PLease Advise! So Confused with BG levels.

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Hadaza

Hadaza

Member Since 2023
I'm feeling quite disheartened. I don't understand this sugar dance. I'm worried about Calcifur having such high bg levels consistently. I increased his dose to 2 units from 1.5 and his gb dropped below 90. So I decreased to 1.75 and now he's staying mostly in the reds and blacks.

Would ya'll please look at his SS? In the spreadsheet remarks I post all his food intake and other important info. I'm so confused and worried. At what point do I increase? Can he go into DKA if his numbers stay this high? Please help me understand? I just wanna sob! :(
 
I've been reading up on Bouncing with my partner and we wanted to try changing his feeding schedule.

Right now, my idea is to spread out his feeding from 2 meals into 5, to help his glucose levels be more even throughout the day. Hopefully this will help prevent bouncing from starting again.
We want him to eat about 200 calories (low carb of course), from mostly raw meat. So we figure:
60 calories 15 minutes before first (AM) 12 hour insulin shot (prozinc 1.75U),
25 calories 3.75 hours later (at +3.75),
25 calories at +7.5
60 calories 15 minutes before PM insulin (prozinc 1.75U),
30 calories at +4.5

Let me know if you see anything wrong with this!
 
Feeding twice a day is only really good for dogs who have a lower metabolism than cats. Most of us feed the 2 largest meals around shot time and smaller meals and/or treats throughout the day. It does help avoid big sugar spikes and it’s easier on their pancreas. Bouncing, however, is caused by your cat reacting to a lower than usual bg value not food. What’s his ideal weight? If you’re feeding 200 calories a day, I assume he’s 10 pounds right? The rule of thumb is ideal weight x 20 = daily calorie intake.
 
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You do not want to feed your cat anything 2 hours before shot time. Feeding in the 2 hours prior to shot time will artificially inflate the pre-shot number. Rather than feed 15 min. before you give insulin, most of us will test, feed, then shoot. Feeding your cat after nadir may cause the numbers to rise faster than is really desirable. Remember, after nadir, the effect of insulin is beginning to wear off and food will cause a rise in numbers. Whether you feed after nadir depends on how hungry Calcifur is. I agree with Ale that there's no real need to feed your cat only twice a day. You can spread out the meals.

What you're seeing on your spreadsheet is bouncing. Every time Calcifur drops below 200, the numbers spike back up. Bounces take approximately as long as 3 days to clear. Please be aware that it is very unlikely that changing how your feeding your cat will have an effect on a bounce.
 
Ale & Bobo & Minnie (GA) said:
Feeding twice a day is only really good for dogs who have a lower metabolism than cats. Most of us feed the 2 largest meals around shot time and smaller meals and/or treats throughout the day. It does help avoid big sugar spikes and it’s easier on their pancreas. Bouncing, however, is cause by your cat reacting to a lower than usual bg value. What’s his ideal weight? If you’re feeding 200 calories a day, I assume he’s 10 pounds right? The rule of thumb is ideal weight x 20 = daily calorie intake.
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Actually, I think his ideal weight is 16 pounds, hes a pretty big cat and he weighed 21 pounds before we changed his diet to low carb.
We thought the formula for daily calorie intake was closer to ideal weight X 15, so we will feed him more now.
Thank you for the info!
 
Hadaza said:
Can he go into DKA if his numbers stay this high?
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This is an important question. Are you testing for ketones at home? There are two ways to do this. One is to buy a blood ketone meter and test for ketones. The second is to purchase ketone strips that are put in the urine stream while he's using the litter box. Ketones in and of themselves will not cause a cat to go into DKA -- usually there will be another factor such as an infection. If your cat is eating well and drinking normally (some cats don't drink much if they're on a wet diet) and has normal behaviour -- is not lethargic or vomiting, then DKA isn't in the picture. We would work to try to get the ketones down though.
 
Suzanne & Darcy said:
This is an important question. Are you testing for ketones at home? There are two ways to do this. One is to buy a blood ketone meter and test for ketones. The second is to purchase ketone strips that are put in the urine stream while he's using the litter box. Ketones in and of themselves will not cause a cat to go into DKA -- usually there will be another factor such as an infection. If your cat is eating well and drinking normally (some cats don't drink much if they're on a wet diet) and has normal behaviour -- is not lethargic or vomiting, then DKA isn't in the picture. We would work to try to get the ketones down though.
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Ive been testing ketones and glucose with the ketodiastix everychance I get. Usually once a day. He has trace amounts (smallest levels shown on strip) of ketones and high amounts of glucose.
 
