New here, 6yo cat diagnosed in Sept, advice welcomed please!

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Lisa & Snax

Member Since 2022
Hi all!

This forum has been helpful to read through, but I’m at a loss with my problem child (one of two, littermate brother and sister). I’d love to hear if anyone else has been so stressed and had so many issues finding a safe dose!

Snax is now six and a half, and he was diagnosed back in September ‘21 from me noticing things were amiss in late August. He immediately went on a glargine pen 2x per day, 3 units. That quickly went down to 2 since he reacted strangely to it. Glucose curves at the vet haven’t been helpful because he spikes during stress.

In December, he was down to .5 unit 2x per day, curving well, but occasionally going too low for comfort. I take his curves every few weeks with an AlphaTrak II. He’d be 130s down to 80s, sometimes 60s or lower. Vet did a home visit early January and he was super low, so experimentally we went off insulin for a week and a half in case he hit remission (nope…). Hopped back on insulin 1x per day.

Last week’s curve was too high with once daily .5 unit (320s down to 220s at the lowest point), so the vet said do .5 unit 2x per day. First time checking since the switch, this morning before breakfast and insulin, he was in the 420s! Three hours after shot, only down to 350.

Does anyone know why the BG would spike like that? Am I doing something wrong? Gets his insulin at 7:30am/pm on the dots. He gets a can and a half of Fancy Feast pate at both breakfast and dinner. About 5 kibble pieces of Orijen high protein kibble just for something to crunch, and his treats have been switched to freeze dried meat. His weight fluctuates between 14lbs and 14lbs 4oz. His urine clumps are pretty big, but no excessive drinking or urinating. He’s looking better, but still a bit skinnier in the hips than I’d like. He acts well, is playful and alert pretty often. His last kidney/liver/fructosamine blood panel was good on 1/17/22.

Has anyone else had so much trouble? I’m in a constant state of stress, worried he’s getting irreversible damage by being so all over the place. I have two different vets to confer with, but they’re so overworked it’s hard to get straight answers (talking directly to the vet is super rare, at best my questions sort of get answered through reception staff) and I feel pretty alone and up a creek with this!

Any words of advice or encouragement, and/or similar anecdotes and outcomes, would be so very appreciated!

Lisa & Snax (and sister Yoda)
 
Hi Lisa,

Sending you tons of empathy and solidarity. So many of us here have experienced the fear, uncertainty and stress of all of this! Keep posting and reading here. The experienced members are so kind and full of knowledge. I can personally say they have saved Landos life and my sanity ;)

my one piece of advice before an experienced member weighs in, is that taking testing into my own hands gave me the information and control i needed to help Lando. I have other thoughts, but better that the pros get to you first ;)

Good luck hang in there and stick around!
 
Thanks Lando! Or Lando’s owner :)

I’ve definitely taught myself how to test (well, it’s still a bit of a two person job, but I can do it solo when it’s called for). He only had one full curve day at the vet, it didn’t take long to figure out his BG reads were artificially high due to stress, so home testing it is. Knowledge is power, but geez Louis, sometimes it seems that the more I know the more I stress!

Your empathy and solidarity are more appreciated than you probably know right now!
 
Thanks Lando! Or Lando’s owner :)

I’ve definitely taught myself how to test (well, it’s still a bit of a two person job, but I can do it solo when it’s called for). He only had one full curve day at the vet, it didn’t take long to figure out his BG reads were artificially high due to stress, so home testing it is. Knowledge is power, but geez Louis, sometimes it seems that the more I know the more I stress!

Your empathy and solidarity are more appreciated than you probably know right now!
I think i understand, i felt like i was in your shoes Aug2021!
Keep being gentle with yourself- chelsea
 
Welcome to FDMB.

If I had to play a hunch, those spikes you're seeing are what we refer to as "bounces." Snax numbers may have dropped lower than you were aware of and as a result, his liver and pancreas release a stored form of glucose along with counterregulatory hormones which both contribute to the spike in numbers. But, that's a guess on my part.

What I would suggest is that you get more test data. The only way to know for sure what's happening is to test on a regular basis. I couldn't tell from your first post whether you're getting pre-shot tests let alone spot checks. In addition, we don't advise that you the needle tips on the pen. We make dose changes in 0.25u increments which is not possible with the pen. You also have to prime the pen which means you're wasting insulin and Lantus is not cheap! You can ask your vet for a prescription for syringes. (You want U-100 3/10cc syringes with half unit markings.) I also suspect that if you have a better idea of where Snax numbers are, you'll feel less stressed.
 
Thanks Sienne! I’m actually just catching this now, tiffmaxee so kindly linked it to my post this morning!

I use a Basaglar pen (affordable for the most part, and next pen I’ll be switched back to a glaring generic pen at half the cost), and use regular draw syringes with that so can get .25 and anywhere in between.

I try to test regularly, which have tended to be a pre-shot pre-breakfast test (the numbers in my initial post are AMPS), and have done plenty of glucose curves with checks every 2 hours. He was curving beautifully if not a touch low all the way from September to early January when we took him off insulin.

I unfortunately have a very time-consuming and varied-schedule job away from home, so any curves or multiple-test days are limited to the weekends.

