? Very little insulin needed now, have questions!

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David - coco

Member Since 2022
So Suddenly last Monday night night I tested my cat because she was acting funny and she was borderline hypo. Since then, I've needed to reduce the dose drastically. Please see my my spreadsheet. You can also skim this if you want for other info. https://felinediabetes.com/FDMB/threads/low-blood-sugar-dosing-advice.274196/#post-3046554

But I'm just very frustrated not know what's happening and why with the low insulin now being needed. Considering she does still get into the 200s and the last day or so, 300s, she's obviously not in remission like I was initially thinking was happening. I did a curve yesterday just for my curiosity and it seemed normal. One interesting thing was that she dropped right at the end of the cycle at PMPS and I wouldn't have expected that, no?

This morning her AMPS was 222 and I know that anything under 200 I would have skipped regardless but I've been curious to see what would happen if I skipped, so I decided to see. I skipped the dose this morning and fed normally and did another curve. As you can see, she dropped considerably today and had a relatively normal curve I would say. But a drop to 96 with no insulin, that makes no sense to me. That shouldn't happen, right?

The main stress is the morning when I have only about 2 hours to test/feed/shoot and get a +1 and or +2 test in before I need to leave for work. Her constantly dropping is an added stress. Her drops seem to be consistently within the first 2-3 hours which also seems odd given I thought the ProZinc acted longer. Also, I know I have only done it once, but even the "drop" dose brings her down pretty good amount, the one time is dropped lower than the 0.1U.

Can anyone please try and help me to understand what might be happening and what I should be doing here? Why when I skipped dose today did her numbers still drop considerably? I'm seriously tempted to skip again tonight and see if they drop again, depending on what her PMPS is, I just may. Is this maybe a sign that her body is TRYING to get into remission and may be working again slightly to produce insulin? Any advice is appreciated.
 
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David - coco said:
So Suddenly last Monday night night I tested my cat because she was acting funny and she was borderline hypo. Since then, I've needed to reduce the dose drastically. Please see my my spreadsheet. You can also skim this if you want for other info. https://felinediabetes.com/FDMB/threads/low-blood-sugar-dosing-advice.274196/#post-3046554

But I'm just very frustrated not know what's happening and why with the low insulin now being needed. Considering she does still get into the 200s and the last day or so, 300s, she's obviously not in remission like I was initially thinking was happening. I did a curve yesterday just for my curiosity and it seemed normal. One interesting thing was that she dropped right at the end of the cycle at PMPS and I wouldn't have expected that, no?

This morning her AMPS was 222 and I know that anything under 200 I would have skipped regardless but I've been curious to see what would happen if I skipped, so I decided to see. I skipped the dose this morning and fed normally and did another curve. As you can see, she dropped considerably today and had a relatively normal curve I would say. But a drop to 96 with no insulin, that makes no sense to me. That shouldn't happen, right?

The main stress is the morning when I have only about 2 hours to test/feed/shoot and get a +1 and or +2 test in before I need to leave for work. Her constantly dropping is an added stress. Her drops seem to be consistently within the first 2-3 hours which also seems odd given I thought the ProZinc acted longer. Also, I know I have only done it once, but even the "drop" dose brings her down pretty good amount, the one time is dropped lower than the 0.1U.

Can anyone please try and help me to understand what might be happening and what I should be doing here? Why when I skipped dose today did her numbers still drop considerably? I'm seriously tempted to skip again tonight and see if they drop again, depending on what her PMPS is, I just may. Is this maybe a sign that her body is TRYING to get into remission and may be working again slightly to produce insulin? Any advice is appreciated.
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HI!
My boy used to drop early in the cycle as well but his lowest number (nadir) was at usually +10 which is why I switched to lev as it tends to have a reverse nadir and I couldn't worry all day. I did have 1 go into remission (steroid induced) and if the pancreas is working you must dose very carefully. I am not qualified to give advice but I will tag others
@Bron and Sheba (GA) @tiffmaxee @Katsallday
 
David, I think the 0.1 dose is working well.
From November through to mid February you didn't get any mid cycle tests in so we don't know if Coco has been dropping a bit like this for 2 or three months.
At the moment she is having pretty nice cycles and is coming back up to yellow at the end of each cycle..
I don't know why she had the 96 after a NS. Maybe her pancreas is trying to kick in a bit, But she is not ready to go off insulin yet.
If you are concerned about the mornings, leave a little higher carb food out when you walk out the door.
I would just keep giving the 0.1 units unless she drops under 90 and then she would have to go to a drop.
I'm going to tag @Suzanne & Darcy as she is a prozinc user.
 
