12/27 Grace Need eyes.

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KarenRamboConan

KarenRamboConan

Member Since 2009
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This cat is the MOST insulin sensitive cat I have ever worked with. She will drop 200 points on a skinny 0.1u. Her BGs were going too low on a skinny 0.1 so we tried a couple of cycles OTJ ... she stays very stable without insulin, virtually no fluctuation at all, but the BGs are too high. Pop her on 0.1 and she goes too low- peaks in about 2 hours, too, which is fast for Lev. And then goes into nasty rollercoaster highs and lows- way too much.

Then we tried 0.1u SID, and that didn't work.

So now we are trying a fat 0u. After a few cycles, it seemed to work, but I think Hollis shot an empty tonight.

OTJ is not enough. A skinny 0.1u causes rebound.

HELP!!!

SS : https://spreadsheets.google.com/ccc?key ... VWkE&hl=en

22nd
PM PS 11.4 (205)
no shot
+3 15.6 (281)


23rd
AM PS 16.6 (299)
no shot
+2.5 19.4 (249)
+8 17.7 (319)
PM PS 16.9 (304)
+3 18.5 (331)
+10 16.4 (295)


24th
AM PS 19.9 (358) fat 0
+2 16.1 (290)
+5 12.6 (227)
+7 10.6 (191)
+10 16.6 (299)

25th
AM PS 21.7 ( 391) fat 0
+2 16.1 (290)
+5 11.6 (209)
+8 15.6 (281)
+11 15.0 (270)


26th
AM PS 16.4 (295) fat 0
+2.5 12.2 (220)
+4 14.9 (268)
+10 18.6 (335)


27th
AM PS 19.3 (347) fat 0
+4 6.3 (113)
+ 6 7.1 (128)
+ 9 8.3 (149)
PMPS 12.4 (223)
+2.5 15.7 (283)
+4 17.5 (315)
 
karen,
with just a quick look at ss, I see notes on side that recently dx HT and put on tap. also other med changes??
wondering how much all that is affecting BG.

can you sum Grace's meds, dx and recent changes? does she have a profile?
 
OMG - forgot to mention the HyperT. :evil: Was very late and I was wipe when I posted. Sorry!! But yes, I think some of this may be because of the fact that she was diagnosed 3 weeks ago and the meds may be changing her metabolism...

She also has HCM - very stable. Is on Fortekor, baby ASA (every few days) and potassium. Was Dx'd over a year ago. Two episodes of DKA over a year ago, as well, before got her to a new vet (who Dx'd the HCM and HT) and switched her to Lev. She was OTJ for almost a year before a suspected bout of pancreatitis sent her back into this spiral - andthat's when the HT was Dx'd.

I think that's all.

And no, no profile, just the SS. Her mom does not have access to a computer.
 
it looks to me like Grace needs to go back to 0.1 units BID. She did hit 50s a couple of times, but 50s aren't too low and especially on such a small dose. It looks like Grace popped up pretty easily from there with some food, so there shouldn't be any danger of hypo. The fat zero isn't enough to keep her under renal threshhold, at least right now.

If Hollis feels like Grace is dropping too early in the cycle, she could try rearranging Grace's meals a bit. Several people here are doing that with good success - split the AM meal into a few smaller meals and feed, for example, at PS, +1, +2, +3 or whatever works for Grace. It takes some time for the change to really settle in but it is well worth experimenting if she is home to try different schedules. For a lot of cats that helps ensure that sufficient food is on board at the time the insulin onset occurs.

Also, you are on the money that the hyperthyroidism is affecting her blood sugar. This link(for humans) has some easy to understand information on how hyperthyroidism can increase insulin resistance and worsen glycemic control. Once Grace's thyroid is under better control, the glucose should become easier to manage too, but it could take a while to get the thyroid under control.
 
sehjak (Susan & Lanky) said:
I am cross-posting in other forums with link to here:
Feline Health
Levemir (Detemir)
Click to expand...
susan, karen has a thread on Health: https://spreadsheets.google.com/pub...XzAwUEJKaUdUXzNyUDBkVE1KM2c&hl=en&output=html.

i agree with libby on going back to 0.1u bid. if i recall, hollis feeds grace two meals a day. dividing a meal up into small portions might prevent those fast drops. we usually recommend feeding small portions at ps, +1, +2, and +3. however, it's just a starting point. the method will probably have to be tweaked to fit grace's needs.
 
Ha! Great minds think alike. :lol: I advised Hollis to go back to 0.1u last night (starting this morning) .... right before the storm took her phone line out! So fingers crossed!

Libby- she actually dropped into the 30s a couple of times, which is why I went to a skinny 0.1u... but I think going back up and staying below renal threshold is worth it.

Libby and Lucy, Hollis already splits her breakfast into three portions, and does the same with her supper. I may ask her to slightly increase the carb content since this is not working in slowing the free fall.

Susan, thank you, but I had already cross posted, so I deleted your post on Health. But thank you again, all eyes are welcome!

Thanks, all!
 
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