? I can't figure this out?

[DevilPup]

I can't seem to get a handle on Spike's numbers. We just raised him again .25 unit yesterday and his numbers are going up instead of down. For once I believe that his concurrent illnesses are NOT affecting his numbers, still the high (and going higher) numbers!!! We had no choice to keep him on 1.25 units for 10 days. We now plan on doing a curve on Wednesday or Thursday and increase to 1.75. He is now on 1.5. I'm getting nervous...he seems fine. At what dosage level should I start getting concerned that he may be resistant? Is this type of reaction to the increase normal? This is not the "panic" do you think? I think we will only stay on 1.75 for 3 days, then increase again, if necessary. I just took the last reading a few minutes ago. I'm really confused...any thoughts? Help! Thanks. Could it be the type of insulin? His Flovent? (2 puffs/day) the antibiotics? (one more week)

 

[Sandy and Black Kitty]

We just raised him again .25 unit yesterday and his numbers are going up instead of down.

Could be NDW.

At what dosage level should I start getting concerned that he may be resistant?

If the dose gets up to 6u then it would be wise to have your kitty tested for high dose conditions. I wouldn’t focus on that at this point.

I think we will only stay on 1.75 for 3 days, then increase again, if necessary.

SLGS guidelines are to hold a given dose for one week (unless
BG dips below 90, in which case a reduction would be in order ).
Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.

Any chance you can ditch the dry food? It can make a world of difference.

 

[DevilPup]

Could be NDW.
If the dose gets up to 6u then it would be wise to have your kitty tested for high dose conditions. I wouldn’t focus on that at this point.
SLGS guidelines are to hold a given dose for one week (unless
BG dips below 90, in which case a reduction would be in order ).
Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.

Any chance you can ditch the dry food? It can make a world of difference.

I understand about not rushing. I guess I'm just getting nervous. His body doesn't even acknowledge the increase in dosage.....

The dry? I feed him a mixture of 50/50 Science Diet (yes, high carbs) and Young Again/Origen. But he eats so little of it. He pretty much maintains on wet, low carb pate. He has lived his entire life on dry....that he eats mostly wet now is a major accomplishment. I have 4 others civvies. It's a very tough balancing act. We do our best. I will pro-offer wet...when he eats it, he won't go for dry or will just eat a few pieces.

We will wait a week on this dosage. I'm just so afraid he is going to go into the 400s and then be hyperglycemic with all the things that go with that.

 

[DevilPup]

I just tested +10. He went up again. This has been a continual increase all day..... NDW. I guess we will see after a few days. Maybe the insulin? I've only used this vial since the middle of August. I check it each time I fill the syringe; it is not cloudy; it stays refrigerated. Am I just panicking? I look at that face and I am so sad that I cannot help him. Why isn't this stuff working?

 

[Sandy and Black Kitty]

How did you first discover your kitty was diabetic?
Any history of ketones?

He is holding flat-360 and 369 are essentially the same.

Keep in mind that Lantus is a depot type of insulin. When you increase the depot seeks to calibrate to the new dose- so insulin first goes to filling the depot not directly into circulation.

Am I just panicking? I look at that face and I am so sad that I cannot help him.

You are helping him. Unfortunately safely treating FD is a marathon not a sprint.

Have a look at Black Kittys ss -I know the frustration of shooting larger and larger doses and still swimming in a sea of relentless pinks and reds.

Hang in there and hang in here.
It will get better.

 

[Gill & George]

I look at that face and I am so sad that I cannot help him. Why isn't this stuff working?

You are helping him it just can take time to get to a good dose in a safe manner.

You've done a great job converting him to mostly a wet low carb diet, it's not easy with kitties that have been brought up on dry.

Just wanted you to consider that even a few pieces of hc kibble in some cats can really impact bg. I just wanted to link you this ss, when all kibble was removed from the household, Scooter went from 5.5u to otj in the space of 5days check out feb19 2014 on the as https://docs.google.com/spreadsheet/pub?key=0AqyJS-ud54lgdHU2S2FwczByM3YwU2JjRFduOWJLUHc&output=html

Scooter was on a wet diet, but looking back was probably stealing some kibble here and there.

