1/13 Terra, almost 2 weeks and still in the 400s

Status
Not open for further replies.
K

KarenAmelia

Member Since 2012
I'm concerned. Terra has stayed in quite high number territory, despite a day or two in the beginning when her numbers dipped down. There are some days in the chart where there's a dearth of data and it's possible she dropped down undetected. I could accept the theory that she was on rebound for a few days, but now it's been more than a few days. I just tested at +8 and got 411. Based upon earlier data, this time should be only an hour or so past the nadir. I reduced her dose from 2 to 1.5 for a period, when it seemed that she had to be past the bounce phase and was still reading high. Yet since the numbers have been consistently high I went back up to 2 tonight. (Terra's spreadsheet is attached.)

The vet started her on 1.5 units on Dec 31. I switched her over to canned food pretty much right at that time, and still stayed with 1.5. She got some good low numbers early on and now nothing like those early numbers for several days. Am I causing the problem by varying the dose too much? Should I drop back to something really low, as others seem to do when they switch to canned food: say .5unit? Is it possible that too high a dose will cause an extended bounce?

She was very hungry today, and ate what for her recently is a lot: 6-7 oz of canned food. Prior to today she'd been picking at her food or eating more meagerly. Seems that her coat and her energy fluctuate pretty wildly: one 12 hour period her coat will be lustrous and the next, it will have that greasy look that she had before the diagnosis. She seems to regain weight and then lose it, and she goes from acting perky and playful to tired and listless overnight.

I am unable to detect any pattern, and I'm feeling that I'm doing this all wrong: just when I think there's a trend in the right direction, it seems to go the other way. Need some help thinking this through.
 
Are you checking for ketones in the urine? With the high glucose levels, that might be good to check. If you have a blood ketone meter, that'd be even better, although those strips are pretty pricey.

Remember, it can take Lantus 3-5 days for a dose level to stabilize. Stick with the 2 units for 3-5 days, with whatever spot checks you can get aroung the probably nadir. If you can, run a curve after 5 days, and check every 2 hours to see how it goes. With a curve or multiple mid-cycle spot checks for the 3-5 days, if the nadir is between 150-300, you might increase 0.25 units; if the nadir is over 300, I'd be inclined to increase by 0.5 units.
 
Hi Karen,

You haven't been doing this long so there's no much of a pattern to evaluate.

Here's what I would do if Terra owned me and I was a newbie.

I would get those Ketostix BJM spoke about and test Terra's urine (regularly) to make sure there weren't ketone problems brewing. THIS IS IMPORTANT.

Then I would start Terra back at 1U and try my best to follow the protocol on the TR Lantus Board. To follow those rules as best you can doesn't mean you need to post there. But the one rule you do need to follow, as BJM mentioned, is to hold the dose for an adequate period of time and not jump around on the dosing.

Some cats need time to "get with the program." Many can't figure out the program if the caregiver is dose hopping. As I used to tell people back when I did more dosage advising, patience grasshopper and sit on your hands when you get impatient about the dose.
 
Hi, Karen ~

BJ and Venita have both given you some good suggestions. And this information from the Lantus TR board might be helpful, too (scroll down to see how Julie explains bouncing):

New Dose Wonkiness (NDW) and Bouncing Explained

It can take months to get a cat regulated on Lantus or any other insulin, so hang in there with Terra, Karen.

Eva
 
Thanks for the good advice. I know that there's not enough data yet to see any patterns, plus nothing has settled and I've been changing the dose. In thinking about it, though, I came to the same conclusion that I ought to start over. Reducing the dose to .5 or 1 might be good, as I switched her diet about a day into the Lantus dosing (before I got the glucometer so it precedes the chart). I've been wondering if these high numbers represent a struggle between her liver and the insulin . Maybe she's getting more Lantus than she needs and this is just one sustained bounce.

Would it be safe to reduce to .5 at the next dose and just stick with that? I am thinking to ask the vet too but he isn't all that knowledgeable about diabetes.

I think every newly diagnosed FD cat should get a BG curve BEFORE starting on insulin, to see what the baseline is. That would be very helpful in Terra's case.
 
You could start over at .5, but I do worry about possible ketones. Get the ketostix, make sure she continues to eat well, be watchful of any infective processes, and start over at .5. You are the one holding the syringe.
 
Status
Not open for further replies.
Back
Top