3/25, SIUJIM AMPS (373); +4 (342); +9 (396); PMPS (423)

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sun

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hi,

i am new here and thx some of you helping me to do the spreadsheet and advise on the food.
i am in very difficult situation, as siujim blood curve and condition in the last 3 months are very abnormal, the more insulin we gave her, the higher her sugar.

i just sent the info to the vet and waiting for her reply.
for the past 3 months, just keeping raising the dose but not much effect.

pls note the spreadsheet for details.
http://spreadsheets.google.com/pub?key= ... utput=html

she was ok in late dec to mid jan, normal for 10 days on 1 to 1.25unit.
then i made serious mistake by feeding her almo nature (tuna) which she shouldn't eat at all. and then she had diarrhea and her condition got worse and ever since then, we raise the dose from 1.25 to 2.5 unit now (for a very skinny cat only weight 2.45kg) and still the sugar is very high.

pls advise.
i found one thing strange that 2 weeks ago when we started the new dose (2.5unit), she vomited for 3 days continuously (with excessive drinking) and urine sugar is high, then gradually down a bit, of course not going back to normal.

i really wonder, whether she is producing more sugar to counter the insulin, so she is adapting the insulin every time raising the dose but putting on more sugar... because the more insulin she has, the higher the sugar, this is very abnormal.
or, she is NOT responding to this type of insulin, though in the beginning she does?

pls advise and comment. her curve doesn't appear normal.

thxxxx very much.
anson
 
not familiar with your kitties story -- is there a reason you can't get more blood tests?
are you having trouble testing?
Be happy to help you out with that if you are. please post !

When you keep increasing -- esp w/o much data -- you may have missed your kitties optimal dose and he could be in chronic rebound. You also raised at higher increments then are usually done here on the board.
Have you read the dosing protocol at the top of the page?

for an explanation read here about chronic ( somogyi) rebound : http://petdiabetes.wikia.com/wiki/Somogyi_rebound

Personally, If it were my cat, I would start over at 1u 2x a day and stick with it for a minimum of 6 cycles to see what happens. ECID. my kitty always moved on day 4 of an increase.... so you may wish to hold it for a few extra cycles depending on what your numbers show.

and hopefully you can test more. It's really really hard to dose w/o testing more.
and again...... please let us know if you need some help with that.

will look for your posts.
 
the dosage is suggested by vet. i didn't decide myself.
i can test more but vet asked me to test 2 weeks after the raise of dosage.

for now, vet suggested to bring her in the clinic and let them do the injection and testing because they found it very strange that she is not responding to the insulin.
and we have eliminated all possibilities (new bottle of insulin, test the sugar meter, grain-free food, blood test showing most major organs are fine, and no bacteria in the culture, we even doubted whether my way of injection is fine, so i did one before the vet and she said it's fine).

so we are figuring out why...
and this is why i asked here...
 
if you look at the spead sheet.
we started at 3/4 unit. then 1 unit.
then 1.25, then 1.75, then 2 then 2.5

and all are told by the vet.

even i didn't check blood, i test the sugar in urine.
if her urine is normal, or negative, then iwill test blood. and most probably she is in remission.

if still with sugar found in urine, means she is not normal yet.

Cheryl and Winnie said:
not familiar with your kitties story -- is there a reason you can't get more blood tests?
are you having trouble testing?
Be happy to help you out with that if you are. please post !

When you keep increasing -- esp w/o much data -- you may have missed your kitties optimal dose and he could be in chronic rebound. You also raised at higher increments then are usually done here on the board.
Have you read the dosing protocol at the top of the page?

for an explanation read here about chronic ( somogyi) rebound : http://petdiabetes.wikia.com/wiki/Somogyi_rebound

Personally, If it were my cat, I would start over at 1u 2x a day and stick with it for a minimum of 6 cycles to see what happens. ECID. my kitty always moved on day 4 of an increase.... so you may wish to hold it for a few extra cycles depending on what your numbers show.

and hopefully you can test more. It's really really hard to dose w/o testing more.
and again...... please let us know if you need some help with that.

will look for your posts.
Click to expand...
 
Hi And welcome to Lantus Land!

There are some very experienced people here who can read the subtle changes in your kitty's blood sugar and detect patterns that you or I may not be able to pick out yet.

I looked at your ss and would recommend that you test more. I know you are testing urine, but a nice curve would be good to have as a starting point. Perhaps wait until someone comes along and knows better and advises you about when to do the curve?

Diabetes is certainly a confusing condition at times. Many people will be here cheering you along and offering you advice. I wish you the best of luck and urge you very strongly to read about the theory of the Tilly Protocol for dosing Lantus as soon as you can. It may be that your vet is not familiar with this protocol. Many are not. Even very good vets.
 
There is a difference between urine and blood glucose testing. Blood glucose (BG) gives you almost instantaneous information about how various factors influence BG. Because urine is involved in the body's waste production, food and all of those other factors have to be metabolized and the glucose reading that you are getting is several hours old. As a result, if Suijum's numbers are low due to insulin you may be missing that information since the tests do not reflect what is going on at the moment. In addition, a urine glucose test does not give you important information about low blood glucose levels, as glucose is only found in the urine when the blood glucose level is above 10 mmol/L. That is, a negative urine glucose test may be the result of a normal blood glucose level or a dangerously low blood glucose level, with the urine glucose test unable to differentiate between the 2 situations.

