? 11/12 Picchu PMPS >400 322+3 247 +6 (1.5 UI, first post)

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lantuslantus1234

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Hi everyone,
This is all very new to us.
Picchu (15lbs, USA) was diagnosed last week for the first time at 16 year old with blood sugar in the 500. Started on Prozinc on 1/7, he proceeded to vomit all day and had to be hospitalized for 2 nights. He was at 350 on 1/7 with ketones at 1.2 that evening before hospitalization. Has been eating fine.
Treated with IV Insuline he dropped once to 127 and then hover back up to 350, >400 overnight. During the day he dropped to 250 at the lowest and ketones dropped back to 0.2. He was diagnosed with pancreatitis, and abnormal liver function with a heteregenous mass on his liver that we didnt get tested but potentially cancerous.
1/ 8 evening he was started on Lantus 1 UI, spent the night at > 400/HI.
1/9 day he was around 350 for most of the day, may have dropped a bit lower shortly
Discharged 1/9 night at 350 PMPS, with anti nausea medecine and a suggested dose of 1 UI of lantus.

1/9 evening/night was spend mostly on HI but dropped once to 350 at +6
1/10 day was mostly HI, 400 +3, 335 +6, HI +9, and back to HI preshot
1/10 night he was upped to 1.5 UI HI, 379 +3, HI +6, 330 +9, 290 +11,
1/11 AMPS 383, 376 +3, 383 +6 (with drops between 3-6), 357 +9, 396+11

Tonight, we are at 1.5UI, and he seems on track to drop much quicker. He ate a bit less than previous days. We struggle to get him to eat 3/4 of a 3oz can at once before shots (he was free feeding before, have not change his wet food to limit changes, but he had been on kibble for most his life with wet food as a treat).So far:
1/12 PMPS HI, 322 +3, 247 +6, ??? +9
We ended up giving a tiny snack at +6 because our vet had told us we didnt want him to drop too fast even if the numbers are still very high, and we have not clue what to do.

Any advice would be greatly appreciated. We are trying to understand whether he is doing ok ish or he is in a dire situation. It is now 3 am and I am up checking on his level regularly to see if he drops below 200. I am not able to call our vet until Monday 8am.
 
lantuslantus1234 said:
Hi everyone,
This is all very new to us.
Picchu (15lbs, USA) was diagnosed last week for the first time at 16 year old with blood sugar in the 500. Started on Prozinc on 1/7, he proceeded to vomit all day and had to be hospitalized for 2 nights. He was at 350 on 1/7 with ketones at 1.2 that evening before hospitalization. Has been eating fine.
Treated with IV Insuline he dropped once to 127 and then hover back up to 350, >400 overnight. During the day he dropped to 250 at the lowest and ketones dropped back to 0.2. He was diagnosed with pancreatitis, and abnormal liver function with a heteregenous mass on his liver that we didnt get tested but potentially cancerous.
1/ 8 evening he was started on Lantus 1 UI, spent the night at > 400/HI.
1/9 day he was around 350 for most of the day, may have dropped a bit lower shortly
Discharged 1/9 night at 350 PMPS, with anti nausea medecine and a suggested dose of 1 UI of lantus.

1/9 evening/night was spend mostly on HI but dropped once to 350 at +6
1/10 day was mostly HI, 400 +3, 335 +6, HI +9, and back to HI preshot
1/10 night he was upped to 1.5 UI HI, 379 +3, HI +6, 330 +9, 290 +11,
1/11 AMPS 383, 376 +3, 383 +6 (with drops between 3-6), 357 +9, 396+11

Tonight, we are at 1.5UI, and he seems on track to drop much quicker. He ate a bit less than previous days. We struggle to get him to eat 3/4 of a 3oz can at once before shots (he was free feeding before, have not change his wet food to limit changes, but he had been on kibble for most his life with wet food as a treat).So far:
1/12 PMPS HI, 322 +3, 247 +6, ??? +9
We ended up giving a tiny snack at +6 because our vet had told us we didnt want him to drop too fast even if the numbers are still very high, and we have not clue what to do.

Any advice would be greatly appreciated. We are trying to understand whether he is doing ok ish or he is in a dire situation. It is now 3 am and I am up checking on his level regularly to see if he drops below 200. I am not able to call our vet until Monday 8am.
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Hello and welcome. I moved your post from the Lantus forum to the Feline Health forum, which is where we ask new people to post first. The Lantus forum is a busy one, and to properly help over there with dosing, we need certain things set up first, such as a spreadsheet showing at least the last couple weeks worth of blood sugar data. The instructions on how to set up a spreadsheet are in the link Diane posted above. If you need help with the spreadsheet, let us know, we have people who can help with this.