Bron and Sheba (GA) said:
David, I think the 0.1 dose is working well.
From November through to mid February you didn't get any mid cycle tests in so we don't know if Coco has been dropping a bit like this for 2 or three months.
At the moment she is having pretty nice cycles and is coming back up to yellow at the end of each cycle..
I don't know why she had the 96 after a NS. Maybe her pancreas is trying to kick in a bit, But she is not ready to go off insulin yet.
If you are concerned about the mornings, leave a little higher carb food out when you walk out the door.
I would just keep giving the 0.1 units unless she drops under 90 and then she would have to go to a drop.
I'm going to tag @Suzanne & Darcy as she is a prozinc user.
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Thanks for the reply.

She was diagnosed 12/13/22 and only started testing on 12/30/22, so not sure what you might be seeing back in November? Nevertheless, since I think 2/11 I stopped doing any other mid cycle tests as we were both stressed and she was not doing great as far as digestion and appetite, so I cooled off the tests to help us both. Then we sort of got in a rhythm and was just looking for clinical signs of things and saw none until last week. But you’re right, it’s possible this has been happening for some days or weeks leading up to this.

It’s interesting that the last two days I did the curves, she had pinks at +10 but then came down at PS time, I would’ve thought she would keep going up if anything?

As far as the mornings, is there a min. number you would like to see to be safe to leave (based on the last week or so on my spreadsheet as well) in your opinion? Or do you just like to see a test where it’s going up from the previous test? That’s been my issue, is I will test right before I leave but most of the time its taken until the +2.5 - +3 time for it to go up, by then I’m late. I’ve considered doing a drop dose in the mornings but last time I did that, it dropped her lower than the 0.1u dose lol. And leaving a high carb food does make me feel a little better but I just hope it won’t hinder a potential for remission, if that’s a possibility. I’m trying to get her off the high carb dry, she ended up rejecting the ziwi. I have a sample of the Young Again coming. If she likes that, Maybe I’ll look into a times feeder to drop a little of that couples times a day.

Also, the other thing I’m still learning about the numbers is when to worry on low ones. Is it anything under 68 on the alpha trak is it’s time to feed high carb food? But what about number above that, is anything under 100 trouble for a diabetic cat?

As far as the needing barely any insulin at this point, is there an explanation for that as to what is going on? I know she’s not in remission but is this typically a sign that she’s trying? Or is it impossible to know what’s going on?

I know I have a lot of questions but I really appreciate the help and answering them!
 
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David - coco said:
Maybe I’ll look into a times feeder to drop a little of that couples times a day.
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That’s a good idea
David - coco said:
Is it anything under 68 on the alpha trak is it’s time to feed high carb food? But what about number above that, is anything under 100 trouble for a diabetic cat?
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I’m going to let @Suzanne & Darcy answer that because she is a prozinc user and I am not.

David - coco said:
As far as the needing barely any insulin at this point, is there an explanation for that as to what is going on? I know she’s not in remission but is this typically a sign that she’s trying? Or is it impossible to know what’s going on?
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She just looks like a cat that is needing less insulin now. That happens.. I would not try reading anything into it. Just go with the flow. I can’t tell you what is going to happen…we just need to wait and see. It requires patience. Vigilance is great but don’t over analyse it.
David - coco said:
I know I have a lot of questions but I really appreciate the help and answering them!
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It’s fine to ask all the questions you need to…we are happy to answer them.
David - coco said:
As far as the mornings, is there a min. number you would like to see to be safe to leave (based on the last week or so on my spreadsheet as well) in your opinion? Or do you just like to see a test where it’s going up from the previous test? That’s been my issue, is I will test right before I leave but most of the time its taken until the +2.5 - +3 time for it to go up, by then I’m late. I’ve considered doing a drop dose in the mornings but last time I did that, it dropped her lower than the 0.1u dose lol.
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I’m going to leave this question for @Suzanne & Darcy as she is a prozinc user and I am not.
David - coco said:
And leaving a high carb food does make me feel a little better but I just hope it won’t hinder a potential for remission, if
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No that won’t hinder her if she is heading towards remission.
 
David - coco said:
So Suddenly last Monday night night I tested my cat because she was acting funny and she was borderline hypo. Since then, I've needed to reduce the dose drastically. Please see my my spreadsheet. You can also skim this if you want for other info. https://felinediabetes.com/FDMB/threads/low-blood-sugar-dosing-advice.274196/#post-3046554

But I'm just very frustrated not know what's happening and why with the low insulin now being needed. Considering she does still get into the 200s and the last day or so, 300s, she's obviously not in remission like I was initially thinking was happening. I did a curve yesterday just for my curiosity and it seemed normal. One interesting thing was that she dropped right at the end of the cycle at PMPS and I wouldn't have expected that, no?

