Sonic is responding erractically to insulin

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rgreen

rgreen

Member Since 2014
His first struggle with diabetes occurred about a year and a half ago. When I brought him in two or three months ago for his annual checkup blood sugar had gone up into the 400s or 500s and I increased proZinc from 1 to 2 units. All went well. But then just over a week ago his count skyrocketed. Had him at the vet for a couple of days (said his odds of making it were 50:50); he picked up and I brought him home upping injections to 3. After another day or so he went down again. He's been in the hospital for a week now; they're working with various increments of proZinc and about to try a more expensive alternative; both sodium and sugar get astronomically high; every time he seems to be on an upgrade I find him weak, unsteady, semi-responsive the next day. Vet says he's an unusual case and is researching. All I can do is hope against hope.
 
I'm glad you posted over here from the Facebook group about your sweet Sonic.

Do you home test?

It sounds like your vet doesn't understand how to dose ProZinc either. Dose adjustments are usually made in .25 unit increments, never in whole units because insulin is a VERY powerful hormone and even a tiny difference can cause big swings in blood glucose. It sounds like Sonic is getting too much insulin, going into hypoglycemic crisis (weak, unsteady and semi-responsive are all symptoms of a life threatening hypo) and then his body is trying to save itself by "bouncing". Bouncing happens when the blood glucose goes too low and the liver releases stored sugar and hormones to try to get the blood glucose back up to where it's safe. Unfortunately, when the liver releases these stored sugars and hormones, it can cause the BG to go WAY high again...and if you're not testing at home, you won't know it's happening and then you see a high number and think you're not giving enough insulin, when in fact, you're giving too much
 
Chris & China said:
I'm glad you posted over here from the Facebook group about your sweet Sonic.

Do you home test?

It sounds like your vet doesn't understand how to dose ProZinc either. Dose adjustments are usually made in .25 unit increments, never in whole units because insulin is a VERY powerful hormone and even a tiny difference can cause big swings in blood glucose. It sounds like Sonic is getting too much insulin, going into hypoglycemic crisis (weak, unsteady and semi-responsive are all symptoms of a life threatening hypo) and then his body is trying to save itself by "bouncing". Bouncing happens when the blood glucose goes too low and the liver releases stored sugar and hormones to try to get the blood glucose back up to where it's safe. Unfortunately, when the liver releases these stored sugars and hormones, it can cause the BG to go WAY high again...and if you're not testing at home, you won't know it's happening and then you see a high number and think you're not giving enough insulin, when in fact, you're giving too much
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rgreen said:
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I'm printing this page out for the vet to see. Sonic's low is, as I understand it around 500. He's starting to act more normally at that point and then, just when you think he's readjusting, it shoots back up. If he gets out of this, an extremely big if, I'll home test. As I understand it, he's been hooked up with fluids part of the time in the hospital. They are keeping a watch on electrolytes as well there. They warned me to watch out for hypoglycemia when they first released him. When I brought him back he was droopy and couldn't walk easily. But I think his blood sugar had risen drastically at that point.
 
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If you look at my spreadsheet Luna is doing the same thing as well the last few days.

Sounds like a bounce from what I understand, and is the bodies response sometimes to higher insulin levels.

Would be good to know exactly what her blood sugar level's are. I see no reason for her being stuck in the hospital all week and there shouldn't be such big insulin dose increases as well over such a short time. The shelter my cat was in did the same thing with Luna (1 unit to 3 units overnight) and they sent her into hypo a couple of times according to her paperwork.
 
