WHY is he getting worse???

[Mel Harvey]

Ollie's BG readings are going in the WRONG direction. I don't understand why. I am actually bordering on depression at caring for him. I feel so trapped. Cannot be away for 12 hours. And despite doing everything I have been told to do he is getting worse.

I did a curve today (see spreadsheet). I had to give us both a break from testing over previous weeks as he went from being patiently tolerant to feral. It has become a two person job and even then we sometimes have to concede defeat.

He eats TikiCat tins, pretty much on demand. Occasionally, when not supervised well, he does manage to steal some of our other cat's Fussy Cat raw meat. There is no kibble in our house for him to eat.

When first diagnosed he weighed 8.39kgs (18.5 lbs). Our vet wanted his weight reduced to 6.3kgs (13.9lbs) and he is now down to 6.02kgs (13.3lbs). I honestly thought the reduction in weight would help his both get back to 'normal'.

He is ravenous. All. The. Time. To the point he has become a nuisance, counter surfing, stealing food, resource guarding like a dog. He raids the bin. We have to lock away the food scraps for our chickens or he upends the container.

His water consumption has increased to a level similar to when he was first diagnosed.

The "missing" the litter tray has almost led to my husband and I divorcing. I am sick of scrubbing piss off the laundry floor.

He howls from 6am. Even after we get up to him, feed him, get him fresh water and clean the litter tray. He just cries and cries. The interrupted sleep is getting to me.

When he was first diagnosed 4 units twice per day was recommended. On the recommendation from experts here I lowered it, I was told 4 units was way too high for a starting dose. Now I am worried I did the wrong thing. And I have probably screwed things up by increasing it again.

He recently developed small lumps/bumps on his head. Above his eyes and where his ears meet his head.

Took him to the vet on Tuesday evening. Vet suspects allergy. Cannot treat with steroids due to diabetes. She is not concerned about them as they don't appear to be bothering him.

 

[Bron and Sheba (GA)]

I’m sorry you are having a difficult time with Ollie. And I note you are having trouble testing him.
Looking at Ollie’s SS I can see you are not always testing before each dose of insulin and you are getting almost no tests in during the cycles, but you are continuing to raise the dose in 1 unit increments and not following any dosing method although you have SLGS in the SS.
Without any tests taken during the cycles, it is impossible to know how low the dose is taking him and if he needs a reduction or an increase.
I think increasing the dose without any data to go on is very risky.
Now I know you say you have trouble testing him, so we need to try and find solutions to help you both.
Would you consider putting on a freestyle libre so we can see what the BGs are doing over the 24 hour period. Just getting a curve done with no preshots and no testing within days really does not tell us much. He could be bouncing from lower numbers. Have you tried giving him food while you test?
I would really recommend you try following a dosing method. Is there any reason why you are increasing in 1 unit increments. ?

 

[Mel Harvey]

Thank you Bron.

Up until a few weeks ago I was religiously testing pre-shot as you can see on the spreadsheet. Testing twice per day was pushing his boundaries. And I was never concerned about hypos because his readings were ALWAYS high.

The dose increases have been as per vet advice. And I have done so because nothing else worked.

And I feel like I have zero chance of getting on top of anything because I can’t regularly test throughout the day as I work full time.

I asked the vet about a libre and she said she wasn’t overly keen as she thinks they are only valuable for new diagnoses.

The conflicting information (or lack of consistent information) available is so stressful.

I am the only person in my house who researches and feel like I am just doing everything no wrong.

I am finding myself wishing he had been terminally ill from the start because it would be easier than hating myself over doing everything wrong.

I’m sorry you are having a difficult time with Ollie. And I note you are having trouble testing him.
Looking at Ollie’s SS I can see you are not always testing before each dose of insulin and you are getting almost no tests in during the cycles, but you are continuing to raise the dose in 1 unit increments and not following any dosing method although you have SLGS in the SS.
Without any tests taken during the cycles, it is impossible to know how low the dose is taking him and if he needs a reduction or an increase.
I think increasing the dose without any data to go on is very risky.
Now I know you say you have trouble testing him, so we need to try and find solutions to help you both.
Would you consider putting on a freestyle libre so we can see what the BGs are doing over the 24 hour period. Just getting a curve done with no preshots and no testing within days really does not tell us much. He could be bouncing from lower numbers. Have you tried giving him food while you test?
I would really recommend you try following a dosing method. Is there any reason why you are increasing in 1 unit increments. ?

 

[Bron and Sheba (GA)]

Mel, please don’t blame your self…feline diabetes can be hard on the caregiver.
I disagree with your vet about using the freestyle libre. I think it will give you some breathing space and we can see what is happening with the BGs. And I don’t agree with your vet raising the dose by 1 unit each time with so little data.
Here is what I would recommend you try and see how it goes.
Get a freestyle libre put on
Post here each day…we give consistent advice and plenty of support.
Are you giving snacks during the day? How do you manage that when you are at work?

 

[Deborah & Muffy(GA) & Wendall]

If I'm reading this correctly, your cat lost 6 lbs., or 1/3 of his body weight, in 3 months, is that correct?. To lose weight safely, a cat of that size should lose about 1 lb. per month so 6 lbs. is a lot to lose that fast, yet you never did sufficient testing or lowered his insulin dose to compensate for that. For most obese cats, weight loss means less insulin. Since obesity is one of the primary causes of diabetes, many cats are able to go off insulin as they get closer to a normal weight. Without testing you would not know that.