This morning her AMPS was 222 and I know that anything under 200 I would have skipped regardless but I've been curious to see what would happen if I skipped, so I decided to see. I skipped the dose this morning and fed normally and did another curve. As you can see, she dropped considerably today and had a relatively normal curve I would say. But a drop to 96 with no insulin, that makes no sense to me. That shouldn't happen, right?

The main stress is the morning when I have only about 2 hours to test/feed/shoot and get a +1 and or +2 test in before I need to leave for work. Her constantly dropping is an added stress. Her drops seem to be consistently within the first 2-3 hours which also seems odd given I thought the ProZinc acted longer. Also, I know I have only done it once, but even the "drop" dose brings her down pretty good amount, the one time is dropped lower than the 0.1U.

Can anyone please try and help me to understand what might be happening and what I should be doing here? Why when I skipped dose today did her numbers still drop considerably? I'm seriously tempted to skip again tonight and see if they drop again, depending on what her PMPS is, I just may. Is this maybe a sign that her body is TRYING to get into remission and may be working again slightly to produce insulin? Any advice is appreciated.
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Hi
This is not advice juts my experience with a cat whose pancreas began working .... I would say yes it is trying and please be very (as you have been) careful dosing. I agree lets see what @Suzanne & Darcy say.
 
Even though ProZinc is considered a single cycle insulin, previous cycles can affect the current cycle. It looks like you are seeing some of that (like when you skipped yesterday but she eventually started trending back upward.)

You already know that 68 or below on the AT meter requires HC food. As for feeding under 100, you may need to play it by ear. If she’s hovering near 100, LC may help her to stay there. If you find that does not slow her down or keep here where you want her to be, I would try MC food if she’s at about 90-ish. What is she eating these days?
 
Suzanne & Darcy said:
Even though ProZinc is considered a single cycle insulin, previous cycles can affect the current cycle. It looks like you are seeing some of that (like when you skipped yesterday but she eventually started trending back upward.)
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This is confusing to me since she was up at PS then shot down after food and NS. If the previous cycle insulin was still working, wouldn’t her PS number have stayed lower?
Suzanne & Darcy said:
You already know that 68 or below on the AT meter requires HC food. As for feeding under 100, you may need to play it by ear. If she’s hovering near 100, LC may help her to stay there. If you find that does not slow her down or keep here where you want her to be, I would try MC food if she’s at about 90-ish. What is she eating these days?
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She currently nearly transitioned to Koha wet which I think is 7%~ carbs. But I’m also giving about 1 tbsp of a higher carb dry per meal at the moment. I’m trying to transition to either a low carb dry or just completely off of it.

I guess I’m still just not sure at what number I should intervene (besides below 68). Like I mentioned above, it’s the mornings I worry most as I really need to find a way to get out the door by 8:30 but if you look at me spreadsheet, she has been tough to get going up until later. Definitely drops a little lower in the mornings it seems. Even doing a drop dose lowers her pretty far it seemed. I just need to figure out a routine for the AM. I’d hate to give a higher carb food just to bump her number up to get out the door. That’s why I asked if there was a min. Number you’d like to see to be comfortable to leave or just a test showing the number going up from the previous test?
 
FrostD said:
I would see how the drop dose goes. It's possible the yellows are a little bounce but I'm not entirely convinced...she may need some more carbs early cycle in order to slow those drops and avoid reductions.
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So based on what you see, the drop dose may be the way for right now, vs the 0.1?

Interesting that it seems she drops more in the morning than the night. I wish it was the other way around for my sake. What number to you is a "low" drop?

If the higher numbers are little bounces what does that mean, her numbers may actually be better than they appear? What makes you not convinced that they aren't bounces?

As far as the more carbs early on, what are you suggesting? Do I need to supplement a couple tbsp of MC food with her normal food or something? I currently do give her about 1tbsp of a high carb (38%) dry food every meal. Although I'm trying to get her off that with either a low carb option or completely. I've been working hard to get her to a lower carb diet and so to possibly need to give higher carb food is a little discouraging.

So she's requiring basically no insulin at this point, yet still needs it. Just mind boggling for me. This just seems like its going to be a stressful challenge to keep this in check with so little margin for error. Would you say to skip the next dose if she falls below 90, since there's no way to further reduce?

