11/26 Webster +11.75=532 +2=516 +3=556

Status
Not open for further replies.
W

Websterthecat

Member Since 2014
Yesterday: viewtopic.php?f=9&t=128994

Woke up this morning and Webster followed me around for 45 mins looking for food. I wanted to wait until +12 to get a reading but he insisted on food so I checked him at +11.75 and he was in the black :shock:

Instead of feeding him his entire 1/2 daily allowance at once, I fed him 1/4 and will put out the other 1/4 around +2 after getting his reading.

Looking over his readings over the past 3 days, we are likely looking at an increase from 0.25u to 0.50u this evening. His appetite is much healthier compared in comparison to 11/22 when he continuously dropped below 50.
 
Re: 11/26 Webster +11.75=532

Some cats get very hungry when they drop low while others not so much. To complicate things, Max is his usual unpredictable self and does both. Good luck with the dosecrease. You might want to add a ? to your subject line to get advice about how much.
 
Re: 11/26 Webster +11.75=532

tiffmaxee said:
Some cats get very hungry when they drop low while others not so much. To complicate things, Max is his usual unpredictable self and does both. Good luck with the dosecrease. You might want to add a ? to your subject line to get advice about how much.
Click to expand...

I have noticed that he seems to be hungry even when his BG's are high. He also looks for food whenever his numbers are rapidly dropping off.

Julie advised to bump it back up to .5U if I don't see numbers in the green this morning. Looking back at her post, I'm wondering if I should have increased his morning dose after this mornings 532 reading?

I'm starting to become concerned about ketones with these numbers. I've been trying to catch him in the box so that I can get a urine sample.
 
Re: 11/26 Webster +11.75=532

No worries about not increasing this morning. Just do it tonight if you don't see any green with this cycle. From what I have read about DKA as long as he is eating well it is missing a key component. :smile:
 
Re: 11/26 Webster +11.75=532

Dear Webster and Mikey.

Are you two in cahoots? We beans are worried sick. Please have mercy on us! I know you are conducting secret communications. Please communicate about green and blue and forget pink, red and black. Thank you. confused_cat

Mary
 
Re: 11/26 Webster +11.75=532

tiffmaxee said:
No worries about not increasing this morning. Just do it tonight if you don't see any green with this cycle. From what I have read about DKA as long as he is eating well it is missing a key component. :smile:
Click to expand...

I'm trying not to worry. So far he is alert, active and hungry.

Can someone tell me if I am looking at this correctly? Without enough insulin his body is not processing the sugars from his food which is why his BG has been on the higher side. He's constantly hungry because he's eating but the food is not converting and repairing cells and his body is demanding more food. In the meantime, his body is attacking fat in an effort to find a source of energy. When the fats break down they release ketones which show up in the urine. Is this pretty much whats going on?

I was just looking WikiVet and it said:
DKA is the result of marked insulin deficiency, and ketonaemia and ketoacidosis occur approximately 15 days after insulin concentrations are suppressed to fasting levels
Click to expand...

What is considered "marked insulin deficiency"? Are we talking in the 300's,400's 500's for +-15 days? This whole Ketone thing has me worried.
 
Re: 11/26 Webster +11.75=532

Marycatmom said:
Dear Webster and Mikey.

Are you two in cahoots? We beans are worried sick. Please have mercy on us! I know you are conducting secret communications. Please communicate about green and blue and forget pink, red and black. Thank you. confused_cat

Mary
Click to expand...

Looks like Mikey had a good evening yesterday and just may be headed for another good day today. ;-) How did he eat last night and this morning?
 
His eating is kind of so-so, Mike. He seems to prefer small meals today, which is fine, because I'm here. How about Webster? Is he still doing the same?
 
Marycatmom said:
His eating is kind of so-so, Mike. He seems to prefer small meals today, which is fine, because I'm here. How about Webster? Is he still doing the same?
Click to expand...

He's very active and seems "fine". His appetite is very high. He at 1/2 of his daily calories (just over 3.5oz) within the first 3 hours and is looking for more food. I don't know what to do. Feeding him more is only going to drive his numbers higher because he doesn't seem to be getting enough insulin to process the sugars. Can anyone advise?
 
