When is insulin absolutely needed?

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MisMelzy

MisMelzy

Member Since 2013
NOt sure if this needs a 911 graphic but in my opinion it does. Today I took lucky's BG numbers and it's even higher today than yesterday! Today it was 213! And that's was before she ate. The only thing different is I tried fancy feast instead of friskies. She got one can when I got home, and then that was it until this morning. And this morning it was 213! When do I have to give her insulin? At what number does she absolutely need insulin? I'm freaking out here because my regular vet is open tomorrow and then isn't open again until Tuesday! I don't want to have to bring her in when my vet is closed and pay high prices at an ER vet. I'm frazzled, frustrated, and want to cry. :(
 
Was it the Fancy feast classic pates? The others can be too high in carbs.

Remember this is the new meter - the old Tru2Go was underestimating the numbers. Anyway heres what I think you got...

tru2Go meter
08/23 158
08/28 136
08/24 142
08/25 177 167
08/26 176 146
08/27 170
08/28 138

moved to relion
08/29 PM 195
08/30 213

The 195 and 213 are within meter error so I wouldnt assume its rising. But lets see what happens now that he is on FF instead. Lets hope it comes down more. Really we want it under 150... ideally 50-130.

Wendy
 
Mel,
I wouldn't freak out over the last two numbers. If I remember right, Lucky was over 400 at the vet before you switched the diet?
A 200 indicates she will probably need insulin but it's not off the charts.
The fancy feast was a "classics" flavor, right?

Outside of what your meter is telling you, how is lucky acting? Still drinking and peeing a lot? Is she otherwise acting okay?

What I would do is call the vet today. Tell them you are seeing a 200 before feeding, and see what they advise. They may say tomorrow would be best given the Holiday weekend, but they might feel that Tuesday is okay. They may even be willing to just call in a prescription and you can avoid the office visit.
 
Glucometers provide estimates of the glucose level. The FDA (in the US) stipulates that the readings they provide must be within 20% of what a lab would get.
with your 2 numbers on the same meter:
195 -> 156.0 - 234.0
213 -> 170.4 - 255.6

Since the 120% estimate (234) of the lower numberis greater than the 80% estimate (170.4) of the higher number, these 2 numbers may be considered equivalent.
 
I myself used 200 as the cutoff point before starting insulin when Lightning's BG started to rise. I only found out Lightning was diabetic when I looked at the blood analysis results for another reason.He has the anylsis done to support removing a growth. My vet new said anything about the high (about 200 or so) BG since she though Lightning was already diabetic.
 
It wasn't a pate because I couldn't find it. The place that I found FF cheapest I couldn't find a classic pate. So I checked on the list of Dr. Pierson and found one under 10g carbs that I could find. I only got a few because I didn't know if she'd like it or not. But it was the chicken and tuna. I checked for it on the list and it said it was under 10 grams carbs
 
All of those Fancy Feast flaked style flavors are under 10% carbs. Also, the Fancy Feast chunky style are <10% carbs.

Some cats like the texture of the chunkier foods better, so it's good to try those. I'm surprised you could not find any Fancy Feast classic style foods. My Wink loves the classics, Turkey & Giblet, Liver & Chicken, Chicken Feast, Chopped Grill are some of his favorites. I find these at my local Wal-Mart, Petsmart, Petco and most grocery chains carry them. It can take a little hunting to find them among all the gravy, roasted, sliced, grilled, marinated morsels, breakfast, etc.......

ETA: Breath, just breath, deep breathing exercises. They will help you.
 