I’ll update the forum with his curve this upcoming weekend, but here are sample curves:

Dec 5th, on .5 units twice a day:
7:30am: no test, fed breakfast, gave 1.5 units of insulin
8:30am: 119
10:30am: 74
12:30pm: 88
2:45pm: 79
5:00pm: 79
7:00pm: 74
Dinner and insulin at 7:30

He had been around those numbers in previous curves as well.

Then here’s a curve from 1/30, after he had been off insulin for two weeks and then back on .5 unit once per day (vet ordered) on 1/21:
7:15am: 329
7:30: breakfast and .5 insulin
9am: 274
11am: 283
1pm: 252
3pm: 222
5pm: 250
7pm: 295

And now his AMPS spot checks are consistent with that 300s range.

Again, I’ll update the forum with the new curve this weekend. I’m just worried I did something bad by taking him off insulin and resetting him like this!
 
Hi there, I am very new to all this as well. Sorry to hear of your struggles with Snax. Welcome to the club, this place is like a life-preserver thrown to a drowning person!! No joke. @FrostD @Bron and Sheba (GA) @tiffmaxee and many others have all saved me!

I will let the experienced folk here chime in but I will tell you that in the month or so I've been reading this forum, I have seen similar stories to this where the kitty was taken off of insulin suddenly and then they are right back on it within a few weeks. There are methods recommended here where you reduce gradually and even sometimes shoot like .1 unit for a period of time until finally going what they call "OTJ" or off the juice.

This group is very numbers driven. For the most help, set up a spreadsheet with all the test values and link it in your signature so everyone can look at it and offer advice, see this post here:

https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

And this one:

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
 
Welcome! By chance has anything happened recently - infection, illness, surgery, steroids, etc?

Like others have said tests are best. It is entirely possible that curve on 1/30 was a bounce from lower numbers, we just don't know at the moment. The once a day dosing also doesn't help, I'm not quite sure why the vet advised that? Once the duration is over, that's it, numbers climb back up. Glargine (Lantus, basaglar) is intended to be dosed 2x a day, 12 hrs apart in cats
 
Hi there, I am very new to all this as well. Sorry to hear of your struggles with Snax. Welcome to the club, this place is like a life-preserver thrown to a drowning person!! No joke. @FrostD @Bron and Sheba (GA) @tiffmaxee and many others have all saved me!

I will let the experienced folk here chime in but I will tell you that in the month or so I've been reading this forum, I have seen similar stories to this where the kitty was taken off of insulin suddenly and then they are right back on it within a few weeks. There are methods recommended here where you reduce gradually and even sometimes shoot like .1 unit for a period of time until finally going what they call "OTJ" or off the juice.

This group is very numbers driven. For the most help, set up a spreadsheet with all the test values and link it in your signature so everyone can look at it and offer advice, see this post here:

https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

And this one:

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/


Thank you for the solidarity and support! Bandit’s mom got me set up with a spreadsheet. It’s definitely even more overwhelming than I expected…Snax doesn’t like getting his ears poked and it’s very hard to do myself, though I know we have to learn. Currently, my partner (who has a severe needle phobia, but he has been lovely at helping with insulin when I’m not home) holds him and I poke/read. Problem being that he leaves for work at 6:30am and is back at 5pm, I go to work any time from 8am to 12pm and am home from 7pm to 9:30pm. Breakfast and dinner are at 7:30. It makes it very difficult to plan for so many readings!
 
Welcome! By chance has anything happened recently - infection, illness, surgery, steroids, etc?

Like others have said tests are best. It is entirely possible that curve on 1/30 was a bounce from lower numbers, we just don't know at the moment. The once a day dosing also doesn't help, I'm not quite sure why the vet advised that? Once the duration is over, that's it, numbers climb back up. Glargine (Lantus, basaglar) is intended to be dosed 2x a day, 12 hrs apart in cats

Hello! Nope, nothing had happened. In fact, he had just gotten an annual checkup a month before he got sick with diabetes, and everything was well (except there were no blood tests, so maybe something was lurking).

The curve on 1/30 was just after hopping back on insulin after being off for a couple weeks, during which time I saw him getting thinner and urinating bigger clumps. A week and a half into no insulin, he had a fructosamine test which came back high. So I’m not sure where the BG dip would’ve been to bounce it back up, but it seems possible!

And the once a day shot was actually suggested by two different vet practices because he’d been dipping too low on limited insulin. He’s got a full service vet practice and a house-call one! We’re obviously back on 12 hour shots now.
 
Ok gotcha. I think vets don't trust caregivers to do those small doses, but as was mentioned we usually taper from 0.5U, down to 0.25U, down to 0.1U, then possibly a drop dose. They can be hard to measure, a lot of people here like calipers (Mr Kitty was never on a small enough dose for calipers to matter :rolleyes:)
 
Snax doesn’t like getting his ears poked and it’s very hard to do myself

this forum has been invaluable to me for that

just a few short weeks ago I could not imagine ever doing it solo. Hell, we couldn't do it at all. Then we found this forum and all the helpful videos, tips, tricks, suggestions, hints, and personal experiences.

we picked a pokey spot and stuck with it, we started giving a Whole Life One Ingredient freeze-dried chicken treat every time, ditched the lancing device and it's loud click and went freehand, started singing a song, using the vaseline, a headlamp LED light and also sometimes another flashlight shining from behind. And it worked. Especially those freeze dried chicken treats LOL! Man the cats go nuts for em
 
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