My boy soared to black, after a kibble raid earlier this year, he got into the outdoor cats kibble, it was while we were away on vacation. We have a multicat household (4)to, they're all on LC wet as are the outdoor cats, I know George, he'd get into the kibble one way or otherr and it would play havoc with BG. It would be a lot easier to leave kibble out for the other cats, but I found that I can't take that risk. In any case I do firmly believe that a low carb species appropriate wet diet is better for their health.

If it were possible to remove all dry from his diet it might help his BG. Though young again is LC, I do believe that orijgen is still quite high.

 

[DevilPup]

How did you first discover your kitty was diabetic?
Any history of ketones?



He was not acting "well." His last flare of pancreatitis was extremely long and looking back, I believe this is what brought on his diabetes. I took him back to the idiot vet (whom we no longer see) for complete blood work up and urinalysis. He made us wait for 30 minutes in the office for some b/s about wanting to see if he got enough blood. In the meantime, my boy was extra stressed as he is whenever he is at the vet. He could not take a urine sample because "he could not reach the bladder, his needles weren't long enough."
So after the blood results came back showing pancreatitis flare by Texas A&M (as I already knew) and high blood glucose, I brought in free catch urine samples, where they tested positive. The glucose was high enough that it spilled into his urine. This Vet wanted me to shoot him initially with 7 units of prozinc. When I asked him if that was a typo in his email he said no. Time to move on. He never showed me how to test, how to shoot, the finer details of shooting and the general info that I should know about the illness. That is how I found out he was diabetic.
I have added 2 additional columns to the end of his SS, called "keytones" and weight. Thankfully, he has had no history of keytones.



He is holding flat-360 and 369 are essentially the same.

Keep in mind that Lantus is a depot type of insulin. When you increase the depot seeks to calibrate to the new dose- so insulin first goes to filling the depot not directly into circulation.
You are helping him. Unfortunately safely treating FD is a marathon not a sprint.

Have a look at Black Kittys ss -I know the frustration of shooting larger and larger doses and still swimming in a sea of relentless pinks and reds.


I will look at her SS. I hope she is now swimming in the blue and green seas....
And I will hang in there. I lose hope sometimes. He has been sick with one illness or another, chronically, for the last two years. Prior to that it was random and we could keep up. Between caring for the others.
I am also afraid that if his BG goes too high, he will feel worse as the illness progresses and reduce his quality of life.

Thank you for being there and hearing me out.


Hang in there and hang in here.
It will get better.

 

[DevilPup]

You are helping him it just can take time to get to a good dose in a safe manner.

You've done a great job converting him to mostly a wet low carb diet, it's not easy with kitties that have been brought up on dry.

Just wanted you to consider that even a few pieces of hc kibble in some cats can really impact bg. I just wanted to link you this ss, when all kibble was removed from the household, Scooter went from 5.5u to otj in the space of 5days check out feb19 2014 on the as https://docs.google.com/spreadsheet/pub?key=0AqyJS-ud54lgdHU2S2FwczByM3YwU2JjRFduOWJLUHc&output=html

Scooter was on a wet diet, but looking back was probably stealing some kibble here and there.

My boy soared to black, after a kibble raid earlier this year, he got into the outdoor cats kibble, it was while we were away on vacation. We have a multicat household (4)to, they're all on LC wet as are the outdoor cats, I know George, he'd get into the kibble one way or otherr and it would play havoc with BG. It would be a lot easier to leave kibble out for the other cats, but I found that I can't take that risk. In any case I do firmly believe that a low carb species appropriate wet diet is better for their health.

If it were possible to remove all dry from his diet it might help his BG. Though young again is LC, I do believe that orijgen is still quite high.

