glucose not budging

[labyrinthos]

We started Zephyr on .5u Lantus on 7/18. He's been on a low carb diet since 6/24. Due to work and lack of a glucometer, we didn't do his first curve until 8/8. It was all yellow and pink, so we decided to up him to 1u.

I know I'm supposed to wait a week before we do a full curve, but I haven't been able to resist some spot checks. He's been pink every time.

We feed him at 7am/7pm and give his shot at 7:30am/7:30pm every day like clockwork. He's been gaining weight since we started the insulin, up 10oz! Which is a huge relief. So I know something is working? But then why isn't his glucose lower?

I am just so frustrated that his numbers aren't budging. I don't know what I'm supposed to do to help him, I don't know what well will look and feel like for him.

And I feel like this is impossible. Our life has ground to a halt and centers totally around the cat. Both my husband and I are so busy and I feel like we can't possibly keep this up. And August is an easy month, come the fall we've got out of town weddings, and weeklong out of town work gigs, and I don't know what we're going to do. And I just am feeling so overwhelmed by it right now. I thought we'd have a magic cat who would instantly go into remission and instead I'm just at the beginning of a battle that I don' t know how long I can fight.

 

[Sue and Luci]

Hi there and welcome! I see in your signature that he was diagnosed and/or started Lantus in June - do you have any numbers you could add to your SS from then until now?

I'm not sure how long he's been at 1 unit from your SS - was hoping with more data we could see. It's possible that he's ready for an increase. Which protocol have you decided to try? TR or SLGS - if you're not sure, have a look (yes, lots of reading) at the stickies at the top of this forum.

I'm also not familiar with 'Heart to Tail' but was wondering if you know the carb content? Here's a link to a website where you can look up the carb content of many foods - https://catinfo.org/chart/index.php - very important to make sure he's not taking in too many carbs as that will keep him in higher numbers.

I can understand how you might feel you're in for a long battle, but you never know - first you've got to get those numbers down - some cats are amazing...they pop right back...some (like my Luci) not so much.

It can be challenging to accommodate your cat all the time - but I take Luci in her carrier when we go on a multi-day road trip (which we do twice a year)...and sometimes when we go on day-trips...there is another member here on the forum @Olive & Paula - who recently had to accompany her husband to the hospital in another city and she loaded the cats up and took them with her - although her sugar baby had to stay in an enclosed playpen - she was able to come along with all her diabetic supplies in tow - it can be done - so don't lose hope. I know it sounds crazy - I thought so too, at first - but then I just didn't have the heart to pick a day to have her euthanized! I wanted to try to help her...and I think you love your kitty enough to do whatever it takes to get Zephyr well...One thing about cats - they are portable - and adapt quite well to hotel rooms, etc. Yep, it's a bit more of an effort - but it can be done. Many people here work full time out of the home, some travel for work; all sorts of scenarios.

Don't give up just yet...take the time you have now to read up and figure out what can and can't be done...

Hang in there - you've gotten to the right place to get help and support!

 

[labyrinthos]

Hi there and welcome! I see in your signature that he was diagnosed and/or started Lantus in June - do you have any numbers you could add to your SS from then until now?

No I don't. We didn't actually get the glucometer until 8/8, which is when we first started testing glucose levels. Our vet sent us home with glucose/keto diastix. It took me a while to figure out what we should ACTUALLY be doing.

I'm not sure how long he's been at 1 unit from your SS - was hoping with more data we could see. It's possible that he's ready for an increase. Which protocol have you decided to try? TR or SLGS - if you're not sure, have a look (yes, lots of reading) at the stickies at the top of this forum.

We started him on .5u, trying to do SLGS. He spent 3 weeks at .5u and we upped him to 1u 4 days ago.

I'm also not familiar with 'Heart to Tail' but was wondering if you know the carb content? Here's a link to a website where you can look up the carb content of many foods - https://catinfo.org/chart/index.php - very important to make sure he's not taking in too many carbs as that will keep him in higher numbers.