So what does all of this mean? It is very possible that the situation that Cheryl & Winnie described was going on. Given that you were seeing a better response at lower doses, it may make sense to start over at a lower dose. As suggested, you need to hold a new dose a minimum of 3 days (6 cycles) in order to let the dose settle and allow the shed to adjust to any changes in dose. I would also encourage you to stick with blood glucose testing. Urine testing runs the risk of your not getting immediate feedback and missing the presence of low numbers. Are you able to get BG strips at a reasonable cost?
 
I know there is some language barrier.. but I am absolutely impressed how well you are doing :).. so I'll try to be as straight forward as I can.. please don't take it as being rude or blunt, just want to make sure the message gets through.

You need to test more (with the meter, not the urine).

Start over at 1U.


Now the nice verbose version :).
You're obviously working really hard to give the best care to your cat. Testing with the meter becomes really easy with practice and is a very important part of the process.

It's tough to guess what's going on because you don't have consistent data. But as you have noticed, things were going pretty good on 1U.. it's really unclear to me why an increase was done to 1.25 if things were "normal" (both in urine tests and meter readings). Yes your cat was sick, and that plays a big part. However, the numbers that you are at now are reason to be concerned.. go back to the last known good dose.. maybe the numbers won't be better right away.. but at least you won't have to guess what the results mean.

Starting over at 1U, doing more frequent meter testing, and doing slow increases as needed (typically 0.25 at a time, and rarely more often then once a week initially until you have enough data).. at the VERY least will give you a solid baseline of information to continue helping your cat.

A vet can be fantastic and not be up to date on the latest and greatest of feline diabetes. My cat's doctor has a masters degree in human diabetes research, and she's the first to admit she can't keep up to date on the newest research without help from her clients, because she has to be an "expert" at hundreds of diseases for dozens of species of animals at the same time.
 
thanks.

no worries on the language, we learned abc when we were 3 years old.
hk is a bilingual city.

yes, i see what you mean.
tomorrow, vet suggested that i should bring her to the clinic, and let them do the injection/blood test, and stay for a day.

i used to have a BS meter that is difficult to use. but i've got a new one which is good.
so, i can check more often now.
i didn't check BS often as the vet suggested i should check after 2 weeks time. so i didn't.
but i see what you mean.
at the time when she was normal, if sugar level in urine was negative, i would do blood test to make sure her sugar was not too low for the shot.

i am doing the tests today at home. tomorrow, vet will do it at the clinic. then let's see what the vet suggested.

i will also talk to the vet the suggestion you folks mentioned, starting all over again at 1unit or 1.25 unit, the dose she had when she was the most stable.

vet raised it to 1.75unit as the sugar blood test was higher. to 2 because it didn't go down. further to 2.5 because the blood sugar almost remained that high. and two weeks later after raising to 2.5, the blood sugar is still that high (as shown in the spreadsheet)
and this is why i asked for advice here.

will see how things go in the coming days.
this morning, the figure is very high still over 400. will do +4 a while later (this is noon time in hk).

thxx very much.

btw, i have contacted an animation communicator. will see whether she can help as well. as the condition is very abnormal.


Dawn & Nova said:
I know there is some language barrier.. but I am absolutely impressed how well you are doing :).. so I'll try to be as straight forward as I can.. please don't take it as being rude or blunt, just want to make sure the message gets through.

You need to test more (with the meter, not the urine).

Start over at 1U.


Now the nice verbose version :).
You're obviously working really hard to give the best care to your cat. Testing with the meter becomes really easy with practice and is a very important part of the process.

It's tough to guess what's going on because you don't have consistent data. But as you have noticed, things were going pretty good on 1U.. it's really unclear to me why an increase was done to 1.25 if things were "normal" (both in urine tests and meter readings). Yes your cat was sick, and that plays a big part. However, the numbers that you are at now are reason to be concerned.. go back to the last known good dose.. maybe the numbers won't be better right away.. but at least you won't have to guess what the results mean.

Starting over at 1U, doing more frequent meter testing, and doing slow increases as needed (typically 0.25 at a time, and rarely more often then once a week initially until you have enough data).. at the VERY least will give you a solid baseline of information to continue helping your cat.

A vet can be fantastic and not be up to date on the latest and greatest of feline diabetes. My cat's doctor has a masters degree in human diabetes research, and she's the first to admit she can't keep up to date on the newest research without help from her clients, because she has to be an "expert" at hundreds of diseases for dozens of species of animals at the same time.
Click to expand...
 
hi sun

your post got lost.
just wanted to let you know that in order to prevent that every day here in lantus land a new thread or "condo" is opened every day. You have the header perfect.
in the body of your message please make sure to link to your previous day's post and a link to your spread sheet if you have one.

thank you . I hope to see you posting more soon!
 
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