u/RaspberryCherry12

Hi, sorry I’m turning into quite a regular poster in here. Apologies for multiple posts. I don’t use Facebook so I don’t want to join the feline diabetes group, but I have looked at some of the feline diabetes forum website.

I have been phasing down my cat’s moderate to high carb foods to new lower carb food and I think his insulin dose is too high now but not too sure how much to reduce by. I looked at the SLGS (Start Low Go Slow) protocol but I’m worried it’s not the most appropriate given the change in his BG levels resulting from a relatively quick change in dietary carbs compared to slow insulin titration. I have also unfortunately made quite a few mistakes with his food timing in the last few days that have messed up my curves and making it harder to interpret the numbers.

Prior to food changes:
- All testing on AlphaTrak 3.
- Prozinc insulin 3 units BD has been on this dose since late May/early June, 3 x curved sent to vet and vet advised to remain on 3 units each time.
- preshot levels usually 450-600. Nadirs usually 250-300. Preshot levels likely often influenced by poor timing of dry food which was often given 15-60 minutes before preshot levels.
- Most recent curve which was when I had accidentally introduced slightly lower carb wet food (because of heat wave I was giving more wet food and he ate a bit less of his dry food but it was still the relatively high carb proplan diabetic dry food) I did see one curve where his morning preshot level was 450 and daytime “nadir” was 290 but this was at +12hr at his evening preshot time, nighttime nadir was 195, then it went back up to 430 by the next morning.
- my syringes only have 0.5 unit markings. I can probably try to give a 0.25 unit adjustment if I squint but it could be variable between days.

Currently, on lower carb foods:

Friday: AMPS level was 171. I wasn’t going to be home all day and I’ve never seen a preshot that low before so I gave only 1 unit of insulin. I got home late and checked his PMPS which was 626 at +12.5hrs, so I gave 3 units. I later realised I hadn’t reprogrammed the feeders correctly so he was given a bit of dry food (approx 8-9g) ~30-45mins before his PMPS level. I was also concerned there could have been an element of rebound hyperglycaemia since he’s accustomed to having sugars in the 300-600s.

Saturday: AMPS was 302, I gave 3 units of insulin. AMPS could still have been influenced by the previous day’s underdosing. However I later realised I had made ANOTHER mistake and I had only reprogrammed 1 of the feeders (thanks ADHD) so he likely got some of his sister’s higher high carb food about 30 minutes before his AMPS potentially bumped up that preshot level). I triple checked the feeders so they are now definitely going off at +3-4hrs from insulin and then he gets no more food until I give his evening insulin. Saturday nadir was 94 at +8hrs into insulin, which worries me because it’s such a late nadir? Usually his nadirs are at +4-5hrs as you’d expect. PMPS was 180. I wasn’t sure whether to give insulin so I followed the suggestion on Prozinc SLGS protocol to feed as normal but no insulin, then check BG later and shoot based on that. I checked it an hour later and it was up to 250, but then I wasn’t sure how much insulin to give in case it is influenced by his food? Because it was going to be nighttime so I couldn’t guarantee I’d see symptoms whilst I slept, and because I wasn’t sure how much of Friday’s levels had been influenced by sneaky food, I decided to only give 1 unit again. I did wake up in the night so decided to do a spot check which was at +5.5hr and his BG had gone up to 297 so I was satisfied his morning dose won’t be informed by any rebound hyperglycaemia and 1 unit is definitely too low of a dose.

Sunday: AMPS definitely fasted, but following a previous lower insulin dose (1 unit) his AMPS 466. I’ve given 2.5 units this morning and will check his BG at +4, +6, +8 and then PMPS (his poor ears).

Also all of this is on an AlphaTrak 3 but I’m running out of strips (only about 4-5 left). I had ordered a human dual glucose/ketone monitor but it hasn’t even been dispatched yet, so I’m going to try to buy another human glucose monitor from a pharmacy today. So the readings might be influenced by that. I’ll try to do some side-by-side testing before I run out of AlphaTrak strips.

