
 
Tracey&Jones (GA) said:
Eating is a natural reaction to lowering bgs. Just like us peeps.

Jones was free fed and there were times I noticed he was extra hungry and that seemed to be the times his numbers were a little lower.
Click to expand...

I guess that’s partially while I’m hesitant to give him something right now - I thought I was supposed to be getting his body used to functioning with a normal amount of glucose again.
 
It sounds like it could be much nicer for him too, to be able to eat smaller meals throughout the day, if you are having to syringe feed him and then he is hungry later. That sounds unpleasant for everyone and it doesn't need to be that hard.

Lantus is a long acting insulin, which means it isn't as important to have all food before a shot, as with fast-acting insulins).

My vet also told me to feed twice per day when she prescribed lantus (we don't see that vet anymore... that was one of several red flags she didn't know much about treating FD), I quickly learned that is "old school" thinking. Figaro gets 4 meals and he is allowed to graze til he finishes it. AM/PM I test his BG, give meal, let him eat what he wants, then give insulin.

If you are worried that Velcro won't eat enough without assisted feeding, even over the course of the day with food out, that would be another question.
 
AEHawkeye said:
I guess that’s partially while I’m hesitant to give him something right now - I thought I was supposed to be getting his body used to functioning with a normal amount of glucose again.
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If you’re feeding low carb food which I believe Friskies is (correct me if I’m wrong. I don’t have the food chart right now but I’ll find it for your when I have a moment), his BG should not rise too much and sometimes at all. It depends on the cat of course. Ming’s BG does not rise with low carb food when he’s dropping. I need to feed moderate carb or give honey when he’s diving to even make a dent on his BG. Some cats rise after eating low carb. Most of the time, low carb food influence only lasts for a short period.
 
Crista & Ming said:
If you’re feeding low carb food which I believe Friskies is (correct me if I’m wrong. I don’t have the food chart right now but I’ll find it for your when I have a moment), his BG should not rise too much and sometimes at all. It depends on the cat of course. Ming’s BG does not rise with low carb food when he’s dropping. I need to feed moderate carb or give honey when he’s diving to even make a dent on his BG. Some cats rise after eating low carb. Most of the time, low carb food influence only lasts for a short period.
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Yes it’s low carb.
 
If he's hungry, let him eat - please. I'd be meowing too if I were diabetic and hungry...If you think of how human diabetics behave - the best controls are frequent small meals - minimize the carbs/sugars - switch back to cats - Think Fancy Feast pate's - they are typically low in carbs. Here's the list so you can check which one's are which: http://catinfo.org/chart/index.php

If that number goes any lower, you may need to bring out the Fancy Feast gravy type foods - various amounts of carbs in those (see catfood info per link).

Welcome to the group! As I have said in other condos, many vets are the cause of cats going hypo - they rarely - and I mean rarely know what they're talking about with Feline Diabetes! Please read the stickies at the top of this forum - listen to the comments made by others about their cats - study those spreadsheets to see what other people's cats look like after receiving insulin. It's a bit tricky getting started but you've already got a great start on the SS! Congrats on that!

Please post all your questions and comments - people will help and support you - to help you help your Velcro!

Oh, btw, tomorrow when you start a new condo (that's what we call the thread for each day's BG on each cat) set it up like this 7/20 Velcro AMPS ###...

Each person is allow to start one new condo per day so we all know that it's a new entry for that day.

We'll be watching :)
 
Glad Velcro came up.

Have you read the stickies on the Lantus forum like Sue suggested? It would be helpful to us if you chose a method to follow: Slow Low Go Slow (SLGS) or Tight Regulation (TR).

On SLGS, Velcro would've earned a reduction. Anything under 90 will mean a reduction for his next dose.

On TR, Velcro would continue with 1 unit (unless the rest of the cycle says otherwise). Reductions are earned when a cat goes under 50.

Of course, TR is only doable if you feed low carb food and can test at least 3-4 times a day.

You don't have to choose right now but I do wonder if other more experienced members might have an opinion on Velcro's dose. I'll tag them for you: @Wendy&Neko @Chris & China (GA) @Sienne and Gabby (GA)
 
I’ve been working on my cat’s dental issues and I think it’s helping him heal from diabetes. The vet said he had mild stomatitis, not sure if that’s true as he eats and lets me touch his mouth. He does have sore gums and I’ve been using chlorhexidine gluconate rinse and 1-tdc based on advice here and searching the web. I just wanted to let you know since it’s hard to find info about how to help stomatitis. Let me know if you have any successful treatments you use!
 