I see you cat got into remission. I didn't read through your whole spreadsheet but it seemed to happen nearly over overnight. Bssed on your experience, is it possible my cat is trying to get into remission? The difference is I see your cat had lower numbers throughout the day whereas my cat still has the higher numbers. Its just the need for so little insulin that keep me thinking remission. But I don't know.

Thanks for the help
 
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The 0.1U was bringing her down too much, too fast - hence the drop dose. Since you are still feeding high carb, we use any drop below 90 as a reduction point. The problem with that is, from a drop dose you go to an OTJ (off the juice) trial without insulin. Sounds good BUT her numbers are still too high overall to safely attempt that (risk ketones). Which brings me to the bounce comment...

Rarely, we see a cat that is actually ready to try OTJ, but the drop dose/0.1U is causing mini bounces and essentially inflating the numbers. So, technically, you could try OTJ next time she drops below 90 if you wanted to. Why I'm not convinced they're bounces? They're not quite high enough. I suspect it's more an issue of the high carb food and not enough duration, partly due to that food.

Next step re:food is up to you. Personally, I would focus on getting rid of that dry altogether. I think that would be enough to get her into remission, or at the very least more gentle cycles and longer duration to really give her pancreas time to heal (we call the green numbers "healing greens", but it's only safe to attempt that range on low carb wet diet). I am suggesting more carbs because that initial drop is so big, its probably going to force you OTJ before she's actually ready, and you'll end up with a relapse. She still needs insulin at these numbers, and right now the only way to keep doing that is to add more carbs to slow that early drop in BG. The % carbs is a little bit of a guessing game. You give the 38% at PS? But this is why I say get rid of the HC if you can, it's essentially shooting yourself in the foot twice in this case.

My cat is a special case. He has a pituitary tumor (acromegaly) that secretes excess growth hormone. That growth hormone happens to bind to the exact same receptor on the cells in his body that insulin binds to (his own insulin, or exogenous insulin). That essentially caused his diabetes - he needed extra insulin to overwhelm the growth hormone and actually get into his cells. The overnight switch you saw is when we started a medication to block the growth hormone production from the tumor...it's rare for the medication to get them into remission, but we were fortunate.

She is definitely near remission, and I think it's a good goal to have. But I've seen cats (frustratedly) flirt with the OTJ/drop dose/0.1U/0.25U for months, just to set expectations. And occasionally something happens where all of a sudden their insulin needs go up (develop a chronic condition, or something like dental issues/ infections/medications knock the body out of whack)

Regardless, it's great she's at such a low dose and her numbers are pretty good!
 
FrostD said:
The 0.1U was bringing her down too much, too fast - hence the drop dose. Since you are still feeding high carb, we use any drop below 90 as a reduction point. The problem with that is, from a drop dose you go to an OTJ (off the juice) trial without insulin. Sounds good BUT her numbers are still too high overall to safely attempt that (risk ketones). Which brings me to the bounce comment...

Rarely, we see a cat that is actually ready to try OTJ, but the drop dose/0.1U is causing mini bounces and essentially inflating the numbers. So, technically, you could try OTJ next time she drops below 90 if you wanted to. Why I'm not convinced they're bounces? They're not quite high enough. I suspect it's more an issue of the high carb food and not enough duration, partly due to that food.
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Thanks for the detailed response. If you see, I actually did a NS on Sunday morning and her number still dropped into the 90s and stayed lower most of the cycle until the end, fwiw. It would seem the drop dose is doing about the same as the 0.1 was doing as far as drop. Is it normal to have it drop more or less morning/evening with the same dose? She seems to drop more in the morning on average.

I likely can get her off the dry relatively easy. I did try the Ziwi air dried food but she didn't go for it. Now I have a sample of the young again dry that I'll try, just so she can get her dry food fix. Otherwise I'll just ween her off of it.

FrostD said:
I suspect it's more an issue of the high carb food and not enough duration, partly due to that food.
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Sorry but can you elaborate on this?

FrostD said:
But this is why I say get rid of the HC if you can, it's essentially shooting yourself in the foot twice in this case.
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Can you elaborate on what you mean here?

FrostD said:
You give the 38% at PS?
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I'll usually give her about 1/2 tbsp after she eats the majority of her wet food, after PS and either right after shooting or just before. Depends on how fast she eats her wet food. But the PS is always fasted!