Questions for the community:

1. If his PMPS is <200 today, how much insulin should I give? 1 unit is not enough, and then is going to potentially have a knock on effect onto his levels the next day.
2. if his PMPS is say 200-300, should I still give 2.5 units or should I give something lower e.g 2 units because his AMPS and potentially nadir was likely elevated from not having enough insulin last night?
3. if his preshot shot levels are lower than ideal and I’m going to feed and then shoot later, should I wait at least 2 hours so there’s less likely to be influence from his food?

Full curve from Saturday; (had 1 fingernail sized piece of freeze dried duck with most of his BG checks)
Saturday AMPS: 302 (but possibly had a little bit of dry food before
+0 given 3 units Prozinc 100g wet food (1% wet carbs 5% dry carbs .total 1g CHO)
+3: 240
+3.5: given 8-10g dry food (9.5% wet carbs 10.2% dry carbs. Total 0.8-1g CHO)
+5: 144
+6: 119
+7: 103
+8: 94
+10: 139
+12: 180
+12: given 100g wet food (1g carb)
+13: 254 given 1 unit Prozinc
Sat/Sunday overnight:
+2.5: given 8-10g dry food (0.8-1g carbs)
+5.5: 297
Sunday AMPS: 466 + 2.5 units Prozinc (given at +11hrs from previous dose)

Would appreciate any extra advice on
- insulin dosing
- changes to slightly higher carb foods if his pre shot levels aren’t ideal. E.g to still give the planned dose but to give a different food? I still have the proplan food on hand and some wet food which is 12.5% carbs per dry volume in case of mild-mod hypo. I have honey in case of severe hypo.
- if I need to consider anything particular when switching from AlphaTrak to a human glucose monitor?

I’m not currently interested in buying any other low carb foods, joining the Facebook group, or specific brands for glucose/ketone monitors. I’ve converted all my readings to mg/dL because I gather most people work in those units here, but I am based in Europe and the brands people recommend often aren’t available or are expensive/difficult to get hold of.

Hi all, I’m in the process of switching to lower carbohydrate foods for my cat who is on Prozinc BD. I also have a second cat who is non diabetic.

Recently I have been feeding 2 portions of dry food and 2 1/2 portions of wet food a day, but generally doing them around shot times. The dry food is through an automatic feeder at 06:30/18:30 and I give the wet food with his shot usually around 06:40-7:30 and similar in the evening. I don’t typically do pre-shot testing because his sugars have been so high there has been no concern of hypo until now when I’m changing him to dry food.

Now that I’m increasing the amount of wet food they’re getting (from essentially half a pouch to a full pouch twice daily) and decreasing the dry food (from 20-25g twice daily to 8-10g twice daily - although once stable I hopefully will reduce it to once daily) it seems like a lot of food for them to be eating in one portion and I know cats typically are better suited to smaller more frequent meals.

I plan on shifting the time of the automatic feeders to go off at a different time so I can start checking pre shot BG if his sugars are going to be sitting lower. What timing would you suggest for the extra little portion of dry food, a bit like a “snack” between meals? Would it be better to have it still close to his wet food meals, perhaps 2 hours into his insulin dose? Or have it later on to try to help prevent hypo at the insulin peak (usually about hours 3-6).

I am currently giving purina pro plan diabetic (20-25% carb) but just switching to Thrive premium plus (10% carb) today. It’ll only be about an 8g portion so really it’s only about 1g of carbohydrate in that portion. If it doesn’t matter too much about the timing in terms of blood glucose I’d prefer to spread it out from his meals more e.g have it about half way. I also plan to reduce to once daily dry food pretty much just to top up to his calorie needs without opening a new tin of wet food. Would this be better to do in the night when blood glucose tends to be lower and I’m less likely to be monitoring?

I’ve seen other conversations about meal timings and insulin but they tend to refer to lantus/flatline so I’m not sure. Also grazing isn’t an option because both cats will race to the feeder and wolf down any and all food in sight.

Hi, my cat usually takes Prozinc 3 units BD. His highest BG is usually 400-600 around shot time and lowest is usually 220-300.

I’ve been reducing his carbohydrates in his food slightly over the last two days (halved his 25% Carb dry food, gave 2 x pouches of 15% carb wet food instead), but hadn’t checked his BG levels. No symptoms of hypo.