Crista & Ming said:
Glad Velcro came up.

Have you read the stickies on the Lantus forum like Sue suggested? It would be helpful to us if you chose a method to follow: Slow Low Go Slow (SLGS) or Tight Regulation (TR).

On SLGS, Velcro would've earned a reduction. Anything under 90 will mean a reduction for his next dose.

On TR, Velcro would continue with 1 unit (unless the rest of the cycle says otherwise). Reductions are earned when a cat goes under 50.

Of course, TR is only doable if you feed low carb food and can test at least 3-4 times a day.

You don't have to choose right now but I do wonder if other more experienced members might have an opinion on Velcro's dose. I'll tag them for you: @Wendy&Neko @Chris & China (GA) @Sienne and Gabby (GA)
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I am so new to diabetes (literally no human experience either), I am learning as I go. I have no opinion on anything right now because I dont have any kind of experience or pattern to fall back on. For the next week I can test at will... afterwards I will have to plan more to add more testing in. I’m in the adjustment period right now.
 
Margie and Jackson said:
I’ve been working on my cat’s dental issues and I think it’s helping him heal from diabetes. The vet said he had mild stomatitis, not sure if that’s true as he eats and lets me touch his mouth. He does have sore gums and I’ve been using chlorhexidine gluconate rinse and 1-tdc based on advice here and searching the web. I just wanted to let you know since it’s hard to find info about how to help stomatitis. Let me know if you have any successful treatments you use!
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Thank you. I will look into these - I have spent hours online learning about stomatitis and nothing has really worked yet. Your advice is not something I had seen before, so thank you.
 
It's a lot to learn all at once and we've all been there. Don't worry if you don't understand or have no answers. We're here to help! :)

If you have time, I would read this sticky: http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

Ask questions if you are confused after reading the sticky.

Looks like Velcro's BG is going up. That's great! Let's see what the experienced members have to say about Velcro's dose tonight.
 
What was Velco in the hospital for? The reason he was there may make a difference with regard to dosing.

Also, is the only way your vet is treating the stomatitis with a chlorhexidine rinse? In most cats, the method of relieving the problem is extractions. Have you given any thought to seeing a veterinary dentist?
 
Sienne and Gabby (GA) said:
What was Velco in the hospital for? The reason he was there may make a difference with regard to dosing.

Also, is the only way your vet is treating the stomatitis with a chlorhexidine rinse? In most cats, the method of relieving the problem is extractions. Have you given any thought to seeing a veterinary dentist?
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He had a dental cleaning in March, and I wouldn’t know he had a problem from his behavior. I want to try to help him in a less invasive way. I suspect a dentist will not have much to offer besides extraction or prednisone, but I am thinking about it. His gums are definitely better than they were.
 
Sienne and Gabby (GA) said:
What was Velco in the hospital for? The reason he was there may make a difference with regard to dosing.

Also, is the only way your vet is treating the stomatitis with a chlorhexidine rinse? In most cats, the method of relieving the problem is extractions. Have you given any thought to seeing a veterinary dentist?
Click to expand...
I took Velcro to the hospital because he was visibly dehydrated and extremely lethargic and moving as if he had diabetic Neuropathy (but his last test in Alril did not indicate diabetes). He ended up being severely hyperglycemic and dehydrated. It took 4 days to see any really improvement in his demeanor at which point we asked to treat the diabetes at home. He had known stomatitis which I feel like exacerbated the situation (emergency and normal vets both agree). Normal vet is anti extraction, emergency vet extremely pro extraction. We are treating him with a pain killer for now to see if we can get him stronger from hyperglycemia. Then will decide how to proceed with extraction and if it makes sense.
 
Do you know if he was being treated for diabetic ketoacidosis? Whether you need to be attentive to ketones makes a big difference with dosing strategy. From the way you're describing his behavior, it sounds like ketones were a possibility.
 
Sienne and Gabby (GA) said:
Do you know if he was being treated for diabetic ketoacidosis? Whether you need to be attentive to ketones makes a big difference with dosing strategy. From the way you're describing his behavior, it sounds like ketones were a possibility.
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He was tested and ketoacidosis was not diagnosed.
 
