3/31 - Shakespeare - Stumped!

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dmartini4

dmartini4

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ok so this does not make any sense...this is so outside the norm....
so I reduced last night and he had a decent drop ...+4 = 246
ok, unfortunately, fell asleep...amps was 410, crap so I went back up to 2.8
well all day he was acting blah again...which is what has me puzzled...
as I reduce he starts acting better and better, as soon as I increase he goes funny again
this was his day
amps410 - shot 2.8
+4=294
+7=330
pmps was 445!
so I shot 2.6 and will either stick with that or keep reducing?!?!?!?
I dont know, this is the strangest thing!
anybody ever seen anything like this before?
 
Take a look at Grayson's SS for the entire month of March. About a 25-30% drop - flat as a pancake in my mind. He was probably at IHOP w/ Shakes! :lol: I think we're in the same boat - or at least the same parking lot with our kids!
 
Hi Denise,

I looked at Shakes' SS and I see all the red at shot time. I noticed the note about the cystitis. Sid's numbers get all crazy and he acts different when he has an infection. I hope the Dasequin (is that what you are giving Shakes?) is helping if there is something.

I know how frustrated you feel about those numbers.
 
So sorry that it is so frustrating right now. I will be praying for improvement very soon! You are doing a great job!!!!
 
Hi Denise,
I'm stumped too. :?

OK, you (way back when) tried Humulin and you tried Lantus, then switched to Prozinc... And for a while, you looked like you were making progress, and then the "meter crisis" with Freestyle happened, and you found out that you couldn't trust any of the old numbers. And since then, it's been nothing but confusing and frustrating.

You have previously been on higher doses, and saw some decent numbers periodically, but nothing consistent.

That about sum it up?

So now you are trying to see if lower doses will help.
The observation you've made that has me perplexed is that on lower doses, he acts like he feels better, but on higher doses, he acts lethargic. Why that is odd is because lethargy is a symptom of blood glucose that is too low. Humans who are low, feel like crap and "tired". Which is what it sounds like you are describing. But you don't see any numbers that would make that seem like what is happening. Maybe you are just missing those numbers? Maybe they happen quick, and his body fights them off really fast? I don't know, it's that whole "timing" thing for me again!

The numbers on your spreadsheet "look like" his doses are too low. But you increase and they don't get much better, if at all. So.... maybe a drop is worth a try. Like even lower than his current lowered doses. Maybe 2.0? For 3 or 4 cycles, and see what it does or doesn't do.

Couple of questions first:
Has Shakes ever been tested for one of the "high dose" conditions like Cushing's or IAA or Acro?
Is the antibiotic he's taking for cystisis still being given?
Have they done any urine cultures to see if there's a UTI hiding someplace?

Is he "normal" in terms of eating and appetite, and are his litter box trips "normal"?
The 5 P's thing, is he good on those?
I want to believe that there is something else that is causing Shake's problems besides just diabetes, and if that is fixed, the numbers will start to make sense again....

Carl
 
Hi CArl,
I am starting to see a pattern since I have been on vaation last week(first one in over a year and stayed home)
I started lowering a week ago..and it seems that he will dip at night, give a decent amps, then
stay flat all day....this has been every day all week...also...one weird thing..I noticed in the moring for the
first 6 hours, he eats like a mad man....if he falls into a deep sleep, he will wake suddenly
and run to the food bowl and eat like crazy
I take his numbers during the day but he stays flat..could that be because of the constant eating?
the reamainder of the 6 hours in a cycle he does not eat....weird...
Also he has been tested for all the cushings etc...nothing....
Now, what i have also been wondering...if he has been insuch high numbers for over a year..why has he never DKA...
also...why is he gaining weight?...he went from 14 lbs at diagnosis..to now 17 pounds, gaining a half pound in the last 6 months...if he is so uncontrolled shouldnt he be losing wight?
the cycstitus is cleared up and he is fine and not on antibiotics in weeks...
did a urine culture..no infection
He is acting better I think on the lower dose..I am going to lower tonight to 2.4 or 2.3 since he moves only at night right now..just a thought, what if he has always n=moved only at night, I always did my curves during the day...
Sorry so many thoughts and really not sure what to do
thanks for all of your time
 
The lowering to see sounds like a plan to me. Hope it helps or at least gives you more information to go on!
 