One reason he may be so ravenous is that he truly needs the food to keep from crashing. He's not crying for food just to irritate you.

Please stop complaining and wishing that Oliver had a terminal illness. Treating a diabetic is challenging and your frustration is understandable but it's not Oliver's fault he he got sick. He likely would not have become diabetic if he had not been allowed to become overweight so stop blaming the cat. He's picking up on your frustration and wondering what he did to make you so angry and that isn't going to help anything.

A week ago we adopted a 19 lb. cat who was getting a whopping 7 units of insulin and was never tested. Since being fed a better diet, she has not been high enough to get any insulin and her appetite is normal. I suspect she had to eat more just to stay alive. Don't know if it'll hold but for now I'll take it. You might consider that it's a possibility for Oliver.

There are lots of wonderful supportive people here to help you. Let them.

 

[Mel Harvey]

Mel, please don’t blame your self…feline diabetes can be hard on the caregiver.
I disagree with your vet about using the freestyle libre. I think it will give you some breathing space and we can see what is happening with the BGs. And I don’t agree with your vet raising the dose by 1 unit each time with so little data.
Here is what I would recommend you try and see how it goes.
Get a freestyle libre put on
Post here each day…we give consistent advice and plenty of support.
Are you giving snacks during the day? How do you manage that when you are at work?

Thank you Bron. I will discuss with the vet to see how I can arrange the Freestyle Libre organised.

My husband WFH three days per week. He feeds Oliver and our other cat whenever they surface looking for food. I am happy for him to eat on demand and am certainly not comfortable to restrict his feeding to twice per day.

Apologies in advance for this question as Deborah's response above has made me feel very dejected. I did a curve yesterday after 5 units and his BG never dipped below 18.4mmol. Why would this be? Surely given how the general consensus within this group that that is a massive dose I would have expected that he might have significantly dropped and then bounced up. But yesterday's curve showed that is not the case.

 

[Mel Harvey]

If I'm reading this correctly, your cat lost 6 lbs., or 1/3 of his body weight, in 3 months, is that correct?. To lose weight safely, a cat of that size should lose about 1 lb. per month so 6 lbs. is a lot to lose that fast, yet you never did sufficient testing or lowered his insulin dose to compensate for that. For most obese cats, weight loss means less insulin. Since obesity is one of the primary causes of diabetes, many cats are able to go off insulin as they get closer to a normal weight. Without testing you would not know that.

One reason he may be so ravenous is that he truly needs the food to keep from crashing. He's not crying for food just to irritate you.

Please stop complaining and wishing that Oliver had a terminal illness. Treating a diabetic is challenging and your frustration is understandable but it's not Oliver's fault he he got sick. He likely would not have become diabetic if he had not been allowed to become overweight so stop blaming the cat. He's picking up on your frustration and wondering what he did to make you so angry and that isn't going to help anything.

A week ago we adopted a 19 lb. cat who was getting a whopping 7 units of insulin and was never tested. Since being fed a better diet, she has not been high enough to get any insulin and her appetite is normal. I suspect she had to eat more just to stay alive. Don't know if it'll hold but for now I'll take it. You might consider that it's a possibility for Oliver.

There are lots of wonderful supportive people here to help you. Let them.

I appreciate that there are wonderful supportive people here to help. Indicating that I have caused my cat's diabetes by allowing him to become overweight is unhelpful. It is certainly something I am already blaming myself for, though given my other cat who lives in the same house and ate the same food is underweight then I guess it's just luck of the draw.

 

[Bron and Sheba (GA)]

If Ollie is bouncing after dropping into lower numbers, his BGs will stay high for up to 6 cycles. The only way to find out if this is happening is to test more often and regularly. I’m glad to hear you are thinking of getting a libre attached. Don’t let the vet put you off.

 

[Mel Harvey]

If Ollie is bouncing after dropping into lower numbers, his BGs will stay high for up to 6 cycles. The only way to find out if this is happening is to test more often and regularly. I’m glad to hear you are thinking of getting a libre attached. Don’t let the vet put you off.

Hi Bron. I have just spoken with my vet. She is happy to go ahead with the libre. Do you have any suggestions as to which model and where to purchase in Australia?

Thanks.

 

[Bron and Sheba (GA)]

Hi Bron. I have just spoken with my vet. She is happy to go ahead with the libre. Do you have any suggestions as to which model and where to purchase in Australia?

Thanks.

I have not purchased one but I will tag someone who I know has used several. Hopefully she will see the tag.
@Din can you tell Mel what is the best libre to buy in Australia please and where you got yours from Thanks

 

[Din]

Hi Mel big hug for you and your beautiful kitty. I do buy Free style libre 2 from Chemist warehouse. It should be any pharmacy such as chemist warehouse/ discount chemist / my chemist .

 

[Din]

With many many libres I found this is the most suitable place to Libre attach. ( side )

 

[Din]

Hi Mel , My Cierra does the same.. she is starving.. licking the floor… all ways hungry. So I’m giving her food every three hours.

Per day 2 can and 10g of freeze dried food ( not dry food)

2 can divided to 6
4am/5am- 1 /6 add 30 ml water
8am
11am
2pm
5pm
8pm
10 or 11 pm
Some times again 1 or 2 am
Every time I add 30 ml water.
This little bit helps her. But still hungry.