Thanks. I looked at Scooter's SS. I'm sorry he is no longer with you. Like my boy, it seemed like he had a lot of other issues going on too.
I did find it interesting to see his BGs plummet after removing the dry. I really, really am working on this. With his pancreatitis and rhinitis, sometimes I just want him to eat. I re-reviewed Origen's analysis. Carbs come up to 18%. I know that is still high. I tend to put more of the Y/A in the bowl. When I do, I find they don't go for it as much....even though it is being offered. Perhaps I can continue to reduce the amount of HC dry with Y/A. Before long, they will either eat the Y/A or decide against dry totally. We weigh them (all 5) every week. So this is a good way to keep a handle on the dry vs wet issue. I do agree that the LC wet pate is better for their health. Thanks for replying!

 

[DevilPup]

How did you first discover your kitty was diabetic?
Any history of ketones?

He is holding flat-360 and 369 are essentially the same.

Keep in mind that Lantus is a depot type of insulin. When you increase the depot seeks to calibrate to the new dose- so insulin first goes to filling the depot not directly into circulation.
You are helping him. Unfortunately safely treating FD is a marathon not a sprint.

Have a look at Black Kittys ss -I know the frustration of shooting larger and larger doses and still swimming in a sea of relentless pinks and reds.

Hang in there and hang in here.
It will get better.

I looked at Black Kitty's SS. That was such a long journey...a definite marathon to drop those BGs. What an awesome job you did for her. I'm sorry she is gone. An amazing transformation. Did you change insulins mid-way thru? And did I read your chart right that she was getting over 14 units every 12 hours? Wow, then she started dropping....amazing. I am truly amazed. Thank you for sharing this.

 

[Sienne and Gabby (GA)]

It doesn't really matter how much HC food you give -- it's still HC and can spike BG levels. One option is to crush some of the dry stuff and sprinkle some on Spike's food. He's likely to smell it which will stimulate his appetite vs. having to give him more of the food. I think your idea about slowly decreasing the dry stuff is a good one! Some cats do take a while to transition to LC, canned food.

The thought I have about Spike's numbers is that there are some days when you don't have any spot checks during either AM or PM cycles. Having some tests during each cycle will let you know which way Spike's numbers are heading. We don't know if his numbers dropped and what you're seeing is a bounce.

 

[DevilPup]

It doesn't really matter how much HC food you give -- it's still HC and can spike BG levels. One option is to crush some of the dry stuff and sprinkle some on Spike's food. He's likely to smell it which will stimulate his appetite vs. having to give him more of the food. I think your idea about slowly decreasing the dry stuff is a good one! Some cats do take a while to transition to LC, canned food.

The thought I have about Spike's numbers is that there are some days when you don't have any spot checks during either AM or PM cycles. Having some tests during each cycle will let you know which way Spike's numbers are heading. We don't know if his numbers dropped and what you're seeing is a bounce.

Thanks for the idea on crushing some of the food on top of wet. I can try that, but like you said, it doesn't matter how much HC food it is, it still HC.

Unfortunately, we test when we are home. I am home more often but I cannot test him by myself. I need someone to hold him, at least, while I test. He is very uncooperative. I have tried several times--but I will keep trying.... In just writing this, Spike woke up from his nap and wanted to come in. He came in got a drink and was looking for treats. I broke up some treats on the island, got my testing stuff out and ready and hoisted him up. Took 30 seconds, got a test in and he got his treats.
He was struggling, but it worked!! Great that I was able to test him myself, not so great on what his BG was....at +6 it was 321. This is day 3 of the increased dose. I will keep decreasing the HC dry with just Y/A until they all stop eating it. Or if they do, that's okay because it's LC.

I updated his SS. Thank you!

 

[Beck and Philly]

Don't stress too much about a number like 321, especially soon after changing the dose. We had numbers in the red and black with every dose increase. I chalked it up to new dose wonkiness.

 

[Sandy and Black Kitty]

In just writing this, Spike woke up from his nap and wanted to come in. He came in got a drink and was looking for treats. I broke up some treats on the island, got my testing stuff out and ready and hoisted him up. Took 30 seconds, got a test in and he got his treats.
He was struggling, but it worked!! Great that I was able to test him myself, not so great on what his BG was....at +6 it was 321.

Well Done!
He has made the association between tests and treats .
persistence prevails