01/13 PMPS 421 +3 421

Clarissa & Leo

Clarissa & Leo

Member Since 2020
Hi all,

We are a bit at a loss here and are wondering what to do. Leo's BG was super good until the end of November, with 1 U of Lantus in the AM and PM. All of a sudden in December the BG values increased and in early January we bought a new ampule of Lantus and increased the dose to 1.5 U. 10 days after the increase in dose, his BG is actually higher. How is this possible? We measured his BG PMPS (421) and decided to give him 2U, 3 h after, the levels are the same. Any advice on what to do?

We have not changed his food: he eats Purina Pro-Plan Diabetes Management wet food (1x85 g in AM and 1x 85 g in PM) and Hill's Prescription Diet Diabetes Weight management (10-15 g twice per day, whenever he wants to eat).

For full disclosure: Leo had a vet appointment last Friday. Apparently there's some gingivitis and inflammation, so he will have an appt for teeth cleaning next next Friday. He also might have has a slight ear infection and we are applying medication. In his appt next Friday, they will also do blood tests to check if all is ok.

Strangely, since his blood sugar is higher, Leo seems to be happier, he plays more and hangs out with us more.

Thank you all for any advice you might have!

Clarissa
 
Hi! i'm hoping @Wendy&Neko, @tiffmaxee, or maybe @Bandit's Mom may be able to stop by and provide some guidance.

FWIW, my two cents: to keep Leo safe, you at least want to test before each insulin shot (AM and PM). And then to get clues as to how low the dose is taking Leo, you'll want to get a few other tests (at least once per cycle).

I hope the dental and clearing of the ear infection help bring down his numbers :bighug:

Have you seen the dosing methods sticky? You may want to check it out -a lot of us follow one of the two methods listed in the link here.
 
As you know Lantus is dosed upon nadir. As Susanne said, you need to get an amps and PMPS every day and at least a curve once a week or sporadic tests to see how low the dose is taking him. Since the nadir is not at the same point every cycle more testing up is needed. I can’t give you advice without those tests.
 
Since you say he feels better with higher numbers I wonder if he’s been dropping too low and getting too much insulin.
 
I can't tell from your test data whether Leo is getting too much or too little insulin. Are you familiar with the concept of bouncing? From the New to the Group Sticky Note:
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).

It's possible with just the sporadic tests you are getting that you are testing when he is bouncing high, and missing the low points. The fact that you are seeing higher numbers after an increase means he's probably going lower when you aren't testing due to the new dose, and bouncing higher. We also only change doses by 0.25 units at a time, so as to not bypass a good dose. Cats are sensitive to small changes in dose.

I would go back to giving 1.5 units, and do some more testing. As others have mentioned, it's very important to test before ever shot to make sure it's safe to give insulin. We need the tests in between the shots to see how low the dose is taking the cat, and thus how to adjust the insulin.

Leo also isn't eating the best food for a diabetic, but we won't talk about changes there until you are testing more, as change to a better diet can mean a drastic reduction in the amount of insulin needed.
 
Can't thank you all enough for the feedback provided, and especially the explanation on bouncing. Once changing the dose, and having BG remain high, how many cycles should one wait to make a decision on increasing again? I've read one week.
Just out of curiosity, where could I find more information regarding the food? Apologies for the ignorance or any mistakes, I have not posted here in a long time.
 
Clarissa & Leo said:
how many cycles should one wait to make a decision on increasing again? I
Click to expand...
We have two dosing methods here, one is the Tight Regulation protocol, the other we call Start Low Go Slow. Our Sticky Note on Dosing Methods describes them in detail. Most people pick one of the two dosing methods, which ever suits their lifestyle and goals. Each method differs in how long you hold the dose, and amount of testing you need to do.

We suggest feed low carb wet or raw food, under 10% carbs is best. We don't have a list specifically for Europe, but our lists of low carb foods for the UK can usually be ordered in Europe.
 
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