 

[Hendrick Cuddleclaw]

I appreciate that there are wonderful supportive people here to help. Indicating that I have caused my cat's diabetes by allowing him to become overweight is unhelpful. It is certainly something I am already blaming myself for, though given my other cat who lives in the same house and ate the same food is underweight then I guess it's just luck of the draw.

To my knowledge, the true cause of Feline Diabetes is unknown. Don't beat yourself up too much!

The absolute latest research I am aware of indicates genetics are the biggest factor. I wonder if @Marje and Gracie can chime in, she is a wealth of knowledge.

 

[Deborah & Muffy(GA) & Wendall]

It was not my intention to upset you. Most of us here would do pretty much anything to keep our cats healthy and alive so posting that you would rather Oliver have a terminal illness was offensive. You asked a question and I tried to offer a possible answer based on experience rescuing diabetics for nearly 20 years. If your only takeaway was that I was criticizing you then you missed my point.

 

[Lisa and Witn (GA)]

As mentioned above your dose increases were 1 unit each time. It is possible that you may have missed the optimal dose. We recommend increasing by only 1/4-1/2 unit and staying there for a week before increasing it again. Too much insulin can raise glucose levels, because the cat's body will produce extra glucose to try to prevent hypoglycemia. One suggestion is to go back to a lower dose and see if that helps.

 

[Sienne and Gabby (GA)]

I've only rarely seen reducing the dose be helpful. That said, I think we need more consistent information and getting a Libre will help with that.

I'd also suggest that you stick with following SLGS more closely than you have been. While doses had held longer with SLGS than with Tight Regulation, you're holding the doses longer than is necessary. If a cat sits in high numbers, their body adjusts to those numbers and treats the higher range as the new "normal." This is referred to as glucose toxicity and it makes it harder to get the numbers to come down and can result in more bouncing. It's just going to take some perseverance and systematically raising the dose.

 

[Marje and Gracie]

If I'm reading this correctly, your cat lost 6 lbs., or 1/3 of his body weight, in 3 months, is that correct?. To lose weight safely, a cat of that size should lose about 1 lb. per month so 6 lbs. is a lot to lose that fast, yet you never did sufficient testing or lowered his insulin dose to compensate for that. For most obese cats, weight loss means less insulin. Since obesity is one of the primary causes of diabetes, many cats are able to go off insulin as they get closer to a normal weight. Without testing you would not know that.

One reason he may be so ravenous is that he truly needs the food to keep from crashing. He's not crying for food just to irritate you.

Please stop complaining and wishing that Oliver had a terminal illness. Treating a diabetic is challenging and your frustration is understandable but it's not Oliver's fault he he got sick. He likely would not have become diabetic if he had not been allowed to become overweight so stop blaming the cat. He's picking up on your frustration and wondering what he did to make you so angry and that isn't going to help anything.

A week ago we adopted a 19 lb. cat who was getting a whopping 7 units of insulin and was never tested. Since being fed a better diet, she has not been high enough to get any insulin and her appetite is normal. I suspect she had to eat more just to stay alive. Don't know if it'll hold but for now I'll take it. You might consider that it's a possibility for Oliver.

There are lots of wonderful supportive people here to help you. Let them.

No one has ever been helped by a post like this. Pointing fingers doesn’t fix anything. I allowed my cat to have steroids. So, yes, I’m to blame but I made the best decision I could at the time. She was very young, the vet assured me that a short course of steroids would be ok to address her sterile interstitial cystitis. The vet was wrong. Thankfully, no one on this site blamed me for anything. Sometimes members may say something they don’t mean (such as the remark about the terminal illness) but they are just venting. That’s one of the reasons we are here and it’s a safe place for them to vent. I hope you will consider apologizing.

To my knowledge, the true cause of Feline Diabetes is unknown. Don't beat yourself up too much! The absolute latest research I am aware of indicates genetics are the biggest factor. I wonder if @Marje and Gracie can chime in, she is a wealth of knowledge.

Thank you for the vote of confidence

Ollie's BG readings are going in the WRONG direction. I don't understand why. I am actually bordering on depression at caring for him. I feel so trapped. Cannot be away for 12 hours. And despite doing everything I have been told to do he is getting worse.

I did a curve today (see spreadsheet). I had to give us both a break from testing over previous weeks as he went from being patiently tolerant to feral. It has become a two person job and even then we sometimes have to concede defeat.

He eats TikiCat tins, pretty much on demand. Occasionally, when not supervised well, he does manage to steal some of our other cat's Fussy Cat raw meat. There is no kibble in our house for him to eat.

When first diagnosed he weighed 8.39kgs (18.5 lbs). Our vet wanted his weight reduced to 6.3kgs (13.9lbs) and he is now down to 6.02kgs (13.3lbs). I honestly thought the reduction in weight would help his both get back to 'normal'.

He is ravenous. All. The. Time. To the point he has become a nuisance, counter surfing, stealing food, resource guarding like a dog. He raids the bin. We have to lock away the food scraps for our chickens or he upends the container.

His water consumption has increased to a level similar to when he was first diagnosed.

The "missing" the litter tray has almost led to my husband and I divorcing. I am sick of scrubbing piss off the laundry floor.

He howls from 6am. Even after we get up to him, feed him, get him fresh water and clean the litter tray. He just cries and cries. The interrupted sleep is getting to me.

When he was first diagnosed 4 units twice per day was recommended. On the recommendation from experts here I lowered it, I was told 4 units was way too high for a starting dose. Now I am worried I did the wrong thing. And I have probably screwed things up by increasing it again.