He looked a lot better today; still weak and unsteady but eating and responsive to me. He's on Lantus now and glucose count was down to 280. Still somewhat dehydrated. I see hope, but you never know. If he stays steady into Saturday maybe I can take him home then. I don't think he ever had hypoglycemia and think the vet knows what she was doing. Once he's back with me I'll need to home test him steadily and want to work with you.
rgreen said:
I'm printing this page out for the vet to see. Sonic's low is, as I understand it around 500. He's starting to act more normally at that point and then, just when you think he's readjusting, it shoots back up. If he gets out of this, an extremely big if, I'll home test. As I understand it, he's been hooked up with fluids part of the time in the hospital. They are keeping a watch on electrolytes as well there. They warned me to watch out for hypoglycemia when they first released him. When I brought him back he was droopy and couldn't walk easily. But I think his blood sugar had risen drastically at that point.
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Another bad day after a good one. Lowest it ever got was 200. Every time it normalizes it shoots way up again even with Lantus and it appears another organ, pancreas perhaps, may be involved. I'm hanging in over the weekend. It doesn't appear, though, that there's an exit route. It's very tough.
 
Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Sonic hasn't been released. I need to see him hold steady for a couple of days first. If he gets home I want to keep an eye on him constantly and do every thing you say. But as I've said I only hope against hope we get to that point. Some organ such as pancreas may be involved in this, I fear.
 
rgreen said:
Sonic hasn't been released. I need to see him hold steady for a couple of days first. If he gets home I want to keep an eye on him constantly and do every thing you say. But as I've said I only hope against hope we get to that point. Some organ such as pancreas may be involved in this, I fear.
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Today he was alert, affectionate, happy. He still has trouble standing. Vet wasn't there so I didn't find out his glucose level. If he can only stay stable tonight there's room for optimism.
 
Critter Mom said:
Keeping fingers and paws crossed for little Sonic.
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Your intercessions are bearing fruit. For the first time, he has been eating and been alert and affectionate for two days in a row. The amplitude of glucose level swings is decreasing; max is now 500, far better than 1000+. The vet feels pancreatitis may be a possible factor and if it is not to despair if something like this happens in the future. I will start a graph and continue working with you when he's home, a prospect now more likely.
 
I'm so glad to read that Sonic's doing better. Wild BG swings like that can make a kitty feel really lousy (as I remember only too well from Saoirse's time on Caninsulin last year - her poor system was hammered).

Is your vet running any diagnostic tests? I'd suggest asking your vet about B12, folate, and potassium levels; and also about a Spec fPL test to determine whether pancreatitis is in play.

In case pancreatitis is an issue, here are the IDEXX treatment guidelines for pancreatitis. Lots of valuable information about symptoms and treatment. Several kitties here have pancreatitis (Saoirse included) and we'll do anything we can to help you should the need arise. FWIW, during a flare a cat can become very depressed and lethargic. Things do get better when the right treatments are put in place. It's very encouraging to hear that Sonic is eating better now. Be sure to give him some scritches from me. :)
 
Chris & China said:
That's great news!!

The prayers and vines from this group can do amazing things!
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Maxing now at 470 and the amplitude of the swings continues to decrease. Confidence is returning. I had almost lost hope this weekend. Yes, I'll mention those tests when I come in tomorrow. And thanks for your continuing support.
 
Still affectionate today but kind of drowsy. Up to the lower 500s but I'm told not to worry as the catheter he uses for fluid intake is being removed and he's drinking naturally for water now. Sodium down to practically normal now. He'll be tested for pancreatitis at the end.
 
Critter Mom said:
Just checking in to see how things are going with yourself and Sonic.
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He acts like his normal self now & will be going home Monday. Pancreatitis test was run today; won't know results for over a week. Insulin from now on will be Lantus. Will launch home testing the evening he gets back. I'm told not to be alarmed if he hits 500s or even 600s; it all varies with the time of day.
 
Thanks for the update. I'm very glad to hear that Sonic is feeling so much better in himself and that he will be coming home soon. You must be so pleased and relieved. :)

Have you got all your supplies ready (test strips, hypo kit stuff)? If you need any help, just shout.
 
