High reading

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NadineTheodore

NadineTheodore

Member Since 2023
Hi,

I got home late (30mins) and I got his dose in right away. Normally I give him insulin at 9AM/PM and do the reading 15 mins before. I normally give him food 2 hours before, if he doesn't get regular feedings, his number goes out as he get stressed.

I got home, did a reading and it was 716.4!!! I gave him his insulin right away and fed him, 10 minutes later it shows 471.6---does insulin work that fast???

I retested just now (2 hours later) and it's back to 716.4! I had glitches with my meter so I took another one which verified he is around that range. Is it possible the insulin shot didn't go in him? Or that the insulin is bad (purchased end of May). It should have decreased now per his previous curves... I am really worried, he's never been this high. I didn't think 30 minutes late would send him off so much :(

Is there anything I can do to lower his number

https://docs.google.com/spreadsheets/d/12xCz_cP0ZAXkPKv3s_0DG4mAJv1WbMn77XQ-mkr5nbA/edit?usp=sharing
 
Hi Nadine
I would say Theo is most likely bouncing.
You have no tests done during the last 5 cycles except for the one just now so we don’t know if he could have been dropping too low, too fast or lower than he is used to.
Try and get some tests in during one of the cycles everyday if possible.
If it is bouncing and I suspect it is, there is nothing you can do except wait it out as bouncing can last for up to 6 cycles. Just make sure he is eating and has plenty to drink. it is also a good idea to test a few times a week for ketones in the urine in unregulated cats. For this you need a bottle of kit from Walmart or a pharmacy.
Here is an explanation on bouncing which is quite normal in newly diagnosed diabetic cats
  • 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).
 
Nadine --

I removed the 911. We typically don't use that notation unless it's a potentially life threatening emergency. The high numbers are worrisome, so I do understand.

Please remember to get a ketone test given the high numbers. Given the variability, I'd try to get a few more tests in to try and sort out if it's a meter issue or not. Also, make sure that you don't need new batteries in your meter. (New batteries is a long shot but if you so need batteries, it may be why the numbers are weird.)

I'd also suggest that you give some thought to following the Tight Regulation Protocol for dosing Theo's diabetes. TR will allow you to raise Theo's dose more quickly and given the high numbers (not just today) and history of DKA, I think TR is a better option for your kitty. If you do opt to follow TR, you will need to get at least one test in addition to your PMPS every evening.
 
Bron and Sheba (GA) said:
Hi Nadine
I would say Theo is most likely bouncing.
You have no tests done during the last 5 cycles except for the one just now so we don’t know if he could have been dropping too low, too fast or lower than he is used to.
Try and get some tests in during one of the cycles everyday if possible.
If it is bouncing and I suspect it is, there is nothing you can do except wait it out as bouncing can last for up to 6 cycles. Just make sure he is eating and has plenty to drink. it is also a good idea to test a few times a week for ketones in the urine in unregulated cats. For this you need a bottle of kit from Walmart or a pharmacy.
Here is an explanation on bouncing which is quite normal in newly diagnosed diabetic cats
  • 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).
Click to expand...
Thank you for the explanation, I thought it was maybe because I was 30 minutes late since I know it's important to administer on a tight schedule and panicked. Theodore does not have any ketones, I did a urine test yesterday. I guess he just likes to give his mom scares.:confused:
 
Sienne and Gabby (GA) said:
Nadine --

I removed the 911. We typically don't use that notation unless it's a potentially life threatening emergency. The high numbers are worrisome, so I do understand.

Please remember to get a ketone test given the high numbers. Given the variability, I'd try to get a few more tests in to try and sort out if it's a meter issue or not. Also, make sure that you don't need new batteries in your meter. (New batteries is a long shot but if you so need batteries, it may be why the numbers are weird.)

I'd also suggest that you give some thought to following the Tight Regulation Protocol for dosing Theo's diabetes. TR will allow you to raise Theo's dose more quickly and given the high numbers (not just today) and history of DKA, I think TR is a better option for your kitty. If you do opt to follow TR, you will need to get at least one test in addition to your PMPS every evening.
Click to expand...

Thank you and my apologies about the 911.

