Your cat has been diagnosed FD, you have found DCC and now you are trying to figure out what to do next.

The very first thing you need to do is to learn how to test your cat’s BG, a non-negotiable requirement for TR. We do not support blind dosing (not knowing what your cat’s BG is before giving insulin). It is extremely dangerous to give insulin without knowing if your cat needs it or not.

No doubt you are very anxious to start your cat on TR and get on the the road to healing, BUT, before you change a single thing, you need to perform a 24-hour detox to protect your cat from clinical hypo.  You MUST withhold insulin immediately at the time you change your cat over to an all wet, low carb diet. We cannot emphasize this enough.

Here are some steps that need to be taken before you can start TR, depending on your cat’s situation:

Your cat has just been diagnosed with FD, is being fed dry/high carb food but has not yet started insulin.

If there has to be an optimal stage to be in, this is it. Many cats go into diet controlled diabetic remission simply by switching them to a low carb, all wet, and species appropriate diet. Even if it turns out that your cat needs insulin after making the diet switch, the BG will drop significantly by removing dry food and it is likely the insulin requirements will be much less. Change your cat’s diet immediately to a low carb all wet diet. And test BG at least 4 times a day over the period of 3 to 5 days.

If your cat has already started insulin and is already on a low carb wet diet for longer than three days, it is likely the timing of shots is the only adjustment that will need to be made. You need to do a curve on your cat to provide the data to determine what if any adjustments to dosing are required. It is possible that an adjustment to your doses will be called for, but, until you have done a curve or two on your cat, you won’t know. Experienced members will help you adjust your dosing and guide you through the process of tightening up your shots..

This is where things start to get dicey. When the carbs are removed from your cat’s diet, BG will drop significantly, by as much as 100 points or more. The doses you are currently giving will typically be far too high once the carbs leave the system. You need to perform a 24-hour detox to protect your cat from clinical hypo. 

Too many times we have seen owners continue to give vet prescribed doses of insulin when they remove the dry high carb food only to have their cats end up needing to be rushed to the ER vet due to clinical hypo. This is a very frightening, but avoidable experience.

During the detox period, you will test your cat’s BG. Of particular importance are the tests from +18 to +24 during the detox period. It takes carbs three days to leave the system entirely. Once the 24-hour detox period has passed, you will begin using the starting BSS posted for your particular insulin (see the Insulin sticky). The BSS are conservative doses and it is to be expected that increases will be necessary. Curves must be done on the first two shots in order to determine what adjustments to doses are necessary. It is imperative that you keep your test log up to date in order for experienced members to assist you to make dosing adjustment decisions.

Once the three-day time period for all the carbs to leave the system has passed, you will start to increase doses more aggressively if needed, to obtain ideal normal non-FD numbers at nadir.

Updated March 2011