I don't know the exact carb content, but the can says 10% min protein, 5% max fat, 1.5% max fiber, 78% max moisture, 3% max ash, .5% taurine...so that leaves 2% for carbs. There are no carbohydrate ingredients in the food (veg/potatoes/rice/etc). It's all meat, meat by-products, and added vitamins/minerals/etc.

I can understand how you might feel you're in for a long battle, but you never know - first you've got to get those numbers down - some cats are amazing...they pop right back...some (like my Luci) not so much.

It can be challenging to accommodate your cat all the time - but I take Luci in her carrier when we go on a multi-day road trip (which we do twice a year)...and sometimes when we go on day-trips...there is another member here on the forum @Olive & Paula - who recently had to accompany her husband to the hospital in another city and she loaded the cats up and took them with her - although her sugar baby had to stay in an enclosed playpen - she was able to come along with all her diabetic supplies in tow - it can be done - so don't lose hope. I know it sounds crazy - I thought so too, at first - but then I just didn't have the heart to pick a day to have her euthanized! I wanted to try to help her...and I think you love your kitty enough to do whatever it takes to get Zephyr well...One thing about cats - they are portable - and adapt quite well to hotel rooms, etc. Yep, it's a bit more of an effort - but it can be done. Many people here work full time out of the home, some travel for work; all sorts of scenarios.

Don't give up just yet...take the time you have now to read up and figure out what can and can't be done...

Hang in there - you've gotten to the right place to get help and support!

Thanks for the kind words! We're not giving up anytime soon, just having a hard time figuring out how to make it all work. Unfortunately our work is as flexible as it's going to get for the time being. And I'm not sure how much he'll enjoy being tucked under an economy seat on the planes.

 

[Red & Rover (GA)]

We feed him at 7am/7pm and give his shot at 7:30am/7:30pm every day like clockwork.

The protocol with Lantus is "T/F/S":
Test - to make sure you have a high enough number to shoot
Feed - to make sure the cat eats
Shoot

Feeding only at shot time is old school thinking. You want feed a few snacks during the cycle, picking up any food at +10 so your test at shot time is not food influenced (recommended for beginners so they do not shot a food inflated number).

Vacations/away options:
Reliable neighbour/friend/relative
Pet sitter (ask your vet - often one of the vet techs is willing)
Boarding
There are protocols/suggestions that have been developed over the years. It can be done.

 

[Olive & Paula]

Ah yes travel when you have a sugar cat can be a challenge. Ollie seems to adapt well to travel. I take her to visit my dad in assisted living (she has a pet stroller which makes that easy for me). She doesn't get sick in cars. We spent 5 days in a motel when my husband was moved to hospital farther away. She has more luggage than me to pack and unpack. Only requirements I really needed was a fridge for her insulin and if not I even had that covered with the Frios insulin wallet and a ground floor room because of all the supplies there were. And I did purchase a pop up zippered enclosure (puppy playpen) 45" diameter so it allows litter box (disposable) food bowls, blanket and plenty of room for her to stretch out. When I was there she was allowed to roam in the room. And I was close by to pop in during the day to check on her. Next door neighbor came to house to care for the other non medical kitties.

I should say, husband was in hospital total of 22 days. I took her when I was there for his surgery and post op days (total of 5 days). All the others I commuted every other day while all the testing was done. It seemed results of tests didn't come in until next day, so those were the days I commuted so I was there for the results.

There is one or two people here who take theirs tent camping.

If not taking Zephyr with you is an option there are others such as: boarding with a good facility who will test and give insulin, vet techs from vet office sometimes will come to your home to test and give insulin, maybe find a neighbor willing to learn, pet/house sitter.

She did very well and I wouldn't hesitate to take her again. I think she likes motel living better than being home.

 

[Margie and Jackson]

We started Zephyr on .5u Lantus on 7/18. He's been on a low carb diet since 6/24. Due to work and lack of a glucometer, we didn't do his first curve until 8/8. It was all yellow and pink, so we decided to up him to 1u.

I know I'm supposed to wait a week before we do a full curve, but I haven't been able to resist some spot checks. He's been pink every time.