I really just want to say that I see how distressing it is to look at his spreadsheet and feel so powerless to get those numbers down right now. It really is scary to see so many reds and blacks. I understand. I haven't forgotten what this feels like and to feel like everything you are doing just isn't helping. I remember all of this and more. We are here for you. I really do feel confident that if you can follow the protocol that we will see Calcifur in better blood glucose numbers. He must have been in very high numbers for a long time. His body is used to those high numbers and we are having to break through that. He bounces every time he goes into yellow (or lower). His bounces last for quite a while. That is a protective mechanism of his body; this will get better over time. I do agree that changing his feeding schedule to feed multiple small meals through the day (before nadir -- which looks like about +6/+7 for Calcifur) would be better. Later on when he is in lower numbers, this will be especially helpful. As others have pointed out, with ProZinc, you don't need to wait 15 minutes before shooting (although some people who have cats who tend to vomit will do this) the insulin. If he's usually pretty good at eating and keeping things down, then go ahead and give the insulin with breakfast/dinner. I do remember when he vomited dinner a couple of nights ago though. So that is up to you. It won't hurt anything, but just be sure that he hasn't eaten for two hours before you take the morning and evening preshot tests. Hang in there! We will be here to help you.
 
Please don't be tempted to rush the process and increase too quickly. This could not only put him in danger, but it could go just right past his good dose and mess things up. Believe me, as I said, I understand. My cat had plenty of problems responding to insulin. Calcifur is showing on his spreadsheet (believe it or not) that he is responding to the insulin -- or he would not have gotten to a yellow or a blue number from those high reds and blacks. So he CAN respond positively to the insulin. He just bounces A LOT! Very high! He is not the only cat to do this, so it's not really that unusual. But that doesn't make it any easier for you to keep testing and to see those reds and blacks on the spreadsheet. Sometimes it feels really hopeless, I know. But it is NOT. Hang in there!
 
Suzanne & Darcy said:
And unless he's really overweight, I would not stress out too much about overfeeding him. He does not look overweight in his photograph.
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He is 18lbs as of yesterday. He lost 3 lbs in one week after eating a pigeon a week before he was diagnosed with DM. We thought he had a parasite because he lost his appetite turns out he had DM. I believe the vet said they want him at 15lbs but I will confirm this at his next appointment on the 27th of June.
Suzanne & Darcy said:
And unless he's really overweight, I would not stress out too much about overfeeding him. He does not look overweight in his photograph.
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Suzanne & Darcy said:
Please don't be tempted to rush the process and increase too quickly. This could not only put him in danger, but it could go just right past his good dose and mess things up. Believe me, as I said, I understand. My cat had plenty of problems responding to insulin. Calcifur is showing on his spreadsheet (believe it or not) that he is responding to the insulin -- or he would not have gotten to a yellow or a blue number from those high reds and blacks. So he CAN respond positively to the insulin. He just bounces A LOT! Very high! He is not the only cat to do this, so it's not really that unusual. But that doesn't make it any easier for you to keep testing and to see those reds and blacks on the spreadsheet. Sometimes it feels really hopeless, I know. But it is NOT. Hang in there!
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Could his cardiomyopathy have anything to do with the bouncing?
 
Hadaza said:
Could his cardiomyopathy have anything to do with the bouncing?
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I do not see how the cardiomyopathy could cause bouncing. Is he on any medication for this? You should add any medications that he is on -- and any other health conditions that he has -- to your signature. This is helpful to know. What type of cardiomyopathy does he have? Is it Hypertrophic Cardiomyopathy?
 
Yes he is, when I get home I will update the signature will his diagnosis and medications, precisely. I noticed this recently about other’s signatures but I forgot to do this for mine.
 
Bouncing is caused by two things: (1) the cats BG drops below any number that the cat's body is not accustomed to -- this could even be yellow numbers or lower. It does not have to be a "hypo" number -- just any number that your cat isn't used to. For a cat used to being in red and black numbers, a yellow number or a blue number can trigger the bounce response. It's all about what the cat's body is used to.
(2) cats will also bounce if their BG drops very quickly (say, for example, 100 or more points in one hour). This isn't what's going on with Calcifur right now though. This would be the one time where strategic feeding during those hours where certain cats tend to drop really fast will help to prevent bouncing -- again, not what's happening with Calcifur right now.

The cat's body will release stored forms of sugar that will elevate blood sugar and also hormones that will also work to keep the BG high for some time -- the amount of time that cats stay up in a bounce will vary from cat to cat but can last for up to six cycles (3 days). Some cats spend a lot of time in bounces. They will come down and then go back up again for a few days and then go down again and back up into a bounce. It's all a part of the process. The important part is the time they are spending in the lower numbers -- even if it seems like it's not that much of the time.
 
I think you need to increase to 2 units at this point. Yes there is a lot of bouncing going on, but your nadirs are yellow almost exclusively. This dose has been held too long, I think, and that makes it difficult to get things under control.
 
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