It's not ideal to have him in the 500's - no doubt about it. However, you can only control so much.

I'd feed him his regular amount today. If he were mine, I'd increase his dose tonight if you don't see green today, and it doesn't look like you're going to. I think I wouldn't test again now until pmps.
 
julie & punkin (ga) said:
It's not ideal to have him in the 500's - no doubt about it. However, you can only control so much.

I'd feed him his regular amount today. If he were mine, I'd increase his dose tonight if you don't see green today, and it doesn't look like you're going to. I think I wouldn't test again now until pmps.
Click to expand...


Thank you Julie. So why not test the rest of the day? Because his numbers are likely to be high? What do you think about bumping him back up to .75u instead of bumping him to .50u.

I don't know which scares me more- these really high numbers or really low..
 
I would only increase by 0.25u to a new dose of 0.5u. Consider that is a doubling of his current dose. It is also the "last good dose" and it got him into the low 40's. I would not even consider an increase more than that.

from the TR page:
If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
Click to expand...

Remember that you are dealing with a depot insulin. When you raise the dose, you won't see the full effects of that newly greater dose until the depot and the dose are equalized, which can take a few cycles. Some cats respond immediately to a dose increase, some have a delayed response to the dose increase. Small incremental changes can make significant differences in blood sugar.
 
Mike, I was thinking I should explain more about dose adjustments with Lantus.

One example that people frequently use on here is that steering the blood sugar with a depot insulin is like moving a barge. A small adjustment can change the trajectory, but you can't make quick changes with larger adjustments. A speed boat is light and you can move the steering wheel back and forth and it will respond quickly. But depot insulins are like moving the barge - small change to finesse the barge in the right direction, then wait while it does its thing to see if you've adjusted enough. If not, another small adjustment to fine tune things.

You can't use Lantus to beat down high blood sugar. One reason it works so well in cats is because it lasts fairly long in the cat's body - around 12 hours in most cats, although that varies from cat to cat. Quick acting insulins can bring down a cat's BGs fairly rapidly, but they don't hold them down, so the cat will often soar high once the insulin wears off. It's just a different way of managing the cat's blood sugar, but in the long run it's more effective than quick-acting insulins.

Take a look on this link and look for the posts that talk about the difference between Lantus and Levemir. Understanding the depot is going to be really helpful for you.
 
julie & punkin (ga) said:
Mike, I was thinking I should explain more about dose adjustments with Lantus.

One example that people frequently use on here is that steering the blood sugar with a depot insulin is like moving a barge. A small adjustment can change the trajectory, but you can't make quick changes with larger adjustments. A speed boat is light and you can move the steering wheel back and forth and it will respond quickly. But depot insulins are like moving the barge - small change to finesse the barge in the right direction, then wait while it does its thing to see if you've adjusted enough. If not, another small adjustment to fine tune things.

You can't use Lantus to beat down high blood sugar. One reason it works so well in cats is because it lasts fairly long in the cat's body - around 12 hours in most cats, although that varies from cat to cat. Quick acting insulins can bring down a cat's BGs fairly rapidly, but they don't hold them down, so the cat will often soar high once the insulin wears off. It's just a different way of managing the cat's blood sugar, but in the long run it's more effective than quick-acting insulins.

Take a look on this link and look for the posts that talk about the difference between Lantus and Levemir. Understanding the depot is going to be really helpful for you.
Click to expand...

Thanks for the explanation Julie and I completely understand what you are saying. I'm just looking at Webster like a ticking time bomb right now. His numbers are very high and he's already had DKA once. I understand that you must go slow with the dose and build it up as the complete effect is not seen until several cycles later. This is why we wait 3+ days before considering an adjustment.

It's just hard to watch him while in these high numbers because he is potentially producing ketones as his levels remain high. He's been starving (keeps wanting more and more food) because the insulin is not enough help convert the sugars in his blood.

I guess I will have to sit here and watch him with these high numbers while waiting a few days for the new dose to begin kicking in hoping that he's not producing ketones. I don't know what else I can do for him. :sad:
 
Mikey's at 520. I swear they're communicating. Going to try to get a ketone test myself when he wakes up.
 
