Glucose levels not going down?

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Mayo377

Member Since 2020
Hello! My cat was diagnosed with diabetes a month ago. I've been trying to learn as much as possible, but this has me stumped. Why isn't his glucose levels going down?

We have the home glucose tests and at 1 unit of lantus, my cats glucose was 415 at 6 hours after his dose. The vet had us increase his lantus last night to 1.5. I checked his levels today, and at 6 hours past his morning insulin, it was 422. If anything it seems to be going up. Why would this be?

Thank you so much for any info you can give me. I'm still so new to all of this.
 
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Hello and welcome. I've moved your post to the Feline Health forum where we ask new people to post first. There are a few things you can do to help us help you.
New? How You Can Help Us Help You!

You'll notice that we are very focused blood sugar numbers here. So good on you for doing the home testing. However, with just a couple of data points, it's impossible for us to say what is happening. In that link I included above in blue, you'll see instructions on how to set up your signature and a spreadsheet to contain those blood sugar test values.

It's quite common for a kitty's numbers to temporarily go up after an increase, in the first couple of cycles. Lantus is a depot insulin, and the depot has to rebuild after an increase.

What is your kitty's name? What are you feeding him? Any other medical conditions or medications he's on? Some of those can impact blood sugars.
 
Welcome to fdmb! Wendy has already given you grate advice!

I'd like to say:
WELCOME TO OUR FAMILY:bighug:

Theres a ton of information here with good people to help you navigate it all.

We look forward to getting to know you and your extra sweet kitty.
jeanne
 
Hello!

Please see my signature for the information you requested. I know the spreadsheet doesn't have much. I've only just started and I'm open to any guidance.

For some background information, he was diagnosed about a month ago during a routine check-up, and the vet started him off on .5 unit, twice a day of Lantus. After about a week and a half, they did a curve test at the vet and his numbers were not low enough. They had me increase to 1 unit, twice a day. I did that for 2 weeks and on 11/8 I did an at-home curve test at the instruction of the vet. You can see the numbers on the spreadsheet. The vet was concerned with those numbers as well, so he had me increase to 1.5, twice a day. And that's where we're at now. I did notice, after 6 cycles on the new dosage of 1.5, his 6 hours post insulin number decreased by nearly 100 points. That seems promising. The vet was hoping to get his numbers in the late 200s or somewhere in the 300s.

To answer the other question regarding medication, he is on prednisolone for his IBD, and I also think it helps his arthritis. The vet mentioned switching the prednisolone to budesonide when his glucose numbers are stabilized, but I'm concerned it will cause his arthritis to give him pain again, so we'll see what happens with that. I don't want him to be in pain, either. In addition to the prednisolone, he is on some supplements (salmon oil, dasuquin) and feline cbd oil to help with arthritic pain.

Other medical conditions: FIV+ and urinary crystals (not presently an issue and hasn't been for a few years, but still plays a part in what I can feed him). He's a tough case, has so many things going on. Due to his history of urinary crystals, he's on a wet food diet except for sometimes a little scoop of dry food (Royal Canin hydrolyzed protein/urinary). For wet food, I feed him a variety of high quality, grain-free food in different flavors and brands.

On 11/8, the 579 number, that was pre-morning feeding and pre-insulin. I hope I did that correctly. I also feed him little meals throughout the day because the prednisolone makes him hungry. Not sure if that's impacting the results of the curve tests and if I should do something different in the future.

Any suggestions or advice are welcome! Thank you so much.
 
Boy Max does have a lot going on but take heart there are many cats here that do as well. We'll do our best to help you get your sweet Max sorted. I do know that steroids can induce diabetes. There ARE ways to work around that.

Your spreadsheet ...theres a share button somewhere. You need to click that. Sorry I'm not versed at all about spreadsheets.
If you are still having problems there are people that can help.
All you need do is ask! ;):bighug:
 
Mayo377 said:
Hmm well I’m totally stumped on what I’m supposed to do. I followed those directions. Can you see my signature? What does it do when you click on the spreadsheet?
Click to expand...
It says I need permission. Did you publish to the web? If you do that then copy the url to paste in your signature then it should work.
 
Well.... A couple of thoughts.

It's very likely that the prednisolone is raising Max's BG numbers. Steroids will cause an elevation in BG. Budisonide works differently and may have less of an effect on your cat's numbers. How much of the prednisolone are you giving Max and for how long? The Royal Canin dry is also crazy high in carbohydrates. You may want to reconsider using it with a diabetic cat.

What are you feeding Max? With many IBD cats, they do well on novel proteins. There are a number of novel proteins that are also low in carbs. Many of the food choices for a cat that's prone to crystals, it may be more a. matter of getting more water into your cat's diet. This is a link to information on urinary tract issues that's written by a vet who has done considerable research on feline diet.

I'd like to encourage you to take a look at the sticky notes at the top of the Lantus board. There's a great deal of information there about Lantus, dosing, etc. Once you feel comfortable with the basics (what to feed, testing, etc.), you may want to think about posting over on the Lantus board. (I'm not sure where Wendy moved your post from -- generally people start out here on Health.)

Please let us know if you have questions. We're here to help.
 
Thank you for your response.

Trying to balance all of his medical issues is like trying to keep 6 balls up in the air and never letting them drop. It’s challenging, and frustrating, and probably led to him even having diabetes.

Let me explain...

I’m well versed in urinary blockage issues. That might be one of his few medical issues that feels under control right now. He’s on a mostly wet food diet, and yes, we add lots of extra water to each meal. The wet food, which addresses his urinary issues, is not good for his IBD. That’s where the prednisolone and RC dry food comes in (which are the likely culprits for his diabetes to begin with). It’s a mess, I know.

Switching steroids will be good for his diabetes and likely not impact his IBD either way, but won’t be good for his nearly debilitating arthritis (when not on pred). I’m willing to give it a try, however. And look into whether there’s a different medicine that we can switch him to for his arthritis. I just don’t want him to be in pain.

His prednisolone dosage is 5 mg a day, 2.5 in the am and 2.5 in the pm. Any less than that and his IBD flares up, as does his arthritic pain. I agree that I need to transition him off of the RC. Hopefully between that, and changing his steroid, his diabetes will be more manageable and not flare up his IBD. I’m not so worried about the IBD except it going untreated can lead to cancer. So I don’t know. I’m just trying to do the best for him but there’s so much to balance.

I think my immediate next step is to research good wet food diets for diabetic cats and go from there. If anyone has any suggestions or links, I’d be very interested. And then of course, continue with the plan of transitioning him off the RC and eventually changing steroids.

I will check out the Lantus board more in depth as well. Thank you!
 
Hey there,

you may want to look into Adequan injections for the arthritis issue. They've been really helpful for my cat Emily.

As others have said, budesonide can be a good alternative to prednisolone for IBD; it's an intestinal-specific steroid that has much less effect on blood glucose levels. My kitty Emily unfortunately has inflammation in too many places, so budesonide isn't an option for her... but a lot of diabetic cats with IBD do really well on it!
 
THH said:
Hey there,

you may want to look into Adequan injections for the arthritis issue. They've been really helpful for my cat Emily.

As others have said, budesonide can be a good alternative to prednisolone for IBD; it's an intestinal-specific steroid that has much less effect on blood glucose levels. My kitty Emily unfortunately has inflammation in too many places, so budesonide isn't an option for her... but a lot of diabetic cats with IBD do really well on it!
Click to expand...

Thank you! I’ll look into that.
 
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