ping ponging BG

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AlyMcF

AlyMcF

Member Since 2014
Wondering what to make of this. 12 yr old Sketch was boarded at the vet this past week (we were away) and during this time, he went from needing 3 units of insulin 2x per day in order to keep his BG numbers good, to suddenly his BG being around 50 one morning before his shot (which they of course did not administer). His number stayed low for a few days, so he appeared to be in remission. Then right before he left the vet to come home his BG was around 450. A few hours later today, at home, it was 487. The vet said if it doesn't go below 200 in the next day, to restart him on insulin, 2 units.

What could be going on?

History: he was originally diagnosed with diabetes November 2014 and went into remission quickly, after two weeks of insulin and a switch to a low carb diet. He was good until about June 2015. Then the peeing and water drinking increased and within a week he suddenly had severe pancreatitis. I wrote about that in another thread. It took a week or so, but he recovered from that. His insulin needs kept increasing for a few weeks up to 3 units per day (lantus glargine) then suddenly we had the drop and then spike I mentioned at the beginning.
 
Hi Alyssa. Do you know what he was eating when he was at the vet? Could they have given him high carb food at the end of his stay when his numbers went up? And is there any chance his pancreatitis has flared up again (hopefully not)?

Maybe post on the Lantus forum. Sorry I'm not much help.

Shane
 
Hi, Alyssa - Are you testing his BG at AMPS/PMPS every day, or only spot-checking Spike's blood glucose? As I note there's no spreadsheet appearing in your signature ... Have you started one yet? (Plugging his data into a spreadsheet would help us in advising you regarding what may be going on with Spike.)

Would also help to know:
- Spike's weight (and what his optimum weight should be for his size)
- what type/brand of food he gets (also how much & when he eats his meals)
- if there are other cats at home
- and whether he is allowed to go outdoors unsupervised.

Will look forward to hearing from you again! Thanks - Robin
 
Following on from Shane's question, what quantity of food did Sketch eat at the vets? Sometimes our little ones have a reduced appetite when we are away from them.
 
granadilla said:
Hi Alyssa. Do you know what he was eating when he was at the vet? Could they have given him high carb food at the end of his stay when his numbers went up? And is there any chance his pancreatitis has flared up again (hopefully not)?

Maybe post on the Lantus forum. Sorry I'm not much help.

Shane
Click to expand...
They said he was eating all the food I provided which was mostly low carb stuff. So far no pancreatitis flare, as far as we can tell. Other than stress, or possibly a tumor, they have no explanation. The abdominal ultrasound he had done six weeks ago did not show any tumor on the pancreas.
 
Robin&BB said:
Hi, Alyssa - Are you testing his BG at AMPS/PMPS every day, or only spot-checking Spike's blood glucose? As I note there's no spreadsheet appearing in your signature ... Have you started one yet? (Plugging his data into a spreadsheet would help us in advising you regarding what may be going on with Spike.)

Would also help to know:
- Spike's weight (and what his optimum weight should be for his size)
- what type/brand of food he gets (also how much & when he eats his meals)
- if there are other cats at home
- and whether he is allowed to go outdoors unsupervised.

Will look forward to hearing from you again! Thanks - Robin
Click to expand...

I find the spreadsheet overwhelming so have not done one. I keep my own records in a notebook. Not sure what AMPS/PMPS is but we have been spot-checking Sketch because that is what the vet suggested. This weekend we will attempt a more complete curve on our own, if I can get my family to agree that at least two of us will be home all day Sunday so we can get the blood out of the kitty and onto the test strip every couple of hours.

12 yr old Sketch is about 13 lbs which is about where he should be. He eats Evo dry and for wet food he gets Fancy Feast Classic, BFF and Wellness.
He shares a home with Max, my 15 year old cat. Neither cat goes outside unsupervised.

I guess I was basically looking to find out what, besides a possible pancreas tumor or change in diet or stress, would possibly cause a cat's BG to be steady in the 50s for a few days and then suddenly spike up to 450 or so.
 
Critter Mom said:
Following on from Shane's question, what quantity of food did Sketch eat at the vets? Sometimes our little ones have a reduced appetite when we are away from them.
Click to expand...

Tough to say but they didn't seem to note anything odd about his intake. He had stayed with this same vet before just a month prior and at that time we didn't see this weird phenomenon.
 
