2/19 Jones question from cat sitter

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Silvercattech

Member Since 2017
Good day,
I am Jones pet sitter, Tracey suggested I post to the forum if I had any questions. Tracey has been away for a week and I am getting unusual readings. For background, I am a vet tech with 21 yrs experience with 7 of those cat only.
I am at the home twice daily to test BG and give insulin and oral meds. Other family members are feeding and doing some additional BG readings during the day (although compliance is a bit of a question)
The first 4 days after Tracey left, Jones understandably had normal happy readings (4-6mmol/L). He had been dropped to 0.1 units glargine the day Tracey left. Readings have been creeping up ever since. When I started to get readings over 10 mmol/L I increased to about 0.2 units. It's been 4 days of that dose and readings are creeping over 20. Today I increased to 0.5 units.
Symptomatically, Jones seems fairly normal. His appetite was quite poor initially, so hubby switched from PVD DM to Fancy Feast. Even though he's running a little high, he's eating about 2/3-3/4 his normal amount. No lethargy or vomiting.
When I do get readings from the family mid day or late night they are consistent with the +12 readings I'm getting so I don't think Jones is in symogi. Hubby had been asked to try to get a urine ketone strip but has been reluctant.
I'm a little perplexed at his high readings. If he was stressed from Tracey being gone I would expect him to be running low. With his appetite a little off I would expect low. I'm suspecting the Fancy Feast might be a factor but I don't think that's all of it.
I am at the very end of a glargine pen...maybe its insulin effectiveness?
Opinions/suggestions appreciated,
Cathy
 
I've been helping Tracy & Jones and so has @Wendy&Neko . On 2/12 Jones hit 59 mid cycle. There were no PM cycle tests 2/11-2/13. He may have gone a little lower or started a delayed bounce from that 59. His dose should not have been raised. I would take him back down to the .1u dose and hold it for at least 3-5 days. Too much insulin can cause high numbers making it seem like he needs an increase.

Do you know what Fancy Feast he is eating? Is it pate only or have they been feeding some with gravy?
 
Jones last thread
http://www.felinediabetes.com/FDMB/threads/jones-vacation-dose.173354/
and Jones ss
https://docs.google.com/spreadsheets/d/160TdBFzwpT_-ZG4rLXRGNtS9WanSMehrLvfaIrXR6_k/pubhtml#

If you take a look at Jones ss for an example of what karen is talking about, look at January 24, you'll see that on that day Jones dropped into green numbers (but normal numbers for a healthy cat, not in hypo territory here), you'll see that the amps on the 25 was high(red), that is what we refer to as a bounce, a physiological reaction to numbers that jones isn't used to, this results in his liver temporarily dumping glucose into the blood stream and giving rise to higher readings, the important thing is that we do not 'pay attention' to the readings that we get during a bounce (it can last up to 6 cycles), we wait till the bounce clears and then see where kitties numbers 'land'.

Just so you have an idea we have had kitties that can go from 20 to 5 in the first half of the cycle and then back up to 20 by the next preshot, in an instance like that we would hold the dose.
I don't think there's enough data to support taking the dose up from 0.2 to 0.5 u, the dosing is based on those midcycle numbers and they are not there, you need to try and get the family on board with the testing


I think we really need to try and see if they can get a couple of readings in each cycle, I know that this might be difficult compliance wise.
I would also try and encourage a ketone test, I do think that's important, with Jones not eating as much and numbers being seemingly higher it's a wise precaution.

.

Another thought occurs to me, if compliance is an issue, are they feeding Jones any forbidden foods??
 
The Fancy Feast is the pate Tracey approved, I know hubby is giving copious amounts of Temptations treats also. It took several days for me to convince Mr that he has to discard the old canned, not just wait for Jones to eat it. Once he started doing that, Jones appetite improved.
I appreciate the link to the other thread, Tracey never told me it was recommended to decrease the dose again, I was only told Mr was asked to get more readings. I reiterated the importance of the ketone testing, it seems clear that isn't going to happen.
I increased the dose based on readings from 4 days ago - as numbers continued to increase, I increased the dose. It seemed logical to me, as the dose had been dropped from 0.5 to 0.1 units without a step in between, that his BG numbers would increase. I understand what you are saying that this could be symogi but there is no way for me to tell that without more numbers.
Unfortunately it is easy to say, just get more numbers, but this has not been possible.
I will drop down to 0.1 and wait for Jones' response. What if the numbers continue to climb? I'm not comfortable with him in the 400s long term.
 
Silvercattech said:
I know hubby is giving copious amounts of Temptations treats also.
Click to expand...
That is probably the problem, some members use the temptation treat to help bring up the numbers if kitty is plummeting and looking like they are heading for a hypo.

He needs to stop feeding them routinely, I'm sure tracey left them so that he could use them if Jones needed them for low blood sugar.
They are high in carbs.

If he stops feeding them, you may well see the numbers plummet once the carbs are worked out of the system.
Also he must not feed him anything two hours before you come in to shoot.

Silvercattech said:
Unfortunately it is easy to say, just get more numbers, but this has not been possible.
I will drop down to 0.1 and wait for Jones' response.
Click to expand...
If you do that and Jones dad stops feeding temptations we might find the numbers improve.
I'd be concerned if you kept him at 0.5u and we stopped the temptations because he could bottom out once the carbs from the temptations wear off.
 
Silvercattech said:
as the dose had been dropped from 0.5 to 0.1 units without a step in between
Click to expand...
He did have 3 cycles on the .25u dose which is in between the .5u and .1u. It could take 4-6 cycles to see if reducing is going to make a difference. Temptations will raise the bg's of course so hopefully he will not give any more of those.

Hopefully a few more mid cycle tests can happen. He might need to go up to .25u but take him down, let the depot stabilize and see how he does.
 
Hi Cathy.

You're getting great advice, so I'm not going to add much except to say that Tracey sure picked a great cat sitter! You are obviously very conscientious and open to input and you take initiative. It's not often we get a cat sitter that will post here for help, although we always encourage it. Jones is in great hands.

I also encourage you to hide the temptations. They are aptly named, and it applies to the owners as well as the cats!
 
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