Higher dose but higher BG too?

[Catrina]

Hi all

molson has been on insulin for almost two months now. I know it’s still early… he was on 1.75u and it seemed to be helping his bg when comparing to his other doses, but then once we put him to 2u his numbers have shut up… is this normal? It is so discouraging and it’s hard not to get upset that he’s not showing any improvement. It makes me want to increase his dose more. When he was on 1.5u it was his first and only times he has ever been in the green, ever since then his numbers have been so high and I’ve only been increasing his dose..

Any input would really help. I’m feeling discouraged and not sure what else I can do.. increase his dose more maybe? Although that’s not following the SLGS. I would love to do the TR but I have a newborn baby and can’t guarantee that I can consistently test him

 

[Bron and Sheba (GA)]

Hi Catrina
Do you think you could get some tests in during the pm cycles? At the moment we don't really know what is happening for half of the time.
Even a before bed test each night would be helpful.
It is possible Molson is dropping lower at night and then bouncing back up during the day.
If you want to do TR you would need to get at least one test in every cycle as well as the preshot BGs.
Do you give him snacks during the day and night?

 

[Catrina]

I give him breakfast lunch and dinner and then I give him a snack around 9-10pm

I could try a before bed shot but that would be around +3 is that too close to his shot?

 

[Bron and Sheba (GA)]

could try a before bed shot but that would be around +3 is that too close to his shot?

You mean a before bed BG test, right.? Not a shot…
+ 3 will give us good information. If it is quite a bit lower than the preshot that can mean it’s going to be an active cycle and could drop quite a bit lower. So you might like to get up and test again if that happens.
The snacks you mention sound good.

 

[Catrina]

You mean a before bed BG test, right.? Not a shot…
+ 3 will give us good information. If it is quite a bit lower than the preshot that can mean it’s going to be an active cycle and could drop quite a bit lower. So you might like to get up and test again if that happens.
The snacks you mention sound good.

Yes a test not shot! Lol

okay I will start to try and do more +3 in his pm cycle. The times I have his numbers don’t drop that much though but maybe I just haven’t done them enough

I feel like his bg numbers actually go up after he gets his shot or it barely goes down now. Whereas when he first started on insulin he would get a clear curve, dropping and then rising after the insulin starts wearing off. It’s almost like the higher dose isn’t working as well…

 

[Catrina]

You mean a before bed BG test, right.? Not a shot…
+ 3 will give us good information. If it is quite a bit lower than the preshot that can mean it’s going to be an active cycle and could drop quite a bit lower. So you might like to get up and test again if that happens.
The snacks you mention sound good.

I did a test +3 on his pm cycle. He is higher than his on ore shot. I don’t understand how the insulin is bringing his bg higher. I’m wondering if it’s his food? I feed him fancy feast. But his numbers just seem so high and the insulin doesn’t seem to bring his numbers down at all only higher if anything…

it’s so frustrating because I don’t understand how when he first started his bg would drop after insulin, now it increases. And I know he could be bouncing but he’s not even that low to be bouncing?

 

[Bron and Sheba (GA)]

Until we can see more tests taken during the cycles, we can’t tell if Molson is dropping during the cycles and then bouncing back up.
Keep trying to get at least one test in during every cycle so we can see if there is a parent there. Tests taken in isolation don’t really tell us much. I know it is frustrating, but Molson is still a fairly new diabetic and it can take time for them to settle down. Some cats do it quickly but many others take a few months.
Are his teeth OK?

 

[Catrina]

Until we can see more tests taken during the cycles, we can’t tell if Molson is dropping during the cycles and then bouncing back up.
Keep trying to get at least one test in during every cycle so we can see if there is a parent there. Tests taken in isolation don’t really tell us much. I know it is frustrating, but Molson is still a fairly new diabetic and it can take time for them to settle down. Some cats do it quickly but many others take a few months.
Are his teeth OK?

But I did a test +3 during his pm and he was 18.6 when his preshot was 14 how can his bg go up after receiving insulin to me that seems like the insulin is doing the opposite of what it should be doing. Lately the insulin seems to not really bring his bg down

I used to only feed him fish fancy feast cuz it was the lowest in carbs and during that period his bg would go down after insulin. Since then I switched to more of a mix since I was told that only feed fish is bad. But I’m now wondering if the other flavours (Turkey, beef etc) which are slightly more carbs, if that’s what’s bringing his bg up.


his teeth are good, even when I brought him to the vet they said his teeth are good

 

[Bron and Sheba (GA)]

If he is bouncing from lower numbers earlier in the cycles, he can go up after getting insulin. Have a look at other peoples SS to give you an idea of what can happen. The BG does not go down every time a cat gets insulin.
As I said in an earlier post we need to see more BGs taken during the cycles to see what is happening.
I doubt it has anything to do with the food, if the food you are feeding is low carb.
I know how frustrating it is. FD is a journey not a race and unfortunately the cat calls the tune.