From +7 133 down to +9 58. More honey and some more food. I’m concerned about what to do with his next insulin at 8. I guess test and if low keep testing every hour? I need to sleep at some point...
 
At +10 he was up to 159. 8 pm and his next Landus dosing (1 unit) is pending. Not sure what I should do. Any suggestions?
 
Let's see what his +11 is. Post and change your title to something like: "+11 = ## Dose advice needed".

He's going up and I think if he continues this, you can definitely continue with 1 units tonight. Do you have high carb foods stocked up? He seems to respond well to honey so if you don't, that's good too.

He may also bounce from today's 68 and you may be able to get a good night's sleep. But we'll get there when we do.

Edit: Oh, sorry. I didn't realize he also went down to 58 at +9. That may change what the dose should be next cycle. I'll tag some members for you again. For now, don't feed any food to Velcro.

@Sienne and Gabby (GA) @Wendy&Neko
 
Alright, his +11 reading is 220 but he has had food inside the last 1.5 hours. He got to it before I could take it away. He dosage has been 1 unit. I am not sure he will eat much more before I am scheduled to give him more insulin in an hour.

Edited: His diet has been changed to low carb since we’ve had him home from his hospital stay for 52 hours. It was not always low carb previously and the vet fed him Hills DM during his 4 day stay and initial treatment of glucose levels.
 
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Crista & Ming said:
Let's see what his +11 is. Post and change your title to something like: "+11 = ## Dose advice needed".

He's going up and I think if he continues this, you can definitely continue with 1 units tonight. Do you have high carb foods stocked up? He seems to respond well to honey so if you don't, that's good too.

He may also bounce from today's 68 and you may be able to get a good night's sleep. But we'll get there when we do.

Edit: Oh, sorry. I didn't realize he also went down to 58 at +9. That may change what the dose should be next cycle. I'll tag some members for you again. For now, don't feed any food to Velcro.

@Sienne and Gabby (GA) @Wendy&Neko
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Thank you for the advice. He got to some food inside the last 1.5 hours before I could get it away. I’m not sure he will eat much more at his next scheduled insulin dose. His most recent reading at +11 was 220.
 
Sorry no one got to you in time. It would be interesting to see what Velcro does without insulin tonight. Hope someone with more experience drops by soon.
 
Crista & Ming said:
Sorry no one got to you in time. It would be interesting to see what Velcro does without insulin tonight. Hope someone with more experience drops by soon.
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It’s ok. I’m new to this and it seems like sometimes the vet advice conflicts with tribal knowledge so it is even more confusing since I don’t have my own experience yet. He isn’t going to eat anymore tonight unless he gets hypo low. I will test him in a couple of hours again.
 
I think you made a good decision since you think you won’t be able to get him to eat.

It will be difficult for a while, trying to juggle the advice from your vet and advice here. It’s really up to you what you want to follow and knowing your cat usually trumps everyone’s advice.

Once you gather more data from Velcro on lantus and start to understand how it affects him, you’ll be more confident in knowing what advice to follow. The thing with vets is they either are overdose insulin or hold ineffective doses of insulin until a cat acquires glucose toxicity.

For now, I encourage you again to read up on all the stickies in the forum and go through other threads and learn from everyone here.
 
looks like you're getting your tribal tattoo early ---

another thing you can do, is take a look at the spreadsheets for other partnerships showing similar test results to yours
then check their signature to see how long they've been at it, and what dosages they're on

a lot of very good advice and comfort, hiding in those postings ...

FWIW, I agree with @Crista & Ming
 
Sorry @Crista & Ming I am just seeing this now. I was only online for a few minutes earlier.
I echo everyone's comments on feeding during the cycle as well as preshot. Feeding in the first half of the cycle is best because that is when the insulin is strongest. But of course it kitty drops lower in the second half of the cycle, then you will need to give some low carb food unless it is under 50.
You don't need your vets permission to feed at other times than preshot. That is old thinking and was used when the fast acting insulins were given. Now cats get longer acting insulins and don't need all their food before the shot.
Velcro has had a very good response to the Lantus insulin already so as the depot fills he might head towards a reduction. Although skipping will empty the depot somewhat until it fills again.
To combat dehydration which is very common in FD kitties, try adding a little warm water to Velcros food ( if he will eat it). It will be more sourly but is a good way to get fluids into him if he is reluctant to drink water.
Well done getting the SS up and running and also testing !
 
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