22.5 mmol (410 mg) Glucose, 2 days before surgery

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Tosca

Tosca

Member Since 2022
I am worried about Tosca. I monitored her today with Alphatrack and the Freestyle sensor. Her glucose varied from 12 mmol (4 hours after insulin), and now 22.5 mmol, 2 hours before her second dose (both readings with Alphatrack).
She is on 1U Glargine twice a day, treatment started 1 week ago.
She eats well, behaves almost normal, uncomfortable with the jacket to hold the sensor, and dental pain (I give pain medication). She is supposed to have dental surgery on Tuesday. Should I insist to control better the diabetes before the surgery? Is she at risk for ketoacidosis now?
 
Without seeing more than a couple of BGs, it is very hard to give an opinion. If you could set up the spreadsheet it would be much easier to help you.
If you have any trouble, @Bandit's Mom can help you.

Tosca said:
Is she at risk for ketoacidosis now?
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Are you testing for ketones in the urine? If not I would get a bottle of Ketostix from Walmart or a pharmacy and test the urine. If there are more than a trace of ketones present you need to tell the vet.
Make sure she is eating and drinking well.
 
The vet should be able to continue with the dental surgery in spite of the high numbers. My Neko's first dental she was over 400. If a cat needs a dental, it can make a cat hard to regulate. So getting the dental is the best thing.
 
Thank you! I finally filled out the spreadsheet, today we are having our first BG curve, after 7 days insulin. I see big changes in one day today, from lowest of 6.9 at 11am and coming close to 20 now at 5pm.
I am waiting for the call from the vet to discuss details about the surgery tomorrow. I am worried about the gap between numbers. I wonder how does it look as a curve and what it means? For me is not clear yet if we keep same dosage or increase, but I am very new to this and still learning.
 
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Her numbers, and the range of numbers, is completely normal for cats new to insulin. Her body isn't used to lower numbers again, and is doing a reaction we call bouncing. Again, completely normal and it will get better over time as she gets used to lower (but normal) blood sugar numbers again. Here is the definition of bouncing:

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

We determine how to change the dose based on how low the dose is taking the cat, and which dosing method we are following. You might want to look at this document that is used by people here giving Lantus/glargine. Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR) The choice of dosing method is based on your lifestyle, ability to test, and goals for Tosca.
 
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