AMPS-402 3/7/21 dose increased 3/5 question about food and results

Hello again...

At the end of this post I included links to my previous posts/questions in case someone needs to refer back to a previous conversation. Basically I finally increased my cats dosage from 2.0 to 2.5 BID (I hope that means twice a day) and the first day was great. I was super excited to see some numbers in the 200's finally and thought we were finally getting somewhere. However; that same night and following days to come his numbers climbed back up like they were post dose increase. I had a long hard think about what could have been different that day and nothing comes to mind. The only thing that could be a HUGE factor is his kibble (Purina-DM) and maybe he just didn't eat as much of it the day of the dose increase and that is the factor involved. In order to test this theory, I took his kibble away today and have been feeding him wet only. His numbers still stayed in the 300's and never reached the 200's.

My question is should I continue to see improvements on a daily bases after a dose increase? Why would he respond great the first dose and then go back to previous numbers? And is it dangerous for me to now switch him to a wet only diet considering I just increased his dose? Even though his numbers are still showing pretty high should I let him have his kibble and start a diet change a week from the dose increase?




Links to previous Questions of mine:
https://felinediabetes.com/FDMB/posts/2748584/
https://felinediabetes.com/FDMB/posts/2749160/
https://felinediabetes.com/FDMB/threads/3-2-ashfur-amps-344-question-about-dosage.243990/

 

I'm tagging @Critter Mom she is very knowledgeable and may be able to help you. It could also be helpful to put your question in the Lantus specific forum, located here. I, unfortunately, do not have an answer for you. I'm sorry!

 

Thank you for your reply regardless. I have managed to not feed him any dry food except this morning at about 6Am (when I think he usually eats it the most) I gave him about 2tbs with his wet food...Today his BGS were TERRIBLE. I don't know if its from him going without dry food and then having a tiny bit for breakfast OR if maybe I accidentally did a fur shot this morning. OR maybe he has another health issue going on. Difficult to say. I think at this point my plan is to continue feeding him as much wet food as I possibly can and if his BGs continue to be high tomorrow, maybe a visit to the vet is in order to rule out UTI.

I am just so clueless as to the pattern that is happening and what is causing the difference between the numbers I get in the day versus night. ARGGGGGGG

Anyway....
Thank YOU!

 

You should probably also get the vet to rule out any infections in general, especially the teeth. I do think you're right to be suspicious of no change, that's a pretty big dose of Lantus bid with no real change.

Acromegaly can present like uncontrollable diabetes (at least in the light reading I have done), so that could be another possibility.

I skimmed some of your other posts, are you having a lot of trouble getting him to eat wet food?

 

I also read in your spreadsheet that he was hospitalized for kidney failure last month? What kind of treatment is he getting for that?

 

So I did a whole lot of reading on the Acromegaly myself today and I looked up "what does uncontrolled diabetes look like". I don't know if I am being unrealistic with his numbers or not because whenever I reach out to my vet she seems to think his numbers look "just fine" and its very frustrating. I went up in dose after telling her that was my plan basically and she agreed it was ok to do so. But, I feel as if I am always pushing the treatment further for better results. Which makes me question if its my lack of knowledge about this disease and how it works or if its her just being satisfied with the fact that my cat is not showing physical signs of diabetes.

I thought I would have more trouble getting him on wet food. I think it was more my problem then his. I was concerned he would go without while I was at work BUT he actually doesn't eat that much. I bought a timed feeder but I'm only gone for 7 hours and I think If I leave 2 bowls out he will just eat when he's hungry (he is not the type of cat to eat unless he is hungry).

The day he was diagnosed with diabetes he stopped eating and drinking and went into DKA and I believe that is what happened to him and caused him to be hospitalized. I looked over his papers the other day and compared some of the values to his labs and now I understand more today than I did that day what happened. So we have not had any blood work since that day because we had to switch vets. Maybe I should bring that up to the new vet.....good observation

 

His numbers looked great last night!!!

Would you mind posting pictures of his last bloodwork? And do you have a blood ketone meter? Urine strips to check ketones never worked for Moo Moo.

Does he get let outside at all? Could it be possible another family leaves out kibble for him?

 

Yes I do have a blood ketone reader I use it for myself because I am on the keto diet. I wasn't sure if that blood meter worked for cats but and my vet told me it wouldn't so I picked up urine strips.

ABOUT HIS NUMBERS LAST NIGHT.....they panicked me a little. They were great, but they came out of nowhere, and I worried that I might have dosed him 3.5 instead of 2.5....It just makes no sense all the sudden. I always recheck the syringe BUT mistakes happen. When I checked his BG a couple hours ago it was 147 and it was 2 hours away from shot time. I made the mistake of feeding him, and now that his BG is raised I cant tell if its because his shot is wearing off or if its from the food he ate. I should have looked it up BEFORE I fed him.

Do you think it would be unwise to dose him like normal today? I thought about posting this question but maybe I'm overreacting. I don't know. I feel like I am just worried all the time. I have to work today from 3pm-9pm so I can't be home if something were to happen. It scares me. Its shot time now and his BG is 345.

 

I'm sorry I didn't see this right when you posted, I don't know enough to give you dosing advice. I used a human meter on Moo Moo and it worked for her.
Did you give his normal dose?

 

I waited an extra hour and he ate another meal and I gave him 2 units (Preshot BG- 380). I think I'm just over-reacting. His numbers finally looked good and I got scared. I always triple check his dosage so I'm sure I gave him normal dosage last night. Maybe the numbers went down because of a combination of factors. 1- I finally learned to gently mix the insulin to prevent bubbles (I wasn't shaking it before but I did it much slower last night after reading an article) 2- I injected in another area after reading circulation is better (in his side area versus the scruff) 3- he had been on a way lower carb diet than ever before for the 48 hours leading up to last night. 4- my husband said he didnt eat anything all night and he usually does.

I think maybe could have just been the perfect combination of things. OR IM JUST DRIVING MYSELF MAD with this LOL.
I'm hoping I can come home from work at the "peak" hour just to check on him tonight. BUT Im sure he will be just fine!

anyway, even though your not able to give me advice. Its nice to just be able to say what I am thinking to another human being that knows more than people around me what I am experiencing. So thanks for lending me your time

 

You're welcome! Please let me know if you are able to check, I would leave out food for him while you're gone so he can eat if he starts dropping.

 

Yes I'm going to leave out both for him. fingers crossed I made the right choice!

 

Hi! Just checking in on how Ashfur is doing

 

Thank you for checking in nice of you.
I definitely did NOT mess up his insulin dose the other night because last night same thing happened again. I believe its the diet change that is reflecting in the numbers. I'm having the same problem again this morning though, his BG is lower than his usual number and I feel like the shot is not wearing off soon enough...I'm just now seeing these lower numbers so they make me a little uneasy, I think as we go on this should get easier because I'll know more how he responds to certain situations. So I'm going to stick with taking away the dry food and maybe lower the dose for now and then I can increase it after he hasn't had dry food for a solid week. Then I'll feel like I know what will happen.....I hope that makes the most sense for him.
I could be wrong....I'm just kind of winging it. Reading as much as I can and praying everyday.

 

Sorry for not being around much today, I'm glad to see him still dipping into the blues!
I think lowering the dose is a good call, especially when you can't be there to monitor him. Diet can change a lot, and it's crazy how just a little bit of kibble can throw their whole system out of whack with diabetes. I will keep you and him in my prayers

I hope you had a good day!