We feed him at 7am/7pm and give his shot at 7:30am/7:30pm every day like clockwork. He's been gaining weight since we started the insulin, up 10oz! Which is a huge relief. So I know something is working? But then why isn't his glucose lower?

I am just so frustrated that his numbers aren't budging. I don't know what I'm supposed to do to help him, I don't know what well will look and feel like for him.

And I feel like this is impossible. Our life has ground to a halt and centers totally around the cat. Both my husband and I are so busy and I feel like we can't possibly keep this up. And August is an easy month, come the fall we've got out of town weddings, and weeklong out of town work gigs, and I don't know what we're going to do. And I just am feeling so overwhelmed by it right now. I thought we'd have a magic cat who would instantly go into remission and instead I'm just at the beginning of a battle that I don' t know how long I can fight.

I fell into the cat diabetes vortex, too, but now I’m starting to get into a routine. It sounds like you need to look for help when you’re on vacation.
I’ve had friends and family offer to petsit and I pay a service. My cats are important and I don’t mind spending a little on them. You can find people in you’re area by posting on the forum. Maybe you can trade pet sitting with friends or other diabetic cat owners.

My cat’s previous owners gave him to a shelter after neglecting his shots while on vacations. He declined quickly. 3 months after diagnosis he could barely walk. Reach out for help before giving up. It might just take a few more months.

 

[Bobbie And Bubba]

work

Please test prior to each Pre shot number. A must so you know it is safe to shoot. Do continue to test and the more you test, the better. It's like a puzzle and the more puzzle pieces you get, the better.

We test, feed and shoot within a 5-10 minute window. With you waiting 30 minutes after feeding, you have given the food a 20 minute lead to raise the numbers. Lantus is not good at pulling higher numbers down, but rather keeping lower numbers flat. So, please shoot the insulin within 5 minutes of him finishing eating.

Keep testing and keep posting and asking questions as that is how we learn . We are here to help you.

 

[Bobbie And Bubba]

Oh, I forgot to mention , call your vet office and see if any of the vet techs are willing to come to your home twice a day to test pre shots and shoot insulin. Many of them are looking for extra $$. Or if they know of a pet sitter that can help you out. We have a wonderful one you can test and shoot.

 

[Sienne and Gabby (GA)]

It is absolutely acceptable to get spot checks. I'd suggest taking a look at other members' spreadsheets. There's a fair amount of variability regarding how much people test. The reality is that you need to always get a pre-shot test and try to get at least one test during both the AM and PM cycles. Lantus dosing is based on the lowest number in the cycle (i.e., the nadir) so those spot checks are essential to know how low a dose is taking your kitty.

I suspect that part of your frustration is that you've been holding Zephyr's dose a bit too long. With SLGS, you would be increasing the dose 0.25u every week if his numbers are not in the normal range. It's been almost a month so his dose should be somewhere in the neighborhood of 0.75u to 1.0u.

FWIW, everyone wants to have a cat who magically slides down the dosing scale and goes into remission in record time. The problem is that most of us haven't a clue how long our cat was diabetic. It takes patience to let a pancreas heal.

Bobbi had some good suggestions regarding a pet sitter. I've always used a pet sitter when I travelled. Several have been very experienced vet techs or like my current sitter, someone who has devoted her career to caring for other people's pets. You can always post both here and on the Health board with the city you're in and ask if anyone can recommend a cat sitter.

 

[Idjit's mom]

@labyrinthos
We haven't heard from you recently, and when I tried to look at the spreadsheet I was notified that it isn't published. You may want to go back through the spreadsheet instructions and make sure it's published and shared so that we can view.

I hope you, DH and Zephyr are doing well.

 

[labyrinthos]

@labyrinthos
We haven't heard from you recently, and when I tried to look at the spreadsheet I was notified that it isn't published. You may want to go back through the spreadsheet instructions and make sure it's published and shared so that we can view.

I hope you, DH and Zephyr are doing well.

Thanks so much for checking in!

I actually took down the spreadsheet because I feel like I'm not testing enough. It's really hard on Zeph, and on us, to test him before every single feeding session. Since his numbers are still so high I haven't been doing so, but I feel like I'm letting down the community by not doing the testing the correct way. I've put it back up for the time being.

