What to do first--diet change or insulin increase?

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Fig_and_Jane

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Hi everyone,

Sadly we're back after almost 4 years OTJ. Fig was diet controlled for a long time. He's now 16, and big changes have happened in his life (loss of longtime civvie partner Misty, addition of 9-month-old human tormentor Russell). A recent test at the vet's had his blood glucose in the 400s.

The vet has him on 1 unit of Lantus. His AM and PM numbers are usually in the high 200s. I curved him on Friday, and the lowest he got was 208.

1) He has been very happy with the under-12 carbs varieties of Friskies and 9-Lives. Is it worth it to change him over to the low-carb Fancy Feast?

2) If I increase his Lantus dosage, do I go to 1.25 or 1.5 units?

The vet wants us to bring him back in for testing, but honestly, after our experiences last time when our previous vet kept prescribing higher doses when he was rebounding and almost killed him, we prefer listening to this board.
 
Re: From Friskies to Fancy Feast--worth it?

First - make only 1 change at a time, so you can see how it works out.

When you test the food change, you'll be able to see how sensitive he is to carbohydrate level alone. Since he was diet-controlled for a while, that may be the easiest thing to do, with the fastest observable result, unlike the long-acting insulins which take a minimum of 3 days before you change the dose. It may be enough of a change that you wouldn't need to alter the insulin dose.

I'd recommend you pick up urine ketone strips to monitor for ketoacidosis and attempt to get a fresh specimen to test when possible while you are implementing changes. Because he is older, he might be more likely to develop complications like that.

Because he is on a low dose of Lantus, you would increase to 1.25 units first. You'll find it helpful to review the Lantus stickies in the Lantus subforum, and post there where the very experienced, like Sienne, will help you out.

Also, were there any things which might have changed his glucose management? Dental problems are common, and bladder infection, respiratory infection, vet visit stress (good for 100 points or so!), and more can elevate blood glucose measures.
 
Thanks, BJM.

It would be great to hear from people who've switched whether a change benefited their cats. Fig has always been a nervous cat and I hate to put him through unnecessary angst. He's doing great with the shots, though--shots mean BONITO FLAKES. :mrgreen:
 
If you are feeding wet food around 10-12% carbs, then it might do him well to try something around 5% carbs. Many kitties are very carb sensitive, and that can definitely lower insulin needs. It would be better to do that first rather than increase the insulin and then change the food, only to find out you need less insulin. When you do get to upping the dose, lantus should be increased by 0.25u unless numbers are above 300 for the whole cycle.
 
The SAFEST route would be to change the food first. If you up the insulin and then change food, and the food makes a difference, you could be giving too much insulin.

Smokey is a pretty steady girl with her BG, but she does the creeps when we give her the higher range (9-14%) too much. We mix it up with their food a lot, but of course the favorites are going to be the higher and sometimes they get a lot of 11 and 12% in a row and she creeps up to the 100s. If I give the lower stuff (2-6%) for a day or two she'll drop right back down again.
 
Dear Jane,
I see you are already getting all the words of wisdom you need and while I'm sorry you had to come back...I'm glad you turned here rather than take your vet's opinion without checking.
I only wish 2 other new members would read your first post. Nkace, and Topaz....can I copy and post your comments or would you mind visiting their current threads and letting them know your thoughts.
Both don't see the value at all in testing.
One of course advised by vet NOT to test. :YMSIGH:
However if your pretty busy just getting your own kitty and yourself together...I completely understand.
Being back after all that time is stressful I'm sure.
Lori
 
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