I did call my vet today. She said they don't worry about insulin until the cat gets around 400. Which seemed a little high to me. If it was a person they'd be on something by now. She said that she's still close enough to the highest normal reading that she said give the food a chance to work. Sometimes it may take a few weeks to a month to see the blood glucose within normal levels. I have to return the dry yet to the vet that she went into see when she initially got diagnosed. I'll exchange that for the prescription wet stuff. She did agree that getting off the dry is a good thing, but didn't know anything about what commercial cat food there is for diabetics, just the prescription. She said the stuff you get from the store the amount of carbs in those and other ingredients aren't controlled as much so there's variation in how much is in each can. Where as the prescription food for diabetic cats the wet, is made and controlled to have exact amounts in each can. I'll take the remaining cans back tot he store I got them from and exchange them tomorrow. I called and they did get more of a shipment in of other varieties. I'll check the ones that you mentioned and see if they have any. She's getting low on food anyway so I'll make a trip tomorrow.
 
Problem with the prescription wet is that its liver flavour and cats get sick of it fast. Maybe mix it up a bit. We have had a lot of success with cats being regulated and remission on fancy feast classic pâtés, friskies pâtés or wellness grain free canned and they are cheaper too! We have five cats on OTJ trials on the lantus board right now.

Anything over the renal threshold (around 270) will damage the cats organs over time. If it was my cat I don't think I would be waiting for that. But you just started the lower carb fancy feasts, I would give them a week and see how it goes.

Wendy
 
I did notice that the cans don't say Classic on them. So anything that says "classics" in the label is good or does it specifically have to say Pate'? I was looking for Pate' but didn't see any pate. But there were quite a few that had classics listed on it.
 
Here are some I know they had. Will any of these work?

http://www.wag.com/cat/p/fancy-feast-cl ... pla&ca_kw={keyword}

https://www.google.com/shopping/product ... MIBEPMCMAg

http://www.wag.com/cat/p/fancy-feast-cl ... pla&ca_kw={keyword}

And I think this one has all the ones labeled "classic"
http://www.1800petmeds.com/Fancy+Feast+ ... MgodwBMAiA

And how much should she get with fancy feast. I've just been giving her 2 cans a day. One in the AM and one in the PM?

Also my vet asked if I was taking the blood readings at the same time every day. Should I be doing this? I usually just do the reading first thing when I get up. And that may very depending on when I have to be into work.
 
Yep those are fine.

What weight is she? You can work out how much to feed her from this..
How much to feed? Required calories per day = [13.6 X ideal weight in lbs] + 70

Fancy feast is about 85cals a can but while she is unregulated she may need more food so i would start here and weigh her every we weeks and adjust quantity as needed.

It's probably good to test for now around the same time , it probably depends more on when she last ate and her activity level etc but try and be kinda consistent like just before bed, or first thing morning before breakfast..

Wendy
 
Small clarification: The list by Dr Pierson reports percent of calories from carbohydrates, not grams of carbohydrates.
 
I try to do it first thing when I get up. Button if we are having trouble with testing and getting frusterated I take a shower or a break for 5 minutes to regain my sanity.
 
I wouldn't want to hold off on the insulin until the BG reaches 400! That is over the renal threshold, and any excess glucose spilling into the urine increase the chance for UTI's. There is also slow damage to organs and risk of nerve damage leading to diabetic neuropathy when the BG is above renal threshold.

Let's see how your cat does on the low carb foods for no more than a week. Then, I'd definitely get insulin if she continues to be above the renal threshold.
 
I couldn't test her this morning because my fiance was trying to be nice and let me sleep in since I've been so stressed and fed her right away in the morning. So how long should I wait to take blood test? I was going to wait until tonight as then she'd be longer without food. I usually test around 5:30-6:00. This way she's been on the Friskies that I have until I can get the fancy feast. I found it weird that her numbers were lower on Friskies than the Fancy Feast. Must have been the carbs were less? But not by much though. I am also trading in the dry cat food I got from the vet to the canned and I may mix in a little friskies with it. Not much just enough to give a little flavor other than liver. But if she won't eat their wet food. Then Just getting my money back!
 
Its weird because the fancy feast classic pates are lower in carbs than the friskies pates. (you are using pates right?) The fancy feast pates are like 4% carbs and the Friskies are twice that generally.

Looking at your readings I really dont see a statistical difference between the foods, but if she was mine I would try a few days of nothing but the FF and see how that works. Given they are lower carb it might take a few days to kick in.

