Glucose level spikes

[Vannecheta]

My cat Mario has been on Lantus since July. I have been giving him Lantus and using Alpha Trak 2 to check his glucose. Also, I am only giving him wet food. However, Mario’s glucose levels are not controlled. It took me a while (about 2 months) to kind of get it under control (around low 200’s and mid 100’) so, mid September to mid November he has been controlled. However, since about two weeks his glucose levels are crazy! For example, today’s reading were: 167 at 7am, 321 at 1:00pm, and 427 at 7pm.
So, it might be like that for a couple of days and then have a couple of days in the low 200’s and mid 100’s. Ive been giving him for the last 2 months 5 or 5.5 units. He has not lost any weight. He is a little overweight. I can see his hips are getting weak. Please help me help Mario.

 

[Kris & Teasel]

We like to see a spreadsheet with BG test data on it before giving advice. It's too hard to make useful comments without a lot of data to look at. That's a high-ish dose of Lantus. Is he eating only low carb wet food? What is your BG testing routine?

I suggest you post on the Lantus forum for help. Please consider setting up the spreadsheet we use here and enter all BG numbers you have on it.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

The insulin dose won't stay the same over time. Other health issues can have a big impact on BG levels. Dental problems are near the top of that list. Aside from that, it's normal to have to make small increases or decreases based on the BG test data you get. That's why it's important to have a daily testing routine. This is the basic routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

It would be helpful to use if you'd set up your signature. That's the light grey text you see under our posts. Here's how to do it:

• click on your name in the upper right corner of this page
• click on "signature" in the men that drops down
• type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.

 

[Vannecheta]

We like to see a spreadsheet with BG test data on it before giving advice. It's too hard to make useful comments without a lot of data to look at. That's a high-ish dose of Lantus. Is he eating only low carb wet food? What is your BG testing routine?

I suggest you post on the Lantus forum for help. Please consider setting up the spreadsheet we use here and enter all BG numbers you have on it.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

The insulin dose won't stay the same over time. Other health issues can have a big impact on BG levels. Dental problems are near the top of that list. Aside from that, it's normal to have to make small increases or decreases based on the BG test data you get. That's why it's important to have a daily testing routine. This is the basic routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

It would be helpful to use if you'd set up your signature. That's the light grey text you see under our posts. Here's how to do it:

• click on your name in the upper right corner of this page
• click on "signature" in the men that drops down
• type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.

Hi!
I just finished posting Mario’s spreadsheet.
Please help me figure this out.

 

[Kris & Teasel]

Congratulations! This is the best tool - along with BG testing - to help your kitty. Here are my comments:

• You don't have to test hourly after the AM dose unless you want to do a curve to see the full action of a dose. Even then testing every 2 hours between shots is sufficient.
• What is important, though, is testing before every injection AM and PM as I outlined in my post #2 above. You need to know at both shot times whether the BG is high enough to give it safely.
• Lantus works best with consistent dosing AM and PM according to the methods we use here. If a dose needs to be reduced, it's done in fractions of a unit, usually 0.25 u unless the dose magnitude is above about 5 u and then 0.5 u changes might be better. There are other FD groups that dose Lantus differently - we know that.
• I recommended in my post above that you post on the Lantus forum for help. It's a large forum with members that have a high level of expertise and there are two very clearly laid out dosing methods that are very useful in guiding your decisions. One is TR (Tight Regulation) and the other is SLGS (Start Low Go Slow). There are yellow info stickies on that forum that explain everything in detail. The members there will answer any/all questions you have.

I hope this helps!

 

[Yvonne & Andy &BJ (GA)]

My cat Mario has been on Lantus since July. I have been giving him Lantus and using Alpha Trak 2 to check his glucose. Also, I am only giving him wet food. However, Mario’s glucose levels are not controlled. It took me a while (about 2 months) to kind of get it under control (around low 200’s and mid 100’) so, mid September to mid November he has been controlled. However, since about two weeks his glucose levels are crazy! For example, today’s reading were: 167 at 7am, 321 at 1:00pm, and 427 at 7pm.
So, it might be like that for a couple of days and then have a couple of days in the low 200’s and mid 100’s. Ive been giving him for the last 2 months 5 or 5.5 units. He has not lost any weight. He is a little overweight. I can see his hips are getting weak. Please help me help Mario.

Just a word of encouragement - I am not an expert as others on this board but Mario reminds me of my Andy when we first started Lantus. He was on 6+ u twice a day but had no other health issues. His BG's were all over the place and I was really frustrated and scared. Then I came here for help and got so much help and education. He is still not regulated well but we are working on it. This board is the best place to be for help with so many experienced and kind members. Hang in there with Mario and post as much as possible for help. Good luck!