I did a ketone test and he did not have ketones (thankfully). I would love to switch to tight regulation but I do give him about two table spoons of dry food although it is almost all wet food. The reason I give a tiny bit of the dry is it helps with his Megacolon, every time I try to remove it, he gets blocked. Given it's such a small amount of food, do you think I could still try for the tight regulation? The testing is no issue. He's a large cat and eats a lot. He used to be 20lbs at his heaviest. 19.8lbs to be exact when I first got him (extremely bulky) and then we got him down to 16 lbs which I felt looked good on him. He's now 14lbs and feels too skinny to me.
 
Let me run your question past a few of the experienced Lantus people. When a cat has a history of DKA, we tend to focus more on preventing a recurrence than anything else. However, given the more aggressive nature of TR, there was a reason for the no dry food mandate. What dry food are you feeding Theo?

If he's lost weight, you may want to consider increasing the amount you're feeding him. Given his numbers, I suspect he's ravenous.
 
I’m giving him Dr. Esleys but I can look into changing it if needed. I give him food whenever he asks to be honest (WET) - dry is only 2 table spoons. He has muscle loss on his back I hope gets reversed once we get this under control
 
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Nadine -

In discussing Theo with some of the experienced Lantus members, their thoughts were similar to mine. With the history of DKA and Theo intermittently sitting in high numbers, we are thinking of "fast tracking" his dose. However, there is a caveat. You must consistently get a minimum of 4 tests daily -- your 2 pre-shot tests and at least one test during both the AM and PM cycles. You're generally pretty good about the AM tests. The PM testing needs more frequency and regularity. If you want to be more aggressive about dosing, it also means you need to be more aggressive about safety.

Rather than evaluate the dose on a 7-day basis, we're suggesting that the dose be evaluated every 3 days/6 cycles. If you follow SLGS, it will take too long to get Theo's numbers into a better range. Once the numbers are at a better point, we can slow things down if you prefer.

Please let us know what you think of this plan.
 
Wendy&Neko said:
Are you entering BG numbers just into the US tab of the spreadsheet now? If you enter into the World version, it should do the conversion for you. Some of us here still read World BG numbers.

The link to your last post here, included for continuity and for people to be able to see some history: https://felinediabetes.com/FDMB/threads/upped-dose-with-small-response.279262/
Click to expand...
Thank you for bringing that up. I was just converting it and then entering it online. I didn't realize there's a second tab! I will use the world tab going forward.
 
Sienne and Gabby (GA) said:
Nadine -

In discussing Theo with some of the experienced Lantus members, their thoughts were similar to mine. With the history of DKA and Theo intermittently sitting in high numbers, we are thinking of "fast tracking" his dose. However, there is a caveat. You must consistently get a minimum of 4 tests daily -- your 2 pre-shot tests and at least one test during both the AM and PM cycles. You're generally pretty good about the AM tests. The PM testing needs more frequency and regularity. If you want to be more aggressive about dosing, it also means you need to be more aggressive about safety.

Rather than evaluate the dose on a 7-day basis, we're suggesting that the dose be evaluated every 3 days/6 cycles. If you follow SLGS, it will take too long to get Theo's numbers into a better range. Once the numbers are at a better point, we can slow things down if you prefer.

Please let us know what you think of this plan.
Click to expand...
I'm on board! I will be testing min. 4 times a day. I'll start tomorrow :) I am so eager to help him and get him back to feeling good. Should I just continue posting on this thread for help regarding dose advice?
 
I think you could start posting over on the LLBpage from tomorrow. Everyone there uses a depot insulin and there are more people to help you.
Here is the link to how to post on the LLB page
I would say in the Subject line “7/10 Theodore AMPS XXX FIRST POST LLB. Recent history DKA”
That will alert people you are new and may need help.
Unless he drops into a blue BG overnight I would increase the dose to 2.75 U in the morning.
 
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Bron and Sheba (GA) said:
I think you could start posting over on the LLBpage from tomorrow. Everyone there uses a depot insulin and there are more people to help you.
Here is the link to how to post on the LLB page
I would say in the Subject line “7/10 Theodore AMPS XXX FIRST POST LLB. Recent history DKA”
That will alert people you are new and may need help.
Unless he drops into a blue BG overnight I would increase the dose to 2.75 U in the morning.
Click to expand...
I just saw this post after I gave him his insulin but how do I give .25 units? Mine only goes full and half units
 
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