He recently developed small lumps/bumps on his head. Above his eyes and where his ears meet his head.

Took him to the vet on Tuesday evening. Vet suspects allergy. Cannot treat with steroids due to diabetes. She is not concerned about them as they don't appear to be bothering him.

Mel....just sending you this to start as I can feel all of your frustration. There can be many reasons why a cat becomes diabetic. The number one culprit is dry food. But it can be a genetic pre-disposition, steroid use, chronic inflammation, the list goes on and on. Other than tossing out the dry food and being super careful with steroids, many reasons they become diabetic are out of our control. Having said that, I would never blame any caregiver (CG) who fed their cat dry food and it became diabetic. It’s constantly crammed down our throats in commercials and other ads (and even veterinarians sell prescription dry foods) that dry food is so “healthy” for our cats. But, once we find out it isn’t, one way or another, then we move ahead and address any issues it has caused. Believe it or not, I see still vets prescribe dry prescription diet for cats with renal disease. Worst. Thing. Ever. for a kidney cat.

But...let’s look at your Oliver Harvey. We already know the dose was started way too high. Generally, with lantus, we start the dose at 0.25u per kg (2.2 lbs) of ideal body weight. If his ideal body weight is the 13 lbs he is now, that would have been 1.5u twice a day. While we “typically” don’t start over with reduced dosing, it was fine here because (1) you didn’t give the 4u for very long and (2) the 1u bid (that’s twice a day) dose wasn’t too far off where we would have started him at 1.5u.

Where are we now:

• I’m not sure who recommended increasing his dose by so much and I’m sure you’ve already heard that for a cat at 2 or 3u, even with the BGs he’s had, we only increase by a maximum of 0.5u bid. If the dose was much higher (over 6u, we do increase a bit more but not where he is now).
• We three moderators are on the same page and I hope most experienced members are, too, that we don’t increase the dose unless we know how low the current dose is taking him. That was not any information you or anyone else has had. In order to get that information, we need to see more mid cycle tests or, if you work, an “out the door” and “in the door” test every cycle you work in addition to the pre shots. I understand you limited testing because he was getting upset and I hope you can get the Libre for him as that will make it easier for you both. I have seen cats drop from 300 at AMPS to 40 by mid cycle and back to 300 by PMPS. Without any tests anywhere between AMPS and PMPS, the SS would look like Oliver Harvey’s.
• It’s very important to try and get a PS test every single time before you give insulin. I’ve had members shoot “blindly” because the cat had been at high BGs for so long and then the kitty started acting “weird” by +1 and a test found the kitty in the 20s. And, one more word about testing and then I’ll leave that subject alone. In the evening cycle, a +2 and a before bed test helps immensely. Cats tend to go lower at night so is Oliver Harvey going low at night and then bouncing for six cycles? We don’t know.

Where do we go:

• Is Oliver Harvey overdosed or does he have a high dose condition? We really don’t know at this time. Sometimes, we can look at a SS and see “invisible” numbers and based on the patterns, we can determine if it’s overdosing. I don’t feel comfortable using my crystal ball on that. His ravenous eating can be because he’s so far from regulation or he can have a high dose condition but we don’t test for that until the cat hits 6u and we have data to show the dose has been increased correctly and gradually.
• I’d suggest holding this dose, following SLGS as Sienne has suggested, and trying to get those tests either with the Libre or your regular glucometer.

We can help you and we can certainly help the situation improve but we have to have more data and that’s just the short of it. Here’s a great video on how to test fractious cats. If you are allowing him to eat all through the cycle, that could be impacting his insulin duration so let us know how you are doing that.

Have you thought of buying pee pads to put all around the litter box? I had to do that with one of my really, really old guys who got in the box but then aimed his bottom out of it. You can usually buy them at pet stores. It’s a big help because if they get soaked, you just have to wad them up and throw them in the refuse bin outside.

I know you are stressed but one thing that really helps us is having information readily available in your signature block. Yes, I can look on the SS, but it’s nice, if I just need to know what meter you are using or what you feed, to have the info readily available. This is the info we need, please:

• • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Hang in there. We can all work together to help you!

 

[Shelly_F]

Ollie's BG readings are going in the WRONG direction. I don't understand why. I am actually bordering on depression at caring for him. I feel so trapped. Cannot be away for 12 hours. And despite doing everything I have been told to do he is getting worse.

I did a curve today (see spreadsheet). I had to give us both a break from testing over previous weeks as he went from being patiently tolerant to feral. It has become a two person job and even then we sometimes have to concede defeat.

He eats TikiCat tins, pretty much on demand. Occasionally, when not supervised well, he does manage to steal some of our other cat's Fussy Cat raw meat. There is no kibble in our house for him to eat.

When first diagnosed he weighed 8.39kgs (18.5 lbs). Our vet wanted his weight reduced to 6.3kgs (13.9lbs) and he is now down to 6.02kgs (13.3lbs). I honestly thought the reduction in weight would help his both get back to 'normal'.

He is ravenous. All. The. Time. To the point he has become a nuisance, counter surfing, stealing food, resource guarding like a dog. He raids the bin. We have to lock away the food scraps for our chickens or he upends the container.

His water consumption has increased to a level similar to when he was first diagnosed.

The "missing" the litter tray has almost led to my husband and I divorcing. I am sick of scrubbing piss off the laundry floor.