FrostD said:
She is definitely near remission, and I think it's a good goal to have. But I've seen cats (frustratedly) flirt with the OTJ/drop dose/0.1U/0.25U for months, just to set expectations. And occasionally something happens where all of a sudden their insulin needs go up (develop a chronic condition, or something like dental issues/ infections/medications knock the body out of whack)
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The only thing that changed recently that I keep thinking about is she was given an antibiotic injection about 7 days before this started happening and I gave her a B12 shot 2 days before. I don't think either of these could have effecting this?

FrostD said:
Next step re:food is up to you. Personally, I would focus on getting rid of that dry altogether. I think that would be enough to get her into remission, or at the very least more gentle cycles and longer duration to really give her pancreas time to heal (we call the green numbers "healing greens", but it's only safe to attempt that range on low carb wet diet). I am suggesting more carbs because that initial drop is so big, its probably going to force you OTJ before she's actually ready, and you'll end up with a relapse. She still needs insulin at these numbers, and right now the only way to keep doing that is to add more carbs to slow that early drop in BG. The % carbs is a little bit of a guessing game. You give the 38% at PS? But this is why I say get rid of the HC if you can, it's essentially shooting yourself in the foot twice in this case.
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I'm a little confused with this part. So are suggesting to get rid of the dry AND not to feed any higher carb wet food to slow the early drops?

I suppose I could try and introduce a little MC food, I assume this should be given with her main meal and not at +1 or 2? Unless needed of course. My usual feeding routine is to give her about 3/4 of her meal in the form of LC wet. Then I will give about 1/2 tbsp of the HC dry right before or right after her insulin. I'll usually give the other 1/2 tbsp right when I walk out the door about 2.5 hrs after shooting or right before bed, just for peace of mind. In between shooting and leaving/bedtime (mostly in the morning) I may give a little more dry or some MC wet if her number drops, to try and get it back going up before I leave. Not sure if I'm doing this right to give her the best chance at remission?

I appreciate the help. I know I ask a lot of questions but its been tough try to manage this and understand it all. The mornings are the most stressful as I only have about 2.5 hrs at most to monitor her and she's been dropping so much so fast, trying to get her number up before I leave for work. Add to the stress today, I got an email from the internal med vet I saw a month or so back, checking in with me. Last week when I reached out to them for advice on this, they wanted me to come in right away for a curve and about $900 in additional lab work. I had shared my spreadsheet link with her and today she wanted to emphasize I shouldn't be changing insulin doses without checking with a vet first. She said there could be multiple reasons why what's happening, is happening, not just possible remission. Is there anything clinically that could be going on that's causing this?? Are there certain lab test that I should be getting? Trust me, I don't want to play vet at home and have this burden on me but all this vet wanted me to do was come in. just frustrating. At least my family vet is a little more understanding.

I'm just trying to figure out what I can do to move her forward into remission or not. Eventually its going to drive me crazy having to micro manage her on a super small dose.
 
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David - coco said:
By the way, is there a way to prevent this vet from seeing the spreadsheet anymore? Or because she has the link now, there's no way to change that? I guess besides making a new spreadsheet with a different link.
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Unfortunately there is no way to stop sharing a spreadsheet since it is set to "Anyone with link can view". But it's no effort to duplicate the existing spreadsheet and deleting the old one. I can help you with that.
 
Bandit's Mom said:
Unfortunately there is no way to stop sharing a spreadsheet since it is set to "Anyone with link can view". But it's no effort to duplicate the existing spreadsheet and deleting the old one. I can help you with that.
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I would like to do that. Any help is appreciated
 
David - coco said:
Thanks for looking into that. I have a question maybe for you on diet and calories that maybe you can help with. But I’m going to bed so I’ll probably post it tomorrow. Thanks
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@Bron and Sheba (GA)
Maybe I'm overthinking this but thought I'd run this by and anyone else who wants to comment. As far as her diet and calories. Right now she is at about 11lbs, which is up from 10.6 at the lowest at some point the last 2 months. She definitely looks a little healthier and more plump then 2 months ago. Before she looked a little boney in some areas and now is much better. The vet had told me her ideal weight should be around 9-9.5lbs and her maintenance weight calories should be 180-200 per day. And if trying to lose weight to do a deficit of about 20% below that.

I definitely don't want her to gain any more weight from where she's at now as she's a little plump an I know the heavier she is the worse it is for the diabetes. But my question is, does 180-200 calories sound right to you? If I did do a deficit then that would be more like 144-160, does this seem like enough? She could stand to lose a little of the bad weight for sure. I just worry about starving her. by the time its feeding time, she definitely is hungry and ready to eat. I also notice on my day off she acts a little hungry in the middle of the day which make me feel bad. But is this normal for a diabetic to act like this?