He's home and in normal range right now. I'm going to give him 2 1/2 mL Lantus just before he eats in morning and in evening; will try to test him about 2 hrs. later each time. Just beginning to get the feel of all this. On his spreadsheet the first two tests were done by the vet; the last two by me just in the process of learning. Keeping my fingers crossed; a week ago it looked like he might not make it. So I'm going to stay carefully in touch.
 
I am so very glad Sonic is home where he can rest and be with his fave human, you will get through this. My best advise is to breath and take one day at a time, I know it sounds like a platitude but it is very true. Hugs you and your fur baby will make it through this and the people here have been where you are at and are wonderful people willing to give all the advise and emotional support you can ask for.
 
Yay!!! Sonic's home!!!. Happy dance!!! :D

You're going to do fine with the testing and the management of his insulin. You're in a great place to learn and to get help when you need it. You're not alone.

Have a lovely evening snuggling up with your beloved fur baby. :)

:bighug:
 
It's important for you to test immediately before each shot (and for Sonic not to have any food for the 2 hours before) so you know what his blood glucose level is before you shoot

After the shot, you'll want to get at least one test in 5-7 hours later (on the AM cycle) and at least a "before bed" test on the PM cycle. Most cats go lower at night, so grabbing a "before bed" test will let you know if it's important for you to set an alarm to get more tests in overnight.

If you can get a +2 ALSO, that's great...the more tests you can get in, the clearer the picture will be for how Sonic is doing!

So great to hear he's home with you tonight!!
 
Yes, the 2.5 stands for units. The last 490 reading for yesterday was obtained this morning just before his shot and subsequent breakfast. He hadn't had a shot for 14 hours; hope the high reading doesn't mean trouble. I had drawn quite a bit of blood for it. Thanks, everybody, for all the encouraging support.
 
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name,
cat's name,
date of Dx (diagnosis)
insulin
meter
general location (city and state/province)
any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.
 
I think my last two readings on the spreadsheet are accurate. The earlier ones, the near 500 and the 93, were done when I was still learning by trial and error (using up as many as 5 strips for a try). 201 for mid-afternoon when he hadn't eaten anything for a while and 323 around bedtime seem to make sense. Sonic is holding his own right now - just hoping it all stays steady.
 
Congrats to you for getting your spreadsheet started. It was a bit confusing to me too at first, but you'll get the hang of it with experience. I found it useful to look at the spreadsheets of others to learn from people who had more information than me about the things That were confusing. Feel free to take a peek at Radars ss. I am no expert by any means but I've been doing my ss for a little over a month and am happy to help in whatever way I can. Hang in there. It does get easier and when you need help there is a wealth of experience here so please ask lots of questions.

So glad your kitty is feeling better and that he's home. :)
 
Sonic's readings looked reasonably normal until this last one, 461, at bedtime. It took 3 strips before I could get the meter to beep and he was getting pretty stressed. Hope that's all it means & will appreciate hearing reactions from any of you. You provided wonderful encouragement when he was in the hospital and really on the edge.
 
He's probably still bouncing from the 94 yesterday....Bounces can last up to 6 cycles

Now that you have your spreadsheet up and you're testing, I invite you to move over to the Lantus Forum. Everyone there uses either Lantus or Levemir so you'll get the most experienced eyes watching out for you and your extra sweet Sonic.

Here's some information on "Making the most of your Lantus/Levemir Insulin support group experience" to help explain how we post over there
 
Chris & China said:
He's probably still bouncing from the 94 yesterday....Bounces can last up to 6 cycles

Now that you have your spreadsheet up and you're testing, I invite you to move over to the Lantus Forum. Everyone there uses either Lantus or Levemir so you'll get the most experienced eyes watching out for you and your extra sweet Sonic.

Here's some information on "Making the most of your Lantus/Levemir Insulin support group experience" to help explain how we post over there
Click to expand...

I just entered a post on the Lantus forum. Sonic's curve seems to run in a consistent patterns of being high throughout the night and then down after his morning shot takes effect. I feel relieved that he's staying fairly stable; guess we're doing the right thing.
 
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