He howls from 6am. Even after we get up to him, feed him, get him fresh water and clean the litter tray. He just cries and cries. The interrupted sleep is getting to me.

When he was first diagnosed 4 units twice per day was recommended. On the recommendation from experts here I lowered it, I was told 4 units was way too high for a starting dose. Now I am worried I did the wrong thing. And I have probably screwed things up by increasing it again.

He recently developed small lumps/bumps on his head. Above his eyes and where his ears meet his head.

Took him to the vet on Tuesday evening. Vet suspects allergy. Cannot treat with steroids due to diabetes. She is not concerned about them as they don't appear to be bothering him.

Sounds like our cat. Her diabetes had been regulate for a while (for about 5 months) now we found out today she has hyperthyroidism. She is always hungry and has anxiety and now we know what is going on. We are not sure what to do with her. All new learning on 2hrs of sleep

 

[Gracie85]

Sounds like our cat. Her diabetes had been regulate for a while (for about 5 months) now we found out today she has hyperthyroidism. She is always hungry and has anxiety and now we know what is going on. We are not sure what to do with her. All new learning on 2hrs of sleep

Hyperthyroid is quite manageable. Join this group on Facebook, Hyperthyroid Cats, they are incredibly knowledgeable and very helpful. (Been there, done that, with our Lamborghini). https://www.facebook.com/groups/42301610484

 

[Mel Harvey]

No one has ever been helped by a post like this. Pointing fingers doesn’t fix anything. I allowed my cat to have steroids. So, yes, I’m to blame but I made the best decision I could at the time. She was very young, the vet assured me that a short course of steroids would be ok to address her sterile interstitial cystitis. The vet was wrong. Thankfully, no one on this site blamed me for anything. Sometimes members may say something they don’t mean (such as the remark about the terminal illness) but they are just venting. That’s one of the reasons we are here and it’s a safe place for them to vent. I hope you will consider apologizing.

Thank you for the vote of confidence



Mel....just sending you this to start as I can feel all of your frustration. There can be many reasons why a cat becomes diabetic. The number one culprit is dry food. But it can be a genetic pre-disposition, steroid use, chronic inflammation, the list goes on and on. Other than tossing out the dry food and being super careful with steroids, many reasons they become diabetic are out of our control. Having said that, I would never blame any caregiver (CG) who fed their cat dry food and it became diabetic. It’s constantly crammed down our throats in commercials and other ads (and even veterinarians sell prescription dry foods) that dry food is so “healthy” for our cats. But, once we find out it isn’t, one way or another, then we move ahead and address any issues it has caused. Believe it or not, I see still vets prescribe dry prescription diet for cats with renal disease. Worst. Thing. Ever. for a kidney cat.

But...let’s look at your Oliver Harvey. We already know the dose was started way too high. Generally, with lantus, we start the dose at 0.25u per kg (2.2 lbs) of ideal body weight. If his ideal body weight is the 13 lbs he is now, that would have been 1.5u twice a day. While we “typically” don’t start over with reduced dosing, it was fine here because (1) you didn’t give the 4u for very long and (2) the 1u bid (that’s twice a day) dose wasn’t too far off where we would have started him at 1.5u.

Where are we now:

• I’m not sure who recommended increasing his dose by so much and I’m sure you’ve already heard that for a cat at 2 or 3u, even with the BGs he’s had, we only increase by a maximum of 0.5u bid. If the dose was much higher (over 6u, we do increase a bit more but not where he is now).
• We three moderators are on the same page and I hope most experienced members are, too, that we don’t increase the dose unless we know how low the current dose is taking him. That was not any information you or anyone else has had. In order to get that information, we need to see more mid cycle tests or, if you work, an “out the door” and “in the door” test every cycle you work in addition to the pre shots. I understand you limited testing because he was getting upset and I hope you can get the Libre for him as that will make it easier for you both. I have seen cats drop from 300 at AMPS to 40 by mid cycle and back to 300 by PMPS. Without any tests anywhere between AMPS and PMPS, the SS would look like Oliver Harvey’s.
• It’s very important to try and get a PS test every single time before you give insulin. I’ve had members shoot “blindly” because the cat had been at high BGs for so long and then the kitty started acting “weird” by +1 and a test found the kitty in the 20s. And, one more word about testing and then I’ll leave that subject alone. In the evening cycle, a +2 and a before bed test helps immensely. Cats tend to go lower at night so is Oliver Harvey going low at night and then bouncing for six cycles? We don’t know.

Where do we go:

• Is Oliver Harvey overdosed or does he have a high dose condition? We really don’t know at this time. Sometimes, we can look at a SS and see “invisible” numbers and based on the patterns, we can determine if it’s overdosing. I don’t feel comfortable using my crystal ball on that. His ravenous eating can be because he’s so far from regulation or he can have a high dose condition but we don’t test for that until the cat hits 6u and we have data to show the dose has been increased correctly and gradually.
• I’d suggest holding this dose, following SLGS as Sienne has suggested, and trying to get those tests either with the Libre or your regular glucometer.

We can help you and we can certainly help the situation improve but we have to have more data and that’s just the short of it. Here’s a great video on how to test fractious cats. If you are allowing him to eat all through the cycle, that could be impacting his insulin duration so let us know how you are doing that.