I'm glad to see that you are home testing. Do you have a hand held BG meter in addition to the Libre 3? We strongly recommend having a hand held meter for a couple reasons. First, the hand held can be used as a back up should the Libre fail - they do after two weeks and sometimes cats will get them off. Second reason for a back up meter is that the Libre's can read lower than they should in low numbers, so it's good to double check. Most of us use human blood glucose (BG) meters. You want want with cheap test strips that needs a small blood drop.

Are you testing at him with a ketone meter? Since he had a history of DKA, I'd strongly recommend you get either a hand held blood meter for testing ketones, or test him with urinary ketones. More details on how to test and some meters in this post: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters. Figure out how he is doing at home with ketones will help you determine if this is an emergency. Urine testing sticks are available at most people pharmacies. Ketone testing meters might need to be ordered.

There is no issue with feeding Picchu multiple times per day, at this point in time. He doesn't need to eat all his food before the shot. Lantus takes a couple hours to kick in so you have time to get him to eat some. Recovering from DKA, he should be eating 1.5 times his normal calories. Are you still giving the anti nausea medication? What type did they give you? I like ondansetron best.
 
Thank you!
I have created my spreadsheet and updated the signature.
We only have a LIbre for now. I have a human tester but probably one that requires very little blood, i will look into it.
We do not have a way to test for ketones I did not know we could do that at home, I will look into it.
We usually feed picchu dry kibbles, grazing all day, he has not been over eating over the last several months. We have moved over only wet food as directed by the hospital at insuline time but he struggles to eat more than 1.5 oz at once. We leave the remainder out for a few hours usually. I dont think he is getting enough calories. I will provide more to help, during the day. maybe kibbles?
 
What type/brand of kibbles is he eating? Most are too high in carbs for a diabetic.

I can't access the spreadsheet. You need to change the access so anyone with a link can read.
 
It's fine to either leave Picchu's canned food out or put out new food every hour or so. In other words, you can feed him "mini-meals". There are only a handful of dry foods that are low in carbs and frankly, canned food is healthier for cats. They benefit from the moisture content in canned food. If you want to keep up with dry food, Dr. Elsey's Clean Protein or Young Again Zero Carb are possibilities. There are also some freeze dried raw foods (e.g., Stella and Chewy's) that I believe are low in carbs. They need to have water added, though.

It sounds like what you're seeing is that your cat's numbers are at their low point at about 5 - 6 hours after you give Picchu his shot. That would be typical for Lantus. The nadir (low point) is usually about mid-cycle. Because he's fallen out of the habit of spending time in normal numbers, his liver and pancreas may go into panic mode and spike his blood glucose numbers if he drops into a range that's lower than what he's used to.
 
Thanks, It is tough to know what to do. Right now with wet food out, pushing it, he will only eat about 1 5 oz twice a day when no other food is out. i am worried he is not eating enough. wet food is a lower carb fancy feast variety Dry is Iams proactive senior which is likely hgh carb, cant find info.
We have a dm vet dry food but vet suggested to stick to wet food as possible and/or food he knows to limit changes.
Anti nausea meds is Cerenia (maropitant citrate 60mg)
i will try to skip the kibbles and leave out more wet food but it dries out and he wont touch it unless fresh/warmed
 
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Yes, stick with canned food. You may need to feed multiple cans spread throughout the day. Cats can be picky about dried out canned food :rolleyes: Try freezing canned food into meal sizes and put a frozen chunk into the bowl to slowly defrost. Many people use a programmable timed feeder to give their cats small meals during the day. The feeder lid keeps canned food from drying out too fast and some feeders have ice pack features.

Does your cat seem constipated? If there's still no poop tomorrow, call the vet and ask about treatment for constipation. Miralax is often used for occasional constipation in cats. The vet can give you a dose. Mix the powder in some water and then mix into canned food.
 
Diarrhea. He is walking around meowing, confused. he sounds like he needs to vomit but he is not. He is not drinking as much water as usual (a lot). he goes in and out of the litter without doing much there. He was treated with a 10 day antibiotic for urinary infection before discharge as a precaution.
he seems out of it. BG is around 345, lower than usual at thia time but he didnt eat dinner nor did he get an injection.
 
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