Bandit, BG getting higher

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LinMcG

LinMcG

Member Since 2017
We're now up to 2 units daily of Lantus, we started at 1. He's also switched over to all wet food but it's Hill's prescription CD. His BG had been slowly decreasing although lowest I got was 371. This morning I got 507, I then retested same area with two more strips, 498, 495.
Would testing at 6 instead of 6:30 make any difference?
I had left insulin out of the fridge accidentally recently but we've only had it for 19 days.
He's been super hungry the last couple days.
I'll be calling the vet today but any insight as to why it's now going in the other direction would be welcome.
 
One problem I can see is that you are using Hill's CD food. Even the wet food is very high i carbs ranging from 23-28 carbs depending on the variety. Diabetic kitties should be getting 10 carbs or less food. A high carb food will make it almost impossible to get your kitty regulated. Switching to a lower carb food can make a BIG difference in glucose levels.

Also it would be very useful if you could set up a spreadsheet and put your testing data in it. The colour coded spreadsheet can give a good visual as to how well a dose is working and whether increases or reductions would be in order. Also having the data makes it easier for other members to see how the readings are going and make suggestions or give advice. Instructions for setting up a spreadsheet are here:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/


Glucose numbers can and will fluctuate during the day. Getting a glucose reading before each shot...with no food on board for at least 2 hours...and at least once in between shots will give a good idea how well the insulin and dose is working.
 
Tuxedo Mom said:
One problem I can see is that you are using Hill's CD food. Even the wet food is very high i carbs ranging from 23-28 carbs depending on the variety. Diabetic kitties should be getting 10 carbs or less food. A high carb food will make it almost impossible to get your kitty regulated. Switching to a lower carb food can make a BIG difference in glucose levels.

Also it would be very useful if you could set up a spreadsheet and put your testing data in it. The colour coded spreadsheet can give a good visual as to how well a dose is working and whether increases or reductions would be in order. Also having the data makes it easier for other members to see how the readings are going and make suggestions or give advice. Instructions for setting up a spreadsheet are here:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/


Glucose numbers can and will fluctuate during the day. Getting a glucose reading before each shot...with no food on board for at least 2 hours...and at least once in between shots will give a good idea how well the insulin and dose is working.
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Thank you, I realize his food isn't the ideal choice. The vet seems to think a urinary blockage is a real threat for him due to sand in his bladder. I've read that you all prefer Fancy Feast. Do they have a formula for sand in the bladder?
When I tested this morning it was before food and insulin.
I need to get on that spread sheet, life has been a little hectic but I need to make time.
 
Does Bandit have struvite or oxalate crystals? or kidney stones? If he had been eating dry food as a regular part of his diet that can lead to stones or crystals. By feeding wet food and adding extra water to it, this can help prevent the formation of crystals.

Many of the members here will use Fancy Feast pates or Friskies pates (not the Indoor Cat variety..it is a high carb type)
 
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Also getting tests between shots can show how well the dose is working. The dosing depends on HOW LOW a dose is taking your kitty, not just on where the preshot values are. If a kitty is high at prehot and drops low or too fast in between shots, then "bouncing" can occur and the next prehot will be high again.
 
Tuxedo Mom said:
Does Bandit have struvite or oxalate crystals? or kidney stones? If he had been eating dry food as a regular part of his diet that can lead to stones or crystals. By feeding wet food and adding extra water to it, this can help prevent the formation of crystals.

Many of the members here will use Fancy Feast pates or Friskies pates (not the Indoor Cat variety..it is a high carb type)
Click to expand...
He had an ultrasound over this past winter and all the vet said was sand in the bladder.
He's been a dry food cat his whole life, switched to the wet to try to lower carbs.
I'm going to have to get some more testing in. How long after the shot should I test to see how low he gets?
 
"Sand" in the bladder is from crystal formation, either struvite...which is more common or oxalate which is less common.


The "usual" with Lantus is an onset around +2 or +3 hours after the shot and a nadir (lowest number) around +5-+7 hours after the shot. This can vary with each kitty but this gives a general idea. If you are able to do a number of tests between shots it can provide useful data. If possible a +3 and then a +6 should give some indication how the dosing is working. However if there is any "bouncing" going on you may not see much movement. Doing varied tests between shots over a number of days cvan give a clearer picture of how the daily changes are happening.
 