Also if you mix the friskies with the prescription food because she might associate the friskies then with tasting of the nasty DM...

Wendy
 
Well the ones I got the description on the can says it's a classic. But the title does not say specifically that they are pate's. But I assume they are because they are classic. Unfortunately I moved the cat dish wish was empty to wash it and there was a clump of food on the floor and she at it. So if I take all food away and test at 5pm will I get an accurate reading? or doesn't it matter when I test as long as it's before she's eaten?
 
Only for the pre-shot tests do we recommend taking the food away 2 hours before those tests, if possible. Any other tests, we would expect the cat to have eaten.

Understand better now?

Those Fancy Feast cans that say "Classic" are the pate style we have been talking about.
 
Little Confused. My grandmother had diabetes, and we had to take a glucose reading before she had eaten to get a good idea of what her glucose was. If we took it after she had eaten it would be higher and wouldn't be accurate. They wanted to know what her glucose number was normally without food. That's the number we wanted. Isn't it the same way with cats? If you take a reading after they've eaten it's going to naturally be higher and not exactly accurate right?
 
Little Confused. My grandmother had diabetes, and we had to take a glucose reading before she had eaten to get a good idea of what her glucose was. If we took it after she had eaten it would be higher and wouldn't be accurate. They wanted to know what her glucose number was normally without food. That's the number we wanted. Isn't it the same way with cats? If you take a reading after they've eaten it's going to naturally be higher and not exactly accurate right?
 
The pre-shot tests are the tests you do before you give the insulin. Just like for your diabetic grandma, no food before those tests. Non-food influenced tests for before the insulin shots.

We also test at other times during the cycle. For those tests, it's ok of the cat has had some food. Those tests are for monitoring the effects of the insulin, to try to find the nadir, to try to find the duration, to see how fast the insulin starts to work in your cat, if the number is headed down really low and you need to keep track to prevent hypoglycemia. Those other situations, food will have had some influence on the numbers. It's expected.
 
What about non-insulin cats who are trying to regulate with just food? Shouldn't you take the blood before they've eaten to know if the food is working?
 
Cats not yet on insulin should also have their BG (blood glucose) tested before they eat. Pick a time in the morning and evening, roughly 12 hours apart as your test times. Try to pick something that would work with your daily work and life responsibilities. It doesn't have to be exact every day, we know that people have variations in their schedules.

These tests are called AMBG - morning blood glucose and PMBG - evening blood glucose. Just a slightly different name than if you were giving insulin, when they are called AMPS - morning pre-shot and PMPS - evening pre-shot test.

If you want to see what the food is doing to the BG numbers, you would test about +3 to +4 hours after your pre food tests, those AMBG and PMBG tests. Sort of the same way we recommend for people doing an OTJ trial. (OTJ = off the juice, no insulin). Since you have not started insulin yet, those same test suggestions would apply.

Food raises the BG's, insulin drops the BG's. If the cat's own pancreas is producing insulin, you should see a drop in the BG numbers in that +3 to +4 hour period.

Here are some suggestions for testing if your cat is not yet on insulin.
  • Test at your normal AMPS and PMPS times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.
  • If your cat is green (0-99 human meter) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue (100-199 human meter), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!
Click to expand...
 
Hi guys .. I've been reading along on this thread and I just wanted to say I know you're probably feeling overwhelmed and stressed out but please hang in there .. you're going to get excellent advice from the members on here and in no time you'll be the one answering questions other new members have ..

Now, our cat mocha is OTJ (off the juice) and has been for a few years now, thanks to this board!, but we feed her several small meals throughout the day .. she eats at 8 a.m, 12 noon, 4 p.m., 7 p.m. and 10 p.m. .. Thankfully I don't work outside of the home and can give her these small frequent meals .. if you're unable to do that, you may want to look into an automatic feeder .. Just like human diabetics, small meals throughout the day are easier on the system then two large meals twice a day ..

Just keep hanging in there and asking questions!
 
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