Today his new food arrived which is 10% carb for dry an 5% carb for wet. I was going to keep him still on a slightly higher amount of the dry food (there is still the old dry food mixed through as well but he’s generally okay with diet changes). But generally from today then his carb intake would reduce by another 50%.

His pre shot BG is 170. I don’t know whether I should give insulin as I won’t be home today to check his BG levels and his carb intake will further reduce. Or perhaps just give a smaller amount of insulin like 1 -1.5 units?

I have to leave for work pretty soon so I doubt anyone will reply in time I’ll just debate myself over the next 20 minutes!

7yr old male cat with diabetes. He takes ProZinc 3u BD. Vet has not wanted to increase the dose based on the last 2 curves I’ve sent, despite his BG levels never dropping lower than 14mmol/l (252mg/dl) and regularly sitting between 20-35 (360-630).

The first time the vet advised to continue on the same dose it was because his BG levels dipped towards the end of the curve again.
06:48 - 24.6
09:55 - 21.1
12:31 - 23.3
16:13 - 19.1
06:44 - 18.8

Vet asked me to do another curve which I did a week later which was:

06:59 - 28.1
09:04 - 22.8
12:04 - 15.8
14:18 - 14.3
15:50 - 19.4
18:56 - 35.8

Vet advised to continue with 3 units BD. He doesn’t want his BG levels to be lower than 12 (216) despite them going so high.

So now two weeks later I’m doing another curve today, and I’m frustrated because I’ve jabbed his poor ears so many times and I think my vet will say not to increase his insulin because his BG level dipped, but he’s far from a hypo.

Today:
07:13 - 24.8
09:20 - 20.8
11:48 - 17.9
13:12 - 18.5
15:17 - 20.1
17:15 - 16.7 ? Why the sudden dip. I’ll see what it is at ~19:00 when I give him insulin.
Update:
18:55 - 16.2?? He ate full dry food and wet food so I’ve given him his 3 units insulin and followed advice to check nighttime results:
23:00 - 10.8 - his lowest reading since starting insulin in march
00:05 - 13.2
02:35 - 19.3
05:10 - 20.3

Food wise he gets
- 06:30-06:35 automatic feeders go off and he gets about 23g purina pro plan diabetic food
- about ~07:00 1/2 pouch diabetic royal canine wet food with his shot. Whatever time the first reading is on the curve is when I gave insulin.
- same as above at 18:30 and ~19:00
- 2-3 little pieces of freeze dried duck/chicken/beef with some but not all of his ear pricks.

I’m aware he’s not on the most optimal diet, please don’t give me advice to change that to 100% wet food or that dr Ellsey - I’ve looked into it an it’s too expensive.

Is there something that I am doing wrong with the curves? E.g variation in where I draw the sample, should I not give him treats during the day when he behaves so well for me stabbing his ears.

For additional context, my niece/nephews visited yesterday (aged 1-4) which was stressful for him as the 1 and 3 year old did a lot of shrieking. But I would have thought any stress induced hyperglycaemia would have resolved within a few hours or overnight. His BG was 34mmol last night when I gave him his evening insulin but the kids were still visiting at that time.

Urine ketone monitoring is extremely difficult because I have two cats so I have to separate them to try to get a urine sample, which they don’t mind but it means one of them has to be shut downstairs whilst I sleep which they HATE and wail at the door for 20-30 minutes, sometimes an hour which is heartbreaking.

I wanted to try monitoring blood ketones, since I am already regularly drawing blood for glucose testing.

I already have the AlphaTrak but was hoping to switch to a different monitor for glucose because of the cost of the testing strips. I’m happy to continue using the lancet (although it’s a bit flimsy)

1. I’ve seen people recommending the keto mojo for ketones. Does anybody know if it is accurate for glucose monitoring as well?

2. I think the AlphaTrak is calibrated for different animals, so I was wondering if human monitors need any kind of “adjustment factor”. E.g if it reads 300 is it actually 250, or is it just that the optimal range is higher for cats than humans? My vet previously said optimal is about 150-200 (8-12mmol/l) for cats.

3. any other recommendations for 2-in-1 monitors, for context I am in the UK.

Thanks! For context male cat on Prozinc insulin BD for about 3 months. Previously was on senvelgo for ~10 months but switched due to weight loss.