Insulin resistance?

[carmen830]

Hello everyone. My Tigger has been on Lantus/Glargine for close to one year now. I'm noticing that his glucose is staying kind of the higher range. I am supposed to perform a curve tomorrow but I really think he needs his dose adjusted. Although at his last curve in August the vet did not think so. I have some info on my SS, unfortunately I'm not home during the day so for the most part, I can only test twice a day. I feed him the FF white meat chicken with clear broth which is supposedly 0 carbs at different times throughout the day via the automatic feeder because if I divide the feedings into only two full servings a day, he throws up. He also has Dr. Elsey's CleanProtein out for him to graze on throughout the day. Although thankfully it looks like he's finally gaining some weight, he is still constantly hungry! That's another reason I leave out the Dr. Elsey's. Right now, I'm feeding him the FF in increments of every 4-5 hours. (again 1/2 a tray for each feeding) Could this be why his numbers are high again? I'm so confused, b/c I really just want him better controlled with his numbers. And I'm doing the best that I can. *As of a few weeks ago, I started testing him before he eats his wet food in the AM and I try to wait 2 hours after he eats for his PM reading but I think the food I leave out for him to graze on may influence the readings*

 

[tiffmaxee]

It's hard to know what's going on with so little data but if you can do a curve once a week that would help. From what I see here he's staying high but too much insulin and too little can look the same. Can you get a before bed test and set an alarm to get a test sonewhere between -+5-7 at night once in awhile? We need to know how low this dose is taking him. An auto feeder might help you as while grazing is great you don't want him eating less than two hours before pretests or the reading might be food influenced.

 

[carmen830]

It's hard to know what's going on with so little data but if you can do a curve once a week that would help. From what I see here he's staying high but too much insulin and too little can look the same. Can you get a before bed test and set an alarm to get a test sonewhere between -+5-7 at night once in awhile? We need to know how low this dose is taking him. An auto feeder might help you as while grazing is great you don't want him eating less than two hours before pretests or the reading might be food influenced.

Ok, I'm going to do his curve tomorrow and then try to do it once a week, perhaps on a weekend day. To give you an idea, see the attached curve charts. On the excel sheet, each curve is on a different tab on the bottom, from when he was first diagnosed. Please let me know if these chart give you a different view on him.

 

[StephG]

When you have time, do some research on cats converting protein to glucose. The president of Young Again pet food told me that there needs to be a certain amount of fat and protein. He said protein can be converted into glucose. I've done light research on this and it does seem to be right.

 

[tiffmaxee]

A once a month curve is just a snapshot in time. I stand by what I said before that you need to get sporadic tests as often as possible to see what the nadir is most days. Cats often go lower at night so when you can't do it weekdays due to work night tests will help a lot. If Tigger truly is staying this high he needs more insulin. Staying too high for too long can indeed cause insulin resistance like you were thinking. Unless a dose is getting your cat to the range you want you need to increase to avoid it. We just don't have the necessary information to make the call in my opinion. See what others say.

 

[StephG]

I finally got your SS to open... I think an increase is needed. I agree with tiffmaxee that more testing is needed when you can get them done. The second half of the cycle is important too.
My cat is one that usually starts dropping around +6 and nadir is some +8 to +10 and he sometimes double dips. The beginning of his cycles really don't tell me much. Every cat is different but he did see some blues a while back so I think an increase might give him a breakthrough that he needs...

 

[Gill & George]

Hello and welcome to L&LL Carmen and Tigger,

I agree with Elise it's very hard to know what to do regarding dose.

With being at work all day, I would recommend that you always grab a before bed test, and if you can occasionally set the alarm and grab a test later in the cycle that will also be very helpful.

Running a curve once a week, getting some pm data, and grabbing it checks when you can, eg if you are home early and can grab a +10 or even a +11, take the opportunity to gather some data, or if you are heading into work later than usual and can grab a +1 then grab a test, that will help you build a picture of what is going on with Tigger's BG, and it will help us help you better with dosing strategies.

Have you considered changing shot times? Perhaps there's enough leeway in your schedule for you to shooting upon earlier, enabling you to grab a +1 or a +2?

I'm feeding him the FF in increments of every 4-5 hours. (again 1/2 a tray for each feeding)

Feeding small portions and spreading it out through the day would be fine. Most of us would avoid feeding anything too high in carbs in the latter part in the cycle. I tried not to feed anything after +7 when George was on insulin. Feeding late in the cycle can cause the BG to spike by the next PS and can shorten duration. If he needs to have something in his tummy so he doesn't feel sick then try some boiled chicken breast or some freeze dried zero carb treats.

Though it's fine to leave stuff out for him to graze on, like Elise said if you can have it in an autofeeder and have it turn to hide the food two hours prior to shot time that would be great, that way you would know with certainty that the number is not food influenced, this is important to know as it will keep your Tigger safe.

Both the dosing methods we use on this forum guide your dosing decisions on how low the dose is getting kitty, so we really need to get some sort of a feel for that by getting a little more data. At the moment we don't know if Tigger is dropping down into green in the middle of the cycle and the back up to pink by PS, or if his numbers are staying high and flat. This doesn't mean that you need to run curves every day to figure it out, getting some of the spot checks we've suggested along with running a curve when you can, will go a long way to giving us the information we need to assess how well this dose is working for Tigger, and better guide you with dosing decisions.

 

[carmen830]

Hello and welcome to L&LL Carmen and Tigger,

I agree with Elise it's very hard to know what to do regarding dose.

With being at work all day, I would recommend that you always grab a before bed test, and if you can occasionally set the alarm and grab a test later in the cycle that will also be very helpful.

Running a curve once a week, getting some pm data, and grabbing it checks when you can, eg if you are home early and can grab a +10 or even a +11, take the opportunity to gather some data, or if you are heading into work later than usual and can grab a +1 then grab a test, that will help you build a picture of what is going on with Tigger's BG, and it will help us help you better with dosing strategies.

Have you considered changing shot times? Perhaps there's enough leeway in your schedule for you to shooting upon earlier, enabling you to grab a +1 or a +2?


Feeding small portions and spreading it out through the day would be fine. Most of us would avoid feeding anything too high in carbs in the latter part in the cycle. I tried not to feed anything after +7 when George was on insulin. Feeding late in the cycle can cause the BG to spike by the next PS and can shorten duration. If he needs to have something in his tummy so he doesn't feel sick then try some boiled chicken breast or some freeze dried zero carb treats.

Though it's fine to leave stuff out for him to graze on, like Elise said if you can have it in an autofeeder and have it turn to hide the food two hours prior to shot time that would be great, that way you would know with certainty that the number is not food influenced, this is important to know as it will keep your Tigger safe.

Both the dosing methods we use on this forum guide your dosing decisions on how low the dose is getting kitty, so we really need to get some sort of a feel for that by getting a little more data. At the moment we don't know if Tigger is dropping down into green in the middle of the cycle and the back up to pink by PS, or if his numbers are staying high and flat. This doesn't mean that you need to run curves every day to figure it out, getting some of the spot checks we've suggested along with running a curve when you can, will go a long way to giving us the information we need to assess how well this dose is working for Tigger, and better guide you with dosing decisions.

Thank you all so much for your replies. I will definitely try to get more spot checks in there. I just feel so helpless because it seems like he is always hungry! At this point I don't know if he is really that hungry or just being a little glutton. My sweet sweet boy I adore him to pieces. He is like my shadow. I have two others that I love as much but with Tigger we have always had a special bond. Again thank you all very much. I will do at least two or three more checks tonight and then do his curve at home tomorrow.