Have you thought of buying pee pads to put all around the litter box? I had to do that with one of my really, really old guys who got in the box but then aimed his bottom out of it. You can usually buy them at pet stores. It’s a big help because if they get soaked, you just have to wad them up and throw them in the refuse bin outside.

I know you are stressed but one thing that really helps us is having information readily available in your signature block. Yes, I can look on the SS, but it’s nice, if I just need to know what meter you are using or what you feed, to have the info readily available. This is the info we need, please:

• • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Hang in there. We can all work together to help you!

Thank you SO MUCH for your extensive reply. And apologies for not replying sooner - for some reason I stopped getting email notifications of replies on this thread.

I have updated my signature as per your above. And Ollie's spreadsheet is up to date. With numbers still way too high.

I honestly don't know what to do. I have read all the responses and am having such a terribly hard time feeling like I have just done every single thing wrong.

Ollie has now developed small lumps on his face, head and ears. I had to take him to the vet to have them examined. She suspects "allergies" and said to just leave them as steroids are not an option (which I understand). But when she repeated bloods she wanted an increase of his insulin from 5u to 6u. So now I am ghosting the vet.

I feel so so awful and just don't know what to do. Do I decrease his dose? Increase it? I have a Libre to put on him but I am so scared of that. The 'Freestyle Libre for Dogs and Cats' facebook page has put the fear of god into me. I am scared to have the vet put it on him, but don't feel equipped to do it myself.

 

[Bron and Sheba (GA)]

Hi Mel,
I’m sure you are not doing everything wrong. Sometimes or often, cats just don’t read the rule book and don’t fall into line like we would like them to…
By the look of the SS you have been giving 4.5 units, is that correct?
If so I would NOT go up to 6 units.
Can you get one test on each PM cycle so we can see what is happening in the PM cycles?
.I just want to make sure Ollie is not dropping low overnight before I suggest increasing the dose to 5 units.

Thee is no need to be scared of the freestyle libre. What exactly are your concerns.?
The only thing I would suggest is if the BG drops under 100, you double check it with the hand held meter you have. Otherwise they are fine.

What allergies does your vet suspects. Has she suggested a treatment for them?
Bron

 

[Mel Harvey]

Hi Mel,
I’m sure you are not doing everything wrong. Sometimes or often, cats just don’t read the rule book and don’t fall into line like we would like them to…
By the look of the SS you have been giving 4.5 units, is that correct?
If so I would NOT go up to 6 units.
Can you get one test on each PM cycle so we can see what is happening in the PM cycles?
.I just want to make sure Ollie is not dropping low overnight before I suggest increasing the dose to 5 units.

Thee is no need to be scared of the freestyle libre. What exactly are your concerns.?
The only thing I would suggest is if the BG drops under 100, you double check it with the hand held meter you have. Otherwise they are fine.

What allergies does your vet suspects. Has she suggested a treatment for them?
Bron

Thank you Bron.

You are correct. 4.5 units is the current dose.

I have just tested +2 in the PM cycle. Reading was 18.8mmol/L (spreadsheet is updated).

Regarding the Freestyle Libre - I am scared of not prepping correctly and damaging his (already sensitive) skin. I am scared that he will not tolerate it, try and remove it. There is plenty of helpful information on the facebook page, but I just feel so out of my depth and alone.

The vet didn't give a suspicion of a specific allergy. She did mention that we could try a topical steroid ointment if it didn't subside. For a week (maybe 10 days) the lumps did seem to have improved. However, in the past 4-5 days (I think) they have gotten much worse. They are on both sides of his mouth. On his head above his eyes (at the base of his ears). I didn't think they were bothering him too much, but some of them are red and irritated, indicating he has been scratching them.

He is still ravenous. Resource guarding if he manages to steal food he shouldn't have (he jumped onto the dinner table tonight and grabbed a piece of steak off my son's plate.) We have to lock him in the laundry when we prep food and/or eat. Unfortunately the stress of this seems to make him urinate more. This evening he pee'd twice on the floor next to the litter tray.

I just can't stop crying. I am so lost.

 

[Bron and Sheba (GA)]

have just tested +2 in the PM cycle. Reading was 18.8mmol/L (spreadsheet is updated).

If you can get them most evenings that would be helpful.

Regarding the Freestyle Libre - I am scared of not prepping correctly and damaging his (already sensitive) skin. I am scared that he will not tolerate it, try and remove it. There is plenty of helpful information on the facebook page, but I just feel so out of my depth and alone.

Will the vet put it on for you? If she puts it away from where he can reach it, hopefully he won’t remove it. You will only know if you try. If it falls off, then you have tried it.

The vet didn't give a suspicion of a specific allergy

I have a cat who gets allergies and I give her 1/2 zyrtec tablet each morning. The tablets are 10 mg and she get a 1/2 which is 5 mg. It makes a massive difference to her allergies.

He is still ravenous

That will improve once the BG are more under control.
How often are you feeding him and how much?
When you shut him in the laundry when you prep and eat food, are you giving him a snack. Maybe add some warm water to it so it fills him up a bit.

just can't stop crying. I am so lost.

Remember we are here for you so please don’t feel lost. I know how hard it is sometimes when nothing seems to be working. .
But you are looking after him well. He is getting his insulin each cycle and you are trying to sort things out for him.

 

[Sienne and Gabby (GA)]

Mel --

The beginning of this process is hugely overwhelming. I suspect there isn't a member here who hasn't been in tears, thought they were not a good caretaker for their cat, or worse. You're doing your best and the fact that you found us is a testament to how much you care. The rest you can learn and learning doesn't happen overnight. We've got your back.