I do measure her food everyday to make sure I know how much she eats. She usually wont get more than about 90 calories. However the last couple weeks she eaten much better and easily gets 90-100 calories per meal. The last week, because of the constant lower BG, I'll give her a little MC wet or dry so she's actually been eating closer to 100-120 calories per meal, which is probably why she's now at 11lbs. I want to start trying to get her to lose a little weight but don't want her to starve or under feed her. So just thought I'd ask for some advice. Thanks
 
I think maybe it’s wise to skip as well. If you were going to be home, I would say absolutely do the drop dose so we could monitor and see how she does, but since you can’t test, I suppose you should skip. Maybe tomorrow?
 
Another option is to stall without feeding and retest in 30 minutes to see if she’s going up into yellow. I realize, however, that you probably already fed her. :) Have a good work day.
 
Suzanne & Darcy said:
Another option is to stall without feeding and retest in 30 minutes to see if she’s going up into yellow. I realize, however, that you probably already fed her. :) Have a good work day.
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Yeah I did feed. I decided to skip. I can test her but only for a couple hours. Better safe then sorry I suppose. What are you asking about tomorrow? I do work again tomorrow if that’s what your asking, off Sunday and Monday.
 
David - coco said:
Yeah I did feed. I decided to skip. I can test her but only for a couple hours. Better safe then sorry I suppose. What are you asking about tomorrow? I do work again tomorrow if that’s what your asking, off Sunday and Monday.
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Oh yes. I was thinking you would be off on Saturday.
 
Suzanne & Darcy said:
Good. It seems like her pancreas is really trying.
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It’s gotta be her body causing the drop right? With such little insulin, it can’t be an effect from the previous cycle?

She didn’t eat as good this morning as she has been, she’s giving me the sense she doesn’t like her food again. She’s so damn picky.

I just haven’t her a little MC wet food. Do you think I shouldn’t have?
 
David - coco said:
@Bron and Sheba (GA)
Maybe I'm overthinking this but thought I'd run this by and anyone else who wants to comment. As far as her diet and calories. Right now she is at about 11lbs, which is up from 10.6 at the lowest at some point the last 2 months. She definitely looks a little healthier and more plump then 2 months ago. Before she looked a little boney in some areas and now is much better. The vet had told me her ideal weight should be around 9-9.5lbs and her maintenance weight calories should be 180-200 per day. And if trying to lose weight to do a deficit of about 20% below that.

I definitely don't want her to gain any more weight from where she's at now as she's a little plump an I know the heavier she is the worse it is for the diabetes. But my question is, does 180-200 calories sound right to you? If I did do a deficit then that would be more like 144-160, does this seem like enough? She could stand to lose a little of the bad weight for sure. I just worry about starving her. by the time its feeding time, she definitely is hungry and ready to eat. I also notice on my day off she acts a little hungry in the middle of the day which make me feel bad. But is this normal for a diabetic to act like this?

I do measure her food everyday to make sure I know how much she eats. She usually wont get more than about 90 calories. However the last couple weeks she eaten much better and easily gets 90-100 calories per meal. The last week, because of the constant lower BG, I'll give her a little MC wet or dry so she's actually been eating closer to 100-120 calories per meal, which is probably why she's now at 11lbs. I want to start trying to get her to lose a little weight but don't want her to starve or under feed her. So just thought I'd ask for some advice. Thanks
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Sorry I didnt get back to you sooner about this.
Food
20 calories per lb of ideal healthy body weight per day
OR for calories per day= 13.6 x optimal lean body weight in lbs plus 70
 
Sorry I can't do specific quotes, it's a bit of a pain on a phone.

Re: the high carb food and duration. The dry high carb is unpredictable as far as when it starts to affect BG and for how long. We do know that the effects stick around quite awhile, days sometimes. So, as insulin starts to wear off, you still have high carbs likely floating around, which shortens the duration of the insulin (so instead of lasting 12 hours, it's only lasting say 9-10 hours, which allows for that climb at the end of the cycle).

Which is what I mean by shooting yourself in the door. It's elevating BG too much, it's shortening duration, and on top of that now you have to add in some sort of higher low carb or medium carb to slow that big drop. Whereas if you can just get rid of the dry, she probably won't need insulin at all.

If you are going to remove the rest of the dry, I personally would skip insulin a few days - but as always monitor ketones (note for anyone lurking, this advice is very specific to Coco - removing dry and giving a small dose is possibly unsafe, especially if she can't be monitored).

