4/22 Heart - AMPS 277 - BG Rising

[dodgingwrenches]

Hi all,

My cat has been a diabetic for four years (you can see his history in his SS). Anyways, end of last week he started being picky with his food and didn't groom as much and drank more, so I tested him Saturday and put him right back on insulin at 1 unit but then figured given his size 1.5 would be a safe start. Held that for three days but last night his BG went even higher, so I increased to 2 this morning. I guess I don't understand that since I hadn't seen it before with him - I've seen his BG not going down while I gradually find(increase) the dose, but to be honest, given that I caught the diabetes early this time, and his BG wasn't as high as the previous times I started him on insulin, I expected it to be working at a much lower dose and not to see his BG rise? Anyone with a long-term diabetic encounter this?

His appetite is very healthy, but he's becoming a little grease monkey since he won't groom!

Thanks,

Sophia

 

[Chris & China (GA)]

Hi Sophia and welcome back! Sorry that Heart is back here from the Falls though!

First, you need to stay with one dose for 5-7 days since you're back on Lantus to rebuild the depot. You're going up too quickly and not giving the depot a chance to form so you're not going to see how well the dose will work.

I think I might go back down to the 1.5 you were on for 6 cycles and hold it for a few more cycles. On the PM cycle on 4/21 (when he had a PMPS of 166) you didn't get any other tests during that cycle, and he was at 166 at the AMPS on the 22nd....he may have gone much lower during that PM cycle, but there's no way to know.

I know getting them controlled after they come out of remission is tougher, but we still follow the protocol (although we may be a little more aggressive)

Is there any chance he has any infection or inflammation..especially in his teeth? A lot of cats come out of remission due to needing a dental or having a UTI

Good luck to you and Heart! I hope this will be a quick detour and he'll be back at the falls soon!

 

[dodgingwrenches]

Yup, his teeth are bad again so he is going in for his second dental in six months next Tuesday. I was just hoping to get him under control before then...

I can't measure during the day anymore, so it's back to middle-of-the-night alarm clocks to get some readings in between the PM and AM shot. Ugh.

 

[Marje and Gracie]

Sophia

I'm sorry you and Heart have to be back but it's good you got him started on insulin.

Actually, I would not decrease the dose back to 1.5u and I'm glad to see you've raised him as you have. For cats returning from the Falls, you need to be aggressive to have the best chance of getting him back there and we also recognize that you now have experience with FD and can be more aggressive. Finally, we have found that cats returning from the Falls typically (not always but often enough) will need to go above the highest dose they were on the last time around. Let's cross our fingers that Heart will not need to do that.

I would leave him at 2u unless he earns a reduction by going below 40 on a human glucometer. But I also would highly recommend you try to get in a +2 and before bed test every evening so we can make sure he's not coming down somewhere and, if you work during the day, try to get an out the door test and an in the door test.

I would also suggest that, if he does not earn a reduction or start seeing normal numbers at the 2u dose, I would raise the dose after six cycles but only raise it 0.25u.

Hopefully, you will see some movement and once his teeth are taken care of, can get him back to remission.

Let us know how we can help.

 

[Sienne and Gabby (GA)]

I guess Heart just wanted to pay us a visit. Let's just hope it's a brief one.

I agree with everything Marje said. The only thing that I would add is to not draw too many comparisons with Heart's last round on insulin. That was then; this is now.

Whatever you can do to get his teeth taken care of will no doubt help.

 

[julie & punkin (ga)]

just wanted to offer you a little moral support, sophia!

i hope Heart's dental works wonders for his BG's and he's back in remission soon. Good for you for catching things early on!

 

[dodgingwrenches]

Thanks all. Yep, I think he wanted to come visit! Enjoyed it too much last time

I have stuck with the 2 units for now. His evening numbers are looking a bit better, but it's hard to tell since there will be constant food spikes - he's grazing all day and I'm encouraging him to eat as much as possible (his +3.5 this PM was just after eating as well) because he's down a full pound in weight this past month - which is already much skinnier than his healthiest days (used to be 15-16 pounds, peaked at 14 pounds since the last insulin round, and is now 13)