I noticed in your signature, you had a ?? when it came to dosing. I'd suggest you consider the Start Low Go Slow (SLGS) approach to using glargine. There are two methods, Tight Regulation (TR) is the other method. TR is more aggressive. You can always switch but let's get you started with SLGS. This is a link to the sticky at the top of the Lantus forum on dosing methods. You've been holding Oliver's dose at 4.5u since the beginning of the month. With SLGS, you want to evaluate the dose every week by doing a curve (i.e., testing once every 2 hours for a 12-hour period). Since Oliver's numbers are outside of normal range, with SLGS, you'd want to increase the dose by 0.25u.

Quite a few years ago, my vet recommended a few things regarding Gabby having seasonal allergies. She said:
"There are several options—there is a product called Allerderm which is applied once weekly to the skin which can be quite helpful for itchy or dry skin. Additional fish oil omega-3 fatty acids, 200-250 mg daily, are often helpful, but may take up to 2 weeks to really have an effect. Antihistamines are often helpful—we seem to have the best success with Zyrtec, which is over-the-counter, or hydroxyzine which is a prescription medication.

We have Allerderm here, but you may be able to order it online. Zyrtec dosage is ½ of a 10 mg tablet by mouth (in food…) twice daily, or about every 12 hours, try for 7 days. Watch for drowsiness or restlessness, although side effects from Zyrtec are not likely or are very mild. Use plain Zyrtec, or cetirizine, only—no combo meds. The fish oil product we use is AllerG3, or you can use human products."

 

[Mel Harvey]

If you can get them most evenings that would be helpful.
OK. Is there a particular time that is best? +2 is probably right on our bedtime.
That being said, I did get up at 3am this morning to test and feed him. I was wanting to see if this would improve his 5.30am "walking around the house meowing incessantly" behaviour. Unfortunately it didn't make too much of an impact with that. Which further confirms my suspicion that this behaviour isn't 100% hunger related.

Will the vet put it on for you? If she puts it away from where he can reach it, hopefully he won’t remove it. You will only know if you try. If it falls off, then you have tried it.
The vet will. I am just concerned that the vet will possibly use a glue that the folks on the Libre Facebook page say is bad to use. I need to put together an email to the vet with some questions on their approach as I don't think this is something they do very frequently.

I have a cat who gets allergies and I give her 1/2 zyrtec tablet each morning. The tablets are 10 mg and she get a 1/2 which is 5 mg. It makes a massive difference to her allergies.
Thank you. I might give this a try. I assume it would be acceptable to put inside some meat or food to give to him?

That will improve once the BG are more under control.
How often are you feeding him and how much?
When you shut him in the laundry when you prep and eat food, are you giving him a snack. Maybe add some warm water to it so it fills him up a bit.
He is fed on demand. Which feels like constantly :-(
He is fed Tiki Cat tins. We have both the seafood (he likes these, I acknowledge reading somewhere that there is something undesirable about seafood based foods, but I am picking my battles) and the chicken based ones. He could eat 6-8 tins per day, possibly more. I don't keep a strict feeding diary/record, but probably should start, especially if his allergy relates to his food :-(
When he is shut in the laundry he has food and water. The Tiki Cat tins are fairly 'liquid' but if adding warm water to it may help, I can easily do that.

Remember we are here for you so please don’t feel lost. I know how hard it is sometimes when nothing seems to be working. .
But you are looking after him well. He is getting his insulin each cycle and you are trying to sort things out for him.

Thanks. I am my own worst critic and finding this all very overwhelming. I really do appreciate you taking the time to assist.

 

[Mel Harvey]

Mel --

The beginning of this process is hugely overwhelming. I suspect there isn't a member here who hasn't been in tears, thought they were not a good caretaker for their cat, or worse. You're doing your best and the fact that you found us is a testament to how much you care. The rest you can learn and learning doesn't happen overnight. We've got your back.

I noticed in your signature, you had a ?? when it came to dosing. I'd suggest you consider the Start Low Go Slow (SLGS) approach to using glargine. There are two methods, Tight Regulation (TR) is the other method. TR is more aggressive. You can always switch but let's get you started with SLGS. This is a link to the sticky at the top of the Lantus forum on dosing methods. You've been holding Oliver's dose at 4.5u since the beginning of the month. With SLGS, you want to evaluate the dose every week by doing a curve (i.e., testing once every 2 hours for a 12-hour period). Since Oliver's numbers are outside of normal range, with SLGS, you'd want to increase the dose by 0.25u.

Quite a few years ago, my vet recommended a few things regarding Gabby having seasonal allergies. She said:
"There are several options—there is a product called Allerderm which is applied once weekly to the skin which can be quite helpful for itchy or dry skin. Additional fish oil omega-3 fatty acids, 200-250 mg daily, are often helpful, but may take up to 2 weeks to really have an effect. Antihistamines are often helpful—we seem to have the best success with Zyrtec, which is over-the-counter, or hydroxyzine which is a prescription medication.

We have Allerderm here, but you may be able to order it online. Zyrtec dosage is ½ of a 10 mg tablet by mouth (in food…) twice daily, or about every 12 hours, try for 7 days. Watch for drowsiness or restlessness, although side effects from Zyrtec are not likely or are very mild. Use plain Zyrtec, or cetirizine, only—no combo meds. The fish oil product we use is AllerG3, or you can use human products."