Re the vet - no, nothing jumps out at me clinically. This is all very likely due to the food changes.you made, and sometimes cats just do this. If you catch it quickly enough, or if it was triggered by something like steroids or infection, it's often a fairly good chance of remission. Second remissions however, are more difficult. Which is why you want to try to do it the "right" way the first time around - meaning let that pancreas fully heal.

I would not have given MC with no insulin, no. No harm, no foil though.

Yes, the drop you saw is her pancreas working. We just want to continue to support it as long as safely possible.
 
Bron and Sheba (GA) said:
Sorry I didnt get back to you sooner about this.
Food
20 calories per lb of ideal healthy body weight per day
OR for calories per day= 13.6 x optimal lean body weight in lbs plus 70
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So then its right in line with what the vet told me, so thats good.

But this is for maintenance weight, right? So since shes 11lbs right now, then to maintain that weight she should be eating about 220 calories per day. But what if I want her to lose a little weight, recommendations how best way to approach that?

as far as her acting hungry, is this normal for a diabetic cat? So should I not feel bad or feel like she's starving to death?
 
FrostD said:
If you are going to remove the rest of the dry, I personally would skip insulin a few days - but as always monitor ketones (note for anyone lurking, this advice is very specific to Coco - removing dry and giving a small dose is possibly unsafe, especially if she can't be monitored).
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I was hoping to try this when I received my sample of the Young Again dry food, just so she still had dry to eat but obviously low carb. And I wanted to start it when I had my weekend off to monitor, not sure Ill be able to do it this weekend, I may need to wait till next weekend. The mornings when I work are the hardest.

Is the reason to skip insulin, so that she doesn't drop to low??

UPDATE: as an update, I did not give her any dry food last night or this morning. This morning I ended skipping her dose anyway since it was below 200 and I had to leave for work. So are you still thinking I should skip the dose the next few days? Should I also try to refrain from giving any MC wet food as well, unless absolutely necessary??

FrostD said:
I would not have given MC with no insulin, no. No harm, no foil though.
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Curious why?

FrostD said:
Which is why you want to try to do it the "right" way the first time around - meaning let that pancreas fully heal.
Click to expand...

So far, am I doing it the right way? Any further recommendations?
 
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the runs when they did eat it......but you may have better luck many have:cat:
I also was trying to get rid of the dry food but they were addicted so I had to go slow
I gave Dr Elsey more as treats or if Drevon was dropping too low I let him have some with his wet to help him "surf" a good cycle
 
David - coco said:
I was hoping to try this when I received my sample of the Young Again dry food, just so she still had dry to eat but obviously low carb. And I wanted to start it when I had my weekend off to monitor, not sure Ill be able to do it this weekend, I may need to wait till next weekend. The mornings when I work are the hardest.

Is the reason to skip insulin, so that she doesn't drop to low??

UPDATE: as an update, I did not give her any dry food last night or this morning. This morning I ended skipping her dose anyway since it was below 200 and I had to leave for work. So are you still thinking I should skip the dose the next few days? Should I also try to refrain from giving any MC wet food as well, unless absolutely necessary??


Curious why?



So far, am I doing it the right way? Any further recommendations?
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Yes, the reason to skip insulin is so she doesn't go too low. It can take up to 2 weeks for the effects of removing high carb dry to be fully realized, but sometimes it is very dramatic.

If she stays under 200 I would continue to skip and monitor ketones. If she goes above 200, or after 3 days off the high carb, please tag me to take a look.

No insulin = no hypo (for ProZinc). So, no need to give medium carb if no shot.

For reference, the normal BG range for the AlphaTrak is 68-120. So, a non-diabetic cat would always have BG in that range barring any illnesses or infections. For the strongest remission, that is our goal - to keep BG in that range as much as possible, and slowly stepping down insulin dose to give the pancreas time to heal. The caveats are (1) sometimes the insulin is too harsh to allow for that, which is the case right now for Coco and (2) sometimes that's unreasonable for the caregiver due to testing limitations, comfort level, etc. So we discuss and try to find the best compromise for kitty and caregiver.
 
David - coco said:
I would like to do that. Any help is appreciated
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Hi, just seeing this. Not sure why I didn't get an alert when you replied. Can I still help you with setting up a copy of the spreadsheet?

BTW, some cats do very well without dry food in terms of blood sugar. Even the low carb ones like Young Again and Dr. Elsey's.
 
Bandit's Mom said:
Hi, just seeing this. Not sure why I didn't get an alert when you replied. Can I still help you with setting up a copy of the spreadsheet?

BTW, some cats do very well without dry food in terms of blood sugar. Even the low carb ones like Young Again and Dr. Elsey's.
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Yes I would still like to make a copy of the spreadsheet!