Hi Denise,

No advice from me, but want to add that my Pudge feels awful and lethargic (wants to sleep and not move much) when his BG is high. He does much better behavior-wise when his BG is low even as low as 46 (I use ReliOn micro meter and at times double check with a Bayer Contour)). I'm wondering if he'll eventually be one of the cats whose BGs always stay on the low side - of course, I'm just dreaming of that day! Right now he throws me as many curves as he can - from tid to bid cycles. He had a bad day yesterday both behavior (sleepy and lethargic) and number wise (high). Today both his numbers and behavior are much more what I call 'normal.' He's had all the tests and has no underlying conditions, just diabetes. Best wishes to you and Shakespeare ( love that name).
 
Now, what i have also been wondering...if he has been insuch high numbers for over a year..why has he never DKA...
also...why is he gaining weight?
Click to expand...

Denise,
This is a common misperception with DKA. High numbers don't cause it by themselves. And a kitty can go DKA on lower numbers too.
Undiagnosed diabetic cats are also likely to be ketoacidotic by the time they're brought to a vet, but not all cats are prone to ketoacidosis.
Click to expand...

Our bodies normally are "fueled" by burning glucose; they are able to do this provided they have enough insulin (normally or by injection). When there's not enough insulin to allow the body to burn glucose for energy, it begins metabolizing fat to fuel its cells. In particular, the brain cannot go without energy even for a second, so it demands fat conversion to ketones when glucose energy is unavailable[26]. Continuing this process using fat and ketones instead of glucose without sufficient insulin intervention is the path to ketoacidosis.
Adapted from the Wikipedia:
Normally, ketone bodies are produced in minuscule quantities, feeding only part of the energy needs of the heart and brain. When insulin is inadequate, fat must be turned into ketones for energy instead, and they rapidly become a major component of the brain's fuel. As a result, the bloodstream is filled with an increasing amount of glucose that it cannot use (as the body continues adding glucose to the blood with gluconeogenesis and perhaps also glycogenolysis). This extra glucose significantly increases its osmolality.
At the same time, massive amounts of ketone bodies are produced, which in addition to increasing the osmolal load of the blood, are acidic. As a result, the pH of the blood begins to change. The trace element balance of the system is altered by falling bicarbonate blood levels and rising serum potassium levels. The potassium level of the body as a whole is reduced by the polyuria of ketoacidosis[27][28]. There can be changes in breathing (deep, sighing breaths) because the ketones themselves are acids. Any type of acidosis can affect the respiratory system.
Glucose begins to spill into the urine as the proteins responsible for reclaiming it from urine reach maximum capacity. As it does so, it takes a great deal of body water with it, resulting in dehydration[29]. Dehydration worsens the increased osmolality of the blood, and forces water out of cells and into the bloodstream in order to keep vital organs perfused. The vicious cycle is now set, and if untreated will lead to coma and death.
Click to expand...


What causes ketoacidosis in cats?
There are several possible causes including;
Undiagnosed diabetes
Insufficient insulin
Missed insulin
Not enough food
Illness & or infections (especially of the urinary tract)
Obesity
Stress
Surgery
Idiopathic (no known cause)
Click to expand...
Clinical signs include sudden collapse, dehydration, weakness, depression, vomiting, and an increased respiratory rate.
DKA can occur at any age and there is no breed or gender predisposition with this disease.
It appears commonly in obese cats or cats with a history of sudden weight gain. Concurrent disease predispose cats, especially diabetic ones to developing DKA. Concurrent illnesses include chronic renal disease, hepatic lipidosis, acute pancreatitis, bacterial or viral infections and neoplasia[2].
Click to expand...

There's a lot of stuff that needs to happen together in order for DKA to happen. Usually includes not enough insulin, not enough food and an infection of some sort. You can see ketones, and never see DKA. The ketones have to be sufficient enough, and around long enough, to cause the system's PH to also become acidic. Things like not eating, dehydration, vomiting can all cause the liklihood of ketones to become worse. Once a cat has shown ketones, he's more apt to show them again. I often wonder why Bob never did after his DKA, but he didn't.

Carl
 
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