Thank you. I am in Australia and, from what I have seen and read, there are no available syringes that will allow an accurate 0.25u measurement. Do you have any advice regarding that?

 

[Bron and Sheba (GA)]

Mel I also live in Australia and we can’t get 1/2 unit syringes here although you may be able to order them overseas. We did have a company that posted to Australia before covid but it stopped during covid. rhr best I can suggest is to use a magnifying glass and a good light and mentally divide the 1 unit into 4 to get the 0.25 units. That’s what I did for years with good success.
I am trying to find a company that will post 1/2 unit syringes to Australia

 

[Mel Harvey]

Mel I also live in Australia and we can’t get 1/2 unit syringes here although you may be able to order them overseas. We did have a company that posted to Australia before covid but it stopped during covid. rhr best I can suggest is to use a magnifying glass and a good light and mentally divide the 1 unit into 4 to get the 0.25 units. That’s what I did for years with good success.
I am trying to find a company that will post 1/2 unit syringes to Australia

Thank you @Bron and Sheba (GA) I think that will likely be the only available option as I have searched unsuccessfully.

Going back to what to do for Ollie, looking at his spreadsheet is an increase of 0.25u (to 4.75u) warranted now, or do I wait and see if I can get the Libre fitted? I know I haven't completed a strict 2 hourly curve but the readings I have taken have been above 18mmol/L for weeks.

I also purchased some Zyrtec and gave him half a tablet last night. Is there an optimal time of day to give this dose?

Thanks again.

 

[Bron and Sheba (GA)]

I also purchased some Zyrtec and gave him half a tablet last night. Is there an optimal time of day to give this dose?

Anytime is OK to give the zyrtec. Just give it once a day.

I think he most likely does need an increase in dose of insulin BUT I would rather you get the libre fitted first, so we can see what is happening during the PM cycles and during a lot of the days when you don't test. It is safer that way

 

[Mel Harvey]

Anytime is OK to give the zyrtec. Just give it once a day.

I think he most likely does need an increase in dose of insulin BUT I would rather you get the libre fitted first, so we can see what is happening during the PM cycles and during a lot of the days when you don't test. It is safer that way

OK thanks. I will reach out to the vet and see if I can get my head around how they will fit it.

 

[Mel Harvey]

Anytime is OK to give the zyrtec. Just give it once a day.

I think he most likely does need an increase in dose of insulin BUT I would rather you get the libre fitted first, so we can see what is happening during the PM cycles and during a lot of the days when you don't test. It is safer that way

Hi. Oliver had his Libre fitted yesterday, has been wearing it for almost 24 hours.

My head feels like I am in a washing machine. The vet mentioned during the appointment that he is in DKA (as per his blood tests from two weeks ago.) This is news to me. I have asked for the blood tests to be emailed to me.

Vet is concerned about how high his readings are

The readings on Oliver's spreadsheet are way lower than both the vet's Alphatrak and the Libre. When the Libre was fitted we did an ear prick and the vet's Alphatrak read 29.0mmol/L and my FreeStyle Optimum Neo read 20.7mmol/L. The vet said that human monitors are "unrealiable" - but then proceeded to fit the Libre which is a HUMAN MONITOR!!!

We were instructed to increase his dose to 6 units. I have done so because I feel like I just don't know what else to do.

In the 24 hours he has had the Libre fitted the readings have barely moved out of the HI range. Readings consistently above 25mmol/L at all times during the past 24 hours.

What do I do? The urinating outside the litter tray is causing me so much distress. All of this is just wearing me down.

 

[Bron and Sheba (GA)]

The readings on Oliver's spreadsheet are way lower than both the vet's Alphatrak and the Libre. When the Libre was fitted we did an ear prick and the vet's Alphatrak read 29.0mmol/L and my FreeStyle Optimum Neo read 20.7mmol/L. The vet said that human monitors are "unrealiable" - but then proceeded to fit the Libre which is a HUMAN MONITOR!!!

The pet meter always reads higher than the human meter.
The human meters are NOT unreliable
Up until pet meters came about, all vets used the human meters!

The vet mentioned during the appointment that he is in DKA (as per his blood tests from two weeks ago.) This is news to me. I have asked for the blood tests to be emailed to me.

What did the vet do about the DKA?
If Oliver was in DKA, he would be very sick. I would ring the vet back and ask him why he thinks Oliver is in DKA.
Ask him if he has ketones. Ask him if his potassium is normal. Ask him if his blood is acidic. If he has DKA he should be in hospital, it is a very serious illness.
Symptoms of DKA are: not eating, nausea/vomiting, lethargy, weakness, increased drinking, dehydration, depression. Does Oliver have any of these? Is he eating OK
What I would like you to do is buy a bottle of Ketostix from a pharmacy and test Oliver’s urine to see if there are any ketones. You need to collect a urine sample and then dip the test strip into the urine and read the result against the colours on the side of the bottle exactly 15 seconds later.
There should be no ketones in the Urine. If there is any please tell us and if there is more than a trace tell the vet.

The urinating outside the litter tray is causing me so much distress. All of this is just wearing me down.

Has the vet checked to see if Oliver has a UTI.?

In the 24 hours he has had the Libre fitted the readings have barely moved out of the HI range. Readings consistently above 25mmol/L at all times during the past 24 hours.

To be honest the BGs don’t look much different to what they have been. They don’t leek any higher to me.