Right now, she’s trying the young again. She’s only been getting about 1/2 tbsp of dry per meal and plan to continue giving only that much. Just to try and get some easy calories.
 
I do not think ketones are likely in these numbers but to be cautious you could test them occasionally. If she’s in a yellow number then you could try? I realize the timing can’t really be selected by us. right?! I always thought that cats couldn’t go into DKA when they were in yellow numbers, but my boy did. Of course, it was an infection that set him over the edge. That’s just an aside and not something I worry about with Coco. I just think it would make you feel better if you know that she is not producing ketones.
 
@FrostD
So tonight will be 3 days of no insulin and no high carb food. Admittedly, she did have a little MC wet food (13%) mixed into her food (maybe a tablespoon) up until today as I was still slowly transitioning to her new food. Today was the first full day without that mixed in, for what that's worth.

Just curious your thoughts on her numbers the last 3 days and what you recommend I do? With the continued drops after eating, tells me something is trying to work but she still is jumping up at the end of the cycle. Today she finally stayed under 200, at least as far as I can tell with the testing. So its trending in the right direction it seems...

I was off Sunday and Monday so I tried to get some tests in during the day. I have to work tomorrow and the next 5 days so I wont be able to get much testing in besides the first couple hours after her meal and in the evening.

Seems like an obvious answer but gotta make sure. If I skip the shot then there's not risk hypo? So in the morning, I can pretty much leave whenever and not worry about things, like I have been and been late to work lol.
 
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@FrostD @Suzanne & Darcy
So not really sure what or how it happened but she hurt something in her right foot or leg last night and was limping bad, barely putting weight on it. Now I’m freaking out. She did this about 6 months ago and was fine about 24 hrs later. Not sure how this is going to go but if she’s still limping bad, I’m considering taker her in for an X-ray. But I’m concerned that even the trip to the vet will stress her enough to reverse any progress of remission, is that possible to happen? I’m also nervous if they want to give her any pain med, that will kick her out of any possible remission. I just can’t believe this is happening now….My gut tells me it’s just a sprain a will get better like before but not sure.

UPDATE: she’s better this morning. She’s walking around but with a limp still but she’s putting weight on it. Definitely still in a bit of discomfort if you touch it or if she lays on it wrong. It’s her mid foot it seems, between her heel and paw pad. This is almost identical to what and how it happened last time. Randomly started limping in the evening, was a little better and walking on it in the morning, and within 2 days was back to normal and jumping on things again. So I think I’m going to just keep an eye on her the next day or two and see if she gets better.
 
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Glad she seems to be on the upswing.

For what it's worth - you can't not take her in if you're worried about something (logically I'm sure you know this!). So, take each thing as it comes. Sure the stress from a vet visit would raise BG temporarily - but often, so too does inflammation from injuries, etc. As for any medications, you just double and triple check they're aware she's diabetic. Sometimes steroids can't be avoided, but some tend to have lesser effect on BG.
 
FrostD said:
Glad she seems to be on the upswing.

For what it's worth - you can't not take her in if you're worried about something (logically I'm sure you know this!). So, take each thing as it comes. Sure the stress from a vet visit would raise BG temporarily - but often, so too does inflammation from injuries, etc. As for any medications, you just double and triple check they're aware she's diabetic. Sometimes steroids can't be avoided, but some tend to have lesser effect on BG.
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She’s doing much better today, I think a couple more days and she’ll be back to normal. I did end up taking her to vet anyways but it was a total waste of time. The vet we saw (not my normal vet) and she was terrified of getting bitten, so she didn’t do a very good job of checking her. They said in order to do X-rays, they would need to sedate her, which I wasn’t too keen on. Decided to just monitor her till Monday see what happens. They said likely it’s just a soft tissue injury. She barely has a limp today now.

@FrostD So yesterday was 7 full days with no HC dry food. What do you think of the numbers? They seemed to come down everyday but have stalled a bit. I’m a little worried she’s gonna be stuck right on the edge of full remission. Her BG seemed good yesterday even with the vet visit. This morning was a lot higher than I was expecting given the trend the last several mornings. She’s fully on Koha LC wet food since Monday and has been getting a couple teaspoons of young again dry food a day, still working on the sample bag of the YA dry so been limiting how much I give her while the big bag is on order.

Well tonight’s PMPS # trending in the wrong direction again. I assume this isn’t looking good? Or does this sometimes take a couple weeks to happen? Can’t imagine the YA dry is causing any issues? This is bumming me out lol.

What do you think? Thanks!
 
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