We just did another curve yesterday and his numbers are the highest yet. I feel like every time we raise the insulin, we raise his glucose levels. At the same time he's eating well, is holding steady at 11lbs, his coat looks so much better, he isn't drinking or peeing excessively, so he seems basically healthy. It's making me nuts. I don't know how it's possible for him to be showing all positive external signs but still be so sick according to the numbers.

On the bright side we found someone in our building who has offered to stop by on the one off nights we're away, and for a wedding we're away for next weekend my friend has agreed to board him. So we're figuring out the logistics, even if we're not getting him properly regulated.

 

[Crista & Ming]

Maybe you caught a bounce cycle? Cats sometimes go low at night (check on Ming’s SS. He loves to be low at night and not let me sleep! ) Try to get a before bed test if you’re able.

And keep trying to test before giving insulin. I know it’s hard but it helps keep Zephyr safe. You won’t be successful all the time but I’m hoping with enough time and creating a positive experience with testing, things will get easier.

And like others have said, it takes time. Our cats are more than their numbers so seeing that Zephyr is showing positive external signs is a good thing and means something is working.

 

[Idjit's mom]

Oh, I'm so glad you have replied and restored the spreadsheet. You aren't letting anyone on the board down, it's more of a case of allowing members to help you.

I am not experienced with dosing, and I know you are feeling really unsure and frustrated right now. I can recommend that you post daily, if you can, to get the experienced members' input on what's happening with Zephyr and help you get him to feeling better. It's an intricate dance and some of the steps are darned hard to learn!

We just did another curve yesterday and his numbers are the highest yet. I feel like every time we raise the insulin, we raise his glucose levels. At the same time he's eating well, is holding steady at 11lbs, his coat looks so much better, he isn't drinking or peeing excessively, so he seems basically healthy. It's making me nuts. I don't know how it's possible for him to be showing all positive external signs but still be so sick according to the numbers.

I just read something in another thread by a new member that might apply regarding raising the dose and that raises the BG:
http://www.felinediabetes.com/FDMB/threads/need-ss-analysis-and-dosing-advice-new-member.219047/
Post #12 about "bouncing". Not sure, but might apply.

The Pinks on the spreadsheet are higher than you want, true, but not as bad as reds or blacks. So, that's something.

We are here for you, and want to help.

 

[Crista & Ming]

Some positive ways to test that I’ve read about and done myself:

Create a routine and a safe space. Maybe petting and cuddles before a test and treats after. Sing a song or purr with your cat. Practice touching Zephyr’s ear with your finger and pinching it followed by treats.

 

[Sienne and Gabby (GA)]

You are doing a great job of testing during the AM cycle. If you could get a test before you go to bed every night, that would be ideal.

We harp on home testing for several reasons. First and foremost, it is the best possible way to keep your kitty safe. Cats can look perfectly fine for a while when their numbers are low -- that is. until the effects of hypoglycemia kick in and then it's a legitimate emergency requiring a trip to the emergency vet. I am sure. you don't want that and we don't want that for your kitty. Many cats experience lower numbers at night so testing is important. Without PM tests, you're missing half of your data.

We tend to be very numbers driven. You test data allows us to provide your with informed input. Without that information, we're guessing. And like I said, the goal is to get Zephyr safely regulated or into remission.

 

[labyrinthos]

Just to say, we got our first ever blue!!

Thank you to those who suggested checking for night time dips. It seems like he's lower later. I've also managed to test before 4 shots in a row, which feels like an accomplishment Of course I'm leaving town tomorrow and not sure my cat sitter is quite willing to do the testing, but I think he'll be OK for a few days.

I'm trying to get him set up for ear pricks by being more consistent about where we do it, and I think that's helping. Just having him in my lap from wherever he was sitting was too jarring. When I first started administering insulin I put him on our kitchen island (we can now give him insulin anywhere). I've started doing that for the glucose testing and it's going easier. It's not a place we normally interact so I feel like it helps him to know what's coming.

Thanks again for all the feedback and support. It really helps.