AlyMcF said:
I find the spreadsheet overwhelming so have not done one. I keep my own records in a notebook. Not sure what AMPS/PMPS is but we have been spot-checking Sketch because that is what the vet suggested.
I guess I was basically looking to find out what, besides a possible pancreas tumor or change in diet or stress, would possibly cause a cat's BG to be steady in the 50s for a few days and then suddenly spike up to 450 or so.
Click to expand...
(italics mine)

Could be any # of things, really: Stress, the start of an infection, change in amount of food/timing of the feedings, etc. There can be multiple factors that can play into the highs & lows of blood glucose in a cat's day-to-day cycles.

I know that the spreadsheet (SS) can seem overwhelming - it was to me, too, when I started participating here. A longtime FDMB members kindly set mine up for me; I'm sure anyone here who knows what they're doing in putting one together (unfortunately, that's not me) would be happy to help you with that.

The only reason I suggested you start a SS: It helps us to help you, as we can't see your notebook online. The spreadsheet shows us your cat's emerging "patterns," through our being able to see all the BG tests you get @ home, any insulin dose changes, etc. & any other pertinent details you can provide in the "comments" section for each day. It is very, very important that you know your cat's preshot #s (AMPS & PMPS) before you shoot ANY does of insulin; if your vet has told you that you do not need to get that blood glucose # before shooting, he is, in effect, allowing you to play "roulette" with your cat. Without a pre-shot #, you are essentially "shooting in the dark" when you administer insulin, a very powerful hormone.

I am not telling you this to be hard on you; I'm simply encouraging you to make certain your kitty is safe at all times. And unfortunately - as so many of us here at FDMB have found through our own experiences - there's a fair number of veterinary professionals out there who really do not know the most effective ways for you to treat/monitor a cat who has diabetes. Often these vets will encourage you only to "spot-check" & bring the cat in for fructosamine tests ($$$) or full curves done in-office. This approach jeopardizes the safety of your cat! (Not to mention many cats stress out when outside their home environments - which can cause BG #s to spike significantly during at-clinic BG tests.)

Lastly, I can tell you without a moment's hesitation that if it were not for the great guidance and support of FDMB members, my cat would not be as well regulated as she is today. (We're all thoroughly committed to your success in treating your cat's diabetes.) :bighug:- Robin
 
Can you please point me to the spreadsheet again. I can't find it on the site. I found a link to "help" with the spreadsheet someone gave me before, but the link is broken.

My vet is the one who pointed me to this site in the first place, and they are fine with me doing BG curves at home. I'm sorry so many people here have had bad experiences with vets.

In the meantime, we just started a new bottle of insulin today since it occurred me the previous bottle was two months old and had on a number of occasions had been shaken or dropped. 5 hours post shot with the new insulin, Sketch is reading 164. 90 minutes later, 263. So it seems that my hunch that the old insulin wasn't working well may be correct, as we have not seen numbers that low in weeks. But now I have to watch more carefully for hypoglycemia.

So I'm not sure I will really ever get an answer to my original question, but at least I have a fresh bottle of insulin and hope that for at least the next month, if we treat the bottle well, we can get some accurate readings.

Now I'm trying to figure out if my AlphaTrak needs to be recalibrated if I get a new bottle of test strips, but I will see if there's an AlphaTrak forum around here for that.
 
Alyssa, you could also use a human glucose meter. Most of us here don't use the Alphatrak because the strips are so expensive. If you want to keep using the Alphatrak that's fine, but please note in your signature that you're using the AT. That way when people are giving you advice about numbers, they know which meter you're using. The AT numbers are higher than the numbers on a human meter. For instance, the hypo range on an AT is 68 or below. On a human meter, it's below 50. Sorry if I'm telling you something you already know. :)
 
OK I think I've got the spreadsheet basically figured out. I'm a bit bummed because I realized recently that not only was Sketch's insulin likely bad/old/shaken too many times, but that I had failed to recalibrate the AlphaTrak 2 monitor after I got the new bottle of test strips a few weeks ago. This might explain some of the wonkyness of the numbers. I'm going to try to keep the spreadsheet updated with numbers from my notebook at least every other day. And call the vet tomorrow to see if they can confirm the calibration of this monitor and possibly check for ketones.
 
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, test)
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.

The nadir is the lowest glucose between shots. There is a general period when it will happen which is specific to the insulin being used and testing then helps make sure your cat doesn't go too low.

It is merely a grid for storing the info; no math required.
 
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