 

[Vannecheta]

Congratulations! This is the best tool - along with BG testing - to help your kitty. Here are my comments:

• You don't have to test hourly after the AM dose unless you want to do a curve to see the full action of a dose. Even then testing every 2 hours between shots is sufficient.
• What is important, though, is testing before every injection AM and PM as I outlined in my post #2 above. You need to know at both shot times whether the BG is high enough to give it safely.
• Lantus works best with consistent dosing AM and PM according to the methods we use here. If a dose needs to be reduced, it's done in fractions of a unit, usually 0.25 u unless the dose magnitude is above about 5 u and then 0.5 u changes might be better. There are other FD groups that dose Lantus differently - we know that.
• I recommended in my post above that you post on the Lantus forum for help. It's a large forum with members that have a high level of expertise and there are two very clearly laid out dosing methods that are very useful in guiding your decisions. One is TR (Tight Regulation) and the other is SLGS (Start Low Go Slow). There are yellow info stickies on that forum that explain everything in detail. The members there will answer any/all questions you have.

I hope this helps!

Thank you so much for your reply.

 

[tiffmaxee]

Kris has given you some good advice. To tag on to what she said, many cats drop at night. My Max was one of those. So it’s really impiyto get some night tests to get the dose right and keep Mario safe.

 

[Vannecheta]

Just a word of encouragement - I am not an expert as others on this board but Mario reminds me of my Andy when we first started Lantus. He was on 6+ u twice a day but had no other health issues. His BG's were all over the place and I was really frustrated and scared. Then I came here for help and got so much help and education. He is still not regulated well but we are working on it. This board is the best place to be for help with so many experienced and kind members. Hang in there with Mario and post as much as possible for help. Good luck!

Thanks so much for your words of encouragement! I’m really desperate. I think I am doing the right thing but getting bad results.
I am checking the glucose AM before insulin shot, and again PM before insulin shot. I’m giving him fancy feast Purely. I’m also giving him Zobaline because his hips are weak. I don’t see improvement with the zobaline either although I just started it a week ago.

Kris has given you some good advice. To tag on to what she said, many cats drop at night. My Max was one of those. So it’s really impiyto get some night tests to get the dose right and keep Mario safe.

ok

Kris has given you some good advice. To tag on to what she said, many cats drop at night. My Max was one of those. So it’s really impiyto get some night tests to get the dose right and keep Mario safe.

So, following your advice, I tested Mario at 9:30pm.
Here are the results of today’s testing with 6.5 units.
7:30am at 400, 6:30pm at 256, 9:30pm at 321

 

[tiffmaxee]

Nadir is usually between +5-7 so it’s hard to know what is going on. I highly suggest a pmps test every night and a +6 any cycle you can grab one. Maybe do a 12 hour curve. I never did that because I tested most days until nadir. I was able to because I wasn’t working. It’s frustrating I know.

 

[Vannecheta]

Nadir is usually between +5-7 so it’s hard to know what is going on. I highly suggest a pmps test every night and a +6 any cycle you can grab one. Maybe do a 12 hour curve. I. Ever did that because I tested most days until nadir. I was able to because I wasn’t working. It’s frustrating I know.

Hi,
Yes, I’ve done that during the day. 12 hour courve. I know that Nadir occurs around +6. What bothers me is that lately I’ve gotten numbers very high at nadir; very similar to the pre shot am number. I’m increasing the insulin units. Now I’m at 6.5. My plan is to stick to that number for 3 days and then increase again. What do you think?
Also, what makes me worried is that, if you look at my data spreadsheet, Mario was doing fine for a while with a lower amount of insulin, and suddenly about a month or so, things started getting crazy. Highs and lows. Not regulated at all! And nothing has changed on my part for that to happen. Very frustrating indeed.

 

[tiffmaxee]

Any chance of an infection or does he need a dental? He is getting g into b,he territory and possibly lower and bouncing but we don’t know because you aren’t getting the minimum suggested tests at night. One test doesn’t tell us much. Has he been tested for high dose conditions? I suggest reading all the yellow stickies (again if you have already done so). There’s a lot of info to absorb. Also it would be helpful to know more about Mario. I suggest adding to your signature: age, date of diagnosis, any other health issues, protocol, meter used, what you are feeding.

If you look at other spreadsheets you will see it can take time to regulate. It’s a marathon for many and not a race. It took a year for Max.