 

[Catrina]

If he is bouncing from lower numbers earlier in the cycles, he can go up after getting insulin. Have a look at other peoples SS to give you an idea of what can happen. The BG does not go down every time a cat gets insulin.
As I said in an earlier post we need to see more BGs taken during the cycles to see what is happening.
I doubt it has anything to do with the food, if the food you are feeding is low carb.
I know how frustrating it is. FD is a journey not a race and unfortunately the cat calls the tune.

Do you know how I can look at other peoples spreadsheets? I know how to view yours since you’re in this chat but not sure how to search. Or do I just look at other chats?
Today I’m doing a curve and he is higher than his preshot which is discouraging but to your point I didn’t test in the middle of the night so he could have gone lower and bouncing from that

 

[Sienne and Gabby (GA)]

Everyone has a spreadsheet in their signature. Just go to a thread that seems to have a lot of people responding and click on different member's spreadsheet links.

There can be a variety of reasons that numbers go up after you give insulin. Having more mid-cycle and PM data will help us to help you figure out what's going on.

 

[Catrina]

Everyone has a spreadsheet in their signature. Just go to a thread that seems to have a lot of people responding and click on different member's spreadsheet links.

There can be a variety of reasons that numbers go up after you give insulin. Having more mid-cycle and PM data will help us to help you figure out what's going on.

How many more tests do I need to do mid cycle ?

I tested him this cycle and still, his numbers are going up after receiving insulin NOT down. I don’t understand, shouldn’t the insulin bring his bg down then like a curve, it used to but now all of a sudden it seems like the insulin is bringing it up and once it starts wearing off is when his bg goes down

 

[Bron and Sheba (GA)]

How many more tests do I need to do mid cycle ?

I tested him this cycle and still, his numbers are going up after receiving insulin NOT down. I don’t understand, shouldn’t the insulin bring his bg down then like a curve, it used to but now all of a sudden it seems like the insulin is bringing it up and once it starts wearing off is when his bg goes down

If you get a test in the pm cycle around +3 or +4 and that BG is higher than the preshot BG, then it is unlikely the BG will drop low, so I would not bother testing again that cycle. But if the BG is lower than the preshot, then it would be worth while getting another test an hour or two later, depending on how far the BG has dropped at the first test. If it has dropped a lot, it would be worth while testing again within an hour or two and later if the drop is not great.
Here is an explanation about bouncing. You will see there are a few reasons a cat might bounce, and bounces can last from 1 to 6 cycles.
Once we see more data that will help with finding out what is happening. What Molson is doing is not unusual.

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

[Catrina]

If you get a test in the pm cycle around +3 or +4 and that BG is higher than the preshot BG, then it is unlikely the BG will drop low, so I would not bother testing again that cycle. But if the BG is lower than the preshot, then it would be worth while getting another test an hour or two later, depending on how far the BG has dropped at the first test. If it has dropped a lot, it would be worth while testing again within an hour or two and later if the drop is not great.
Here is an explanation about bouncing. You will see there are a few reasons a cat might bounce, and bounces can last from 1 to 6 cycles.
Once we see more data that will help with finding out what is happening. What Molson is doing is not unusual.

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

He has bounced before many times, but only if he has a low number. He hasn’t had a crazy low number and he only increases after he gets insulin (even if he doesn’t get a low bg) and then once the insulin starts wearing off is when his bg starts to decrease but shouldnt it be the opposite? It’s like his curves have gone the opposite way now after recieving insulin where it gets higher not lower.

 

[Bron and Sheba (GA)]

He has bounced before many times, but only if he has a low number. He hasn’t had a crazy low number and he only increases after he gets insulin (even if he doesn’t get a low bg) and then once the insulin starts wearing off is when his bg starts to decrease but shouldnt it be the opposite? It’s like his curves have gone the opposite way now after recieving insulin where it gets higher not lower.

You haven’t been testing enough during the cycles to say he hasn’t had any crazy low numbers…and if you look at the definition of bouncing, a cat doesn’t have to drop very low to bounce. A lower BG than a cat has been used to lately can trigger a bounce. So if a cat has been used to BGs in the 300 and 400s, a drop into the 200s can cause a bounce. And also a fast drop can trigger a bounce. We can’t see any of that in Molson SS yet as there is not enough testing during the cycles? Does that make sense?

If you look at the blue preshots he has had in the mornings…those BGs are on the rise, so you can almost guarantee that during the previous pm cycle, the BGs dropped lower than the following am preshot BG.

 

[Sienne and Gabby (GA)]

Bouncing doesn't always occur as a result of an unusually low number. Bounces also happen if the number is lower than what your cat is used to or they can happen if there's a fast drop in numbers. Many cats tend to experience lower numbers at night (many cats are more nocturnal) which it's why it's important to have some clue as to what's going on at night.

I realize I'm duplicating what Bron has said. Most newer members have a hard time picking up when bounces are occurring other than if numbers drop low. The bouncing is annoying!