Clinical signs are great but numbers are high?

PirateLuke

PirateLuke

Member Since 2026
Hi,

We have been in the process of trying to stabilise Pirate Luke's blood sugar. We switched to Lantus a month ago and are currently at 2 units x 2 a day.

Yesterday, we had the best clinical signs we've ever had. Relatively normal appetite for a cat his size (4 x 85g sachets wet). Normal volume of wee. Playing, sleeping, and cuddling. BUT his numbers were high. His nadir that day was 311.4 and his highest number was 480.6.

Usually with numbers like 480.6 he'll be running around like a maniac and screaming for food.

We have also achieved some very nice numbers on that dose, but with worse clinical signs. We've also had some near-hypos!

Anyone else have this happen? What might be going on?

I have a call with the vet tomorrow to discuss his progress and dose, so I wanted some input from experienced members before talking to her.

Thanks!
Beth and Pirate Luke
 
Welcome to FDMB
There can be many factors for such high glucose levels, such as Ketones, have you tested for Ketones? ThiscIS soñé by testing the urine with a ketones stick as your cat pees, you can get the kit at Walmart. Another reason can be the diet, diabetic cats need to have a diet of wet can or raw foods between 0-10% carbs, eat 3-4 meals during the day as well as the main meals before shot, Lantus is a Depot insulin food keeps it in check, also a schedule of meals , so grazing, dry or “ prescribed foods are out of the question, dry or “prescribed, diabetic food” contains between 18-30% carbs, with such high levels, and 2 units of Lantus which is quite high, hypoglycemia could have happened perhaps for not testing prior to to shot? , did you suddenly switch foods from high to low carbs? When numbers are high or Ketones are present cats become very hungry, you say near hypos, a non-diabetic cats’ glucose levels are between 50-120, also, cats are very sensitive to stress are any any different changes going on in Pirates surrounding? Also know that vet visits will stress Pirate highly, so when tested at the vets the levels will not be realistic causing for an unnecessary dose increase, if your vet suggests a “curve” this you can do yourself, and spare Pirate the stress, is simply testing every 2-3 hours for a cycle (12 hours) this is to see how the insulin is affecting Pirate’s system throughout the day, if it is Ketones, FOOD, feed him all he wants, it eliminates Ketones
 
CORKY said:
Welcome to FDMB
There can be many factors for such high glucose levels, such as Ketones, have you tested for Ketones? ThiscIS soñé by testing the urine with a ketones stick as your cat pees, you can get the kit at Walmart. Another reason can be the diet, diabetic cats need to have a diet of wet can or raw foods between 0-10% carbs, eat 3-4 meals during the day as well as the main meals before shot, Lantus is a Depot insulin food keeps it in check, also a schedule of meals , so grazing, dry or “ prescribed foods are out of the question, dry or “prescribed, diabetic food” contains between 18-30% carbs, with such high levels, and 2 units of Lantus which is quite high, hypoglycemia could have happened perhaps for not testing prior to to shot? , did you suddenly switch foods from high to low carbs? When numbers are high or Ketones are present cats become very hungry, you say near hypos, a non-diabetic cats’ glucose levels are between 50-120, also, cats are very sensitive to stress are any any different changes going on in Pirates surrounding? Also know that vet visits will stress Pirate highly, so when tested at the vets the levels will not be realistic causing for an unnecessary dose increase, if your vet suggests a “curve” this you can do yourself, and spare Pirate the stress, is simply testing every 2-3 hours for a cycle (12 hours) this is to see how the insulin is affecting Pirate’s system throughout the day, if it is Ketones, FOOD, feed him all he wants, it eliminates Ketones
Click to expand...

Hi Corky. He's on 2% carb wet only. He has never had DKA and I have reason to suspect Ketones. His clinical signs were all good. No lethargy, but not manic either.

I have a Libre continuous glucose monitor which gives me his numbers all day.

The only thing I can think of is a) Cats just being cats and sometimes we will get random days where things are different. b) I did have two tradespeople here yesterday, including a plumber with a loud vaccuum. Luke seemed more interested in it than anything, but maybe it stressed him out?

This morning we're at a nice 223.2 at +3 hours after his shot and he seems relaxed and happy. So far, he hasn't been flooding the litter box nor desperate for food.

I'll see what his numbers and clinicals are all day. I'm hoping we've finally reached a decent-ish dose for him and yesterday's numbers were just "one of those things".
 
My apologies to you I was still in bed when I saw your post I wanted to answer right away and did not read your signature. do you have a ketone kit? I believe you can get that at any pet store, is a tube with strip, not expensive, and yes if he does not like strangers the BG will definitely rise, it happens to Corky even when vacuuming he hate the thing, I will tag a member that can assist you with Lantus and dosing, I do not give dosing advice, but I suspect Ketones
@Christie & Maverick
@Sienne and Gabby (GA)
 
CORKY said:
My apologies to you I was still in bed when I saw your post I wanted to answer right away and did not read your signature. do you have a ketone kit? I believe you can get that at any pet store, is a tube with strip, not expensive, and yes if he does not like strangers the BG will definitely rise, it happens to Corky even when vacuuming he hate the thing, I will tag a member that can assist you with Lantus and dosing, I do not give dosing advice, but I suspect Ketones
@Christie & Maverick
@Sienne and Gabby (GA)
Click to expand...
I do have Ketostix in case I need them. But I really have no reason to suspect that. There were absolutely no signs. It was the opposite. He was clinically very well.

He's actually great with strangers. He came from a sanctuary where they had new volunteers staying all the time, and he's super-friendly. But the plumbing machine was pretty loud!

His blood sugar rises when we go in a taxi to the vet though, so I know things do affect him.

Interesting about the vaccuum cleaner. I do need to vacuum soon. I will look at his monitor when I'm doing it and see what happens.
 
I strongly suspect you are seeing bounces. I don't think your kitty's body has become comfortable with lower numbers. When you see numbers in the "blue" range, it's looking like his liver and pancreas panic and release a stored form of glucose along with counterregulatory hormones that spike his blood glucose numbers back up.

One suggestion -- you may want to truly stick to the dosing method. Raising the dose by 1.0u can cause numbers to drop or you can end up flying by what would be a good dose for your cat.
 
Sienne and Gabby (GA) said:
I strongly suspect you are seeing bounces. I don't think your kitty's body has become comfortable with lower numbers. When you see numbers in the "blue" range, it's looking like his liver and pancreas panic and release a stored form of glucose along with counterregulatory hormones that spike his blood glucose numbers back up.

One suggestion -- you may want to truly stick to the dosing method. Raising the dose by 1.0u can cause numbers to drop or you can end up flying by what would be a good dose for your cat.
Click to expand...
Thank you. Yes, I think you're right. We seem to have a day of good numbers then a day of flat and high again.

We're doing SLGS, and he's been on 2 units a few weeks now. I spoke to the vet and we've agreed to raise it from 2 units to 2.25, and then she'll call me in a week and a half to assess progress.

I'm going to be away for a while, so a live-in petsitter will be dealing with him, but I'll be monitoring his Libre by the link app.

Anyway, the good news is we are getting some much better numbers now on Lantus than we ever did on Prozinc, and his clinical signs are much better now whether his numbers are higher or lower. So I'm pleased overall.
 
Good idea. I'm monitoring everything remotely. I have mentioned the forum if she needs it.

I have left a needle with soy sauce in it to show the exact amount because we're now at 2.25.

I watched her measure the insulin and give him his shot this morning and she did great

And I spent an hour going through instructions and have left a whole list of "If this...do this..." etc.

So far, so good!
 
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