This gives an example of what you might expect with a Lantus cycle (from one shot to the next)

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/
 
Tuxedo Mom said:
This gives an example of what you might expect with a Lantus cycle (from one shot to the next)

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/
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Thank you Tuxedo Mom! I realize at some point I'll have to do a curve. I know it's in his best interest but I hate poking him so much... :(
 
LinMcG said:
I know it's in his best interest but I hate poking him so much
Click to expand...

My current FD kitty is not fond of the ear pokes. I tell her every time I test that I am sorry for the pokies but I need to keep her safe. I have a running dialogue I go through every time we test. :D
 
One thing that can be helpful to kitties with bladder issues is to add extra water to every wet food meal to make a sort of stew. My guy had frequent bouts of cystitis until I began doing this.
 
I spoke to the vet and among other things we reviewed what he was eating and when. Turns out, it's likely my own fault this happened. During the switch to wet food I was concerned he was so hungry I started giving him food during the middle of the day. Her opinion is that food without insulin was the cause of the spike in BG. Again feeling like a crap cat Mom, I already knew this. :arghh:
Are you all only feeding AM and PM? Maybe it's just habit but I feel like it's a long stretch between meals.
She suggested bigger meals. How long do you leave the food down? He's not finishing it in one sitting.
Vet also suggested waiting a few days to get back to normal then doing a curve.
 
LinMcG said:
I spoke to the vet and among other things we reviewed what he was eating and when. Turns out, it's likely my own fault this happened. During the switch to wet food I was concerned he was so hungry I started giving him food during the middle of the day. Her opinion is that food without insulin was the cause of the spike in BG. Again feeling like a crap cat Mom, I already knew this. :arghh:
Are you all only feeding AM and PM? Maybe it's just habit but I feel like it's a long stretch between meals.
She suggested bigger meals. How long do you leave the food down? He's not finishing it in one sitting.
Vet also suggested waiting a few days to get back to normal then doing a curve.
Click to expand...
Actually, most of us feed several small meals a day and find that kitty is happier and BG levels more stable with that routine. We remove all food for the 2 hour period prior to pre shot BG tests so there's no food influence on the number. Some people use an automatic feeder to allow that during the day while they're at work and/or overnight if that's what the kitty needs. My vet told me to feed only twice a day at shot time but I didn't follow that. My understanding is that it comes from the routine recommended when faster acting in and out insulins are/were used (eg. Vetsulin, Novolin). There has to be a good meal on board to cushion the impact of those insulins.
 
LinMcG said:
I spoke to the vet and among other things we reviewed what he was eating and when. Turns out, it's likely my own fault this happened. During the switch to wet food I was concerned he was so hungry I started giving him food during the middle of the day. Her opinion is that food without insulin was the cause of the spike in BG. Again feeling like a crap cat Mom, I already knew this. :arghh:
Are you all only feeding AM and PM? Maybe it's just habit but I feel like it's a long stretch between meals.
She suggested bigger meals. How long do you leave the food down? He's not finishing it in one sitting.
Vet also suggested waiting a few days to get back to normal then doing a curve.
Click to expand...
Two meals a day is an older thought. You can certainly make the preshot meals bigger, but most of us feed smaller meals several times a day. Just no food 2 hours prior to the preshot test.
 
Here is what the American Association of Animal Hospitals says:
• Provide the lowest amount of carbohydrate levels in the diet that the cat will eat.
•Canned foods are preferred over dry foods
•Feeding meals four times daily is ideal to prevent clinical hypoglycemia for cats on insulin. Timed feeders are useful for cats that require multiple meals per day to manage weight and control calories. Use of insulin glargine may reduce the need for timed feedings, as long as home monitoring of BG is being done. (See Insulin therapy in the cat.)
•Free-choice feeding is acceptable for underweight cats on insulin therapy.
 
Thank you or that info on feeding, I really thought it was too long between. Maybe the vet was just reaching for an answer or maybe she's not so current with FD info. In general I feel pretty comfortable with how she's handling us, but like any other Dr I need to be the advocate.
I really appreciate the guidance you've all provided, I can't imagine trying to navigate this alone! :bighug:
 
LinMcG said:
Thank you or that info on feeding, I really thought it was too long between. Maybe the vet was just reaching for an answer or maybe she's not so current with FD info. In general I feel pretty comfortable with how she's handling us, but like any other Dr I need to be the advocate.
I really appreciate the guidance you've all provided, I can't imagine trying to navigate this alone! :bighug:
Click to expand...

We all can empathize with how overwhelming it is in the beginning. We are here for you if you need us.

Of you want help getting that spreadsheet going, just ask.
 
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