What is considered "marked insulin deficiency"? Are we talking in the 300's,400's 500's for +-15 days? This whole Ketone thing has me worried.
Click to expand...

If Webster were in the 300s or higher for 15 days we'd be jumping up and down well before that for you to increase the dose! You really can't look at just higher than desirable numbers as the sole predictor of ketones. Unfortunately, ketones can develop even if numbers are normal -- it's unusual, but it can happen. Insufficient insulin is only one piece of the equation. This is why we look at the whole cat -- is the kitty lethargic (that's a red flag for me), is he eating, is he acting like he's sick? Those are all important pieces of the puzzle.
 
Sienne and Gabby said:
What is considered "marked insulin deficiency"? Are we talking in the 300's,400's 500's for +-15 days? This whole Ketone thing has me worried.
Click to expand...

If Webster were in the 300s or higher for 15 days we'd be jumping up and down well before that for you to increase the dose! You really can't look at just higher than desirable numbers as the sole predictor of ketones. Unfortunately, ketones can develop even if numbers are normal -- it's unusual, but it can happen. Insufficient insulin is only one piece of the equation. This is why we look at the whole cat -- is the kitty lethargic (that's a red flag for me), is he eating, is he acting like he's sick? Those are all important pieces of the puzzle.
Click to expand...

He's been more active and energetic than ever and follows me around looking for more and more food. I keep giving him just a little to tie him over and keep him within his calorie limit which just over 7 oz of his current food.

I wish 9:00PM would get here sooner so that I can get him started on his new 0.50u dose and drive those numbers down (not too fast of course)
 
Marycatmom said:
Mikey's at 520. I swear they're communicating. Going to try to get a ketone test myself when he wakes up.
Click to expand...

Very interesting. I Webster a couple hours ago for ketones and is good so far.
 
Psst! Webster! It's Mikey! What colors should we do tomorrow? I think our best bet for freaking them out, is to head way down in the greens. Like about 30. I can hear the panic now! This is going to be great!!!!!

Your partner in crime,
Mikey
 
Marycatmom said:
Psst! Webster! It's Mikey! What colors should we do tomorrow? I think our best bet for freaking them out, is to head way down in the greens. Like about 30. I can hear the panic now! This is going to be great!!!!!

Your partner in crime,
Mikey
Click to expand...

Sounds about right. :smile:

I upped Webster's dose .25u this evening. Let's hope both Webster and Mikey cooperate this weekend!
 
Webster is more than a glucose number, right? You might find it useful to track some of the Secondary Monitoring Tools - maybe water intake, hydration, urine output and characteristics, hunger, etc.- and put them in the notes on your spreadsheet.

Although less precise than glucose monitoring, a "whole cat report" that includes more than the glucose numbers will help you evaluate him overall. You can have great glucose numbers and a very sick cat otherwise. And you can have a somewhat normal seeming cat with high glucose levels. And every permutation and combination in between.
 
i find it intertesting that the only time Webster has been in black is after he's been in green. Makes me wonder if he dipped somewhere or not? Just a thought. I'd try to grab a test some time before bed tonight.

Good luck with the increase, Mike.
 
BJM said:
Webster is more than a glucose number, right? You might find it useful to track some of the Secondary Monitoring Tools - maybe water intake, hydration, urine output and characteristics, hunger, etc.- and put them in the notes on your spreadsheet.

Although less precise than glucose monitoring, a "whole cat report" that includes more than the glucose numbers will help you evaluate him overall. You can have great glucose numbers and a very sick cat otherwise. And you can have a somewhat normal seeming cat with high glucose levels. And every permutation and combination in between.
Click to expand...


Absolutely. I started to track his food & water intake etc but got sidetracked. I'm going to start doing this over the next couple days.
 
Marje and Gracie said:
i find it intertesting that the only time Webster has been in black is after he's been in green. Makes me wonder if he dipped somewhere or not? Just a thought. I'd try to grab a test some time before bed tonight.

Good luck with the increase, Mike.
Click to expand...

That's a possibility. He wasn't cooperating last night but seems to be more cooperative today. Will be monitoring today.
 
Status
Not open for further replies.
Back
Top