5/3 Oscar PMPS 450 (last night), can't seem get get below 400

[Christina and Oscar]

Hi. First time here and long journey to get here.

Oscar was diagnosed in spring of 2020. After a few months on Prozinc he was in remission.
In March 2021 he was not doing well. He was diagnosed with diabetic ketoacidosis and hepatic liver. He has a feeding tube that will probably be removed tomorrow. yay.

He has had a Freestyle Libre glucose monitor on since being diagnosed. A month now. so we have been able to monitor his glucose levels many times a day. Not seeing much change on his daily graph.

I'm working on figuring out the graph. But based on the freestyle info from yesterday:
AMPS: 450 (8am)
11:00: 342
5:00pm: 484
PMPS: 500
10PM: 450 ( the freestyle said HI, but did ear prick using ReliOn reader and BG was 450)

He originally started in March on Prozinc and then was switched to Lantus. We started at 1 unit with no real changes and are now up to 3 units twice a day. I've been frustrated because with the increase, his BG seems to be going up, not down. We are going to the vet tomorrow, but after reading some other posts I'm wondering if we should go back down to 1 unit and slowly increase .5 from there.

He is eating mostly Fancy Feast Classics. Still has a RX W/D dry food. We were basically letting him eat anything he would for a few weeks because of the Hepatic Liver

I'm sure I left something out. Let me know what else and I will work on the graph. Still trying to understand how to complete it.

 

[tiffmaxee]

Do you have a spreadsheet? We would need to see one to give any dosing advice.

 

[Liz & Minnie]

Welcome! I am not qualified to give advice but have sympathies with the DKA / feeding tube situation. We were there only a month ago. If they are removing the tube that means he is eating, which is such a feeling of relief! You will get good advice here. There's a lot to take in at the beginning, but it won't be long before it seems normal.

Oscar is a cutie....I hope he's not a grouch.

 

[tiffmaxee]

We ask that you start on the main/health forum and list your intro. They will help with a ss. I see you gave your signature already which is great. We will help you get Oscar regulated.

 

[Wendy&Neko]

We will be able to help you more if we can look at a spreadsheet. Instructions for creating one are here:

How to Create a Spreadsheet:

• Please set up a Google Spreadsheet as soon as possible. Always keep spreadsheets up-to-date! Valuable time may be lost looking for information when a spreadsheet is not up to the minute.
• If you have not been able to transition your kitty off of DRY food yet, please note it on your spreadsheet and in your signature. A dry food diet will often require higher doses of insulin to bring numbers down. Having this information plainly visible will help us help you.

How to Use the Spreadsheet

 

[Christina and Oscar]

I have started a spreadsheet with the info that I have from the FreeStyle Libre and the ReliOn meters and attached it into my signature. Using the Freestyle Libre, they told me to only scan him twice a day, so I don't have a ton of info. But it does take his average for the last seven days which is 404. In the last 14 days his biggest dips in BG has been between 12 pm and 6.

 

[Liz & Minnie]

Using the Freestyle Libre, they told me to only scan him twice a day, so I don't have a ton of info.

I got addicted to scanning the Libre! If I were you, as long as the Libre is still working I would scan it and get a reading every hour to update the s/s.

Also - the sensor captures/stores data (I don't remember how many hours off the top of my head) even when you don't scan. I was able to get the historical data by logging into the https://www.libreview.com - you can download pdf reports and a csv format. I used an app on my phone but you can only get the history from the website. The pdf reports have pretty charts but the csv shows the readings captured by the sensor every 15min. Not sure if it's worth the effort of getting old data but good info to know - last time I used it to get all the numbers from when I was asleep.

Not saying the Libre replaces the poking, but while you have it I would take advantage of all the data it captures!

 

[tiffmaxee]

Cats using reach their peak around +6-7 but some before and some do later. Lantus is based upon how low it takes your cat. Looking at your Libre results what is the lowest reading at any time on 3 units. If you ditch the dry food we can start on TR provided you can test as much as needed.

 

[Wendy&Neko]

Do you have an idea how much of the high carb dry food he's eating each day vs the wet food? That can make a huge difference in how much insulin is needed. If he's eating and will do so about the dry, I would try removing the dry food gradually. Since you have the Libre on, you can catch if he starts to go lower.

 

[Summer and Susie (GA)]

I have started a spreadsheet with the info that I have from the FreeStyle Libre and the ReliOn meters and attached it into my signature. Using the Freestyle Libre, they told me to only scan him twice a day, so I don't have a ton of info. But it does take his average for the last seven days which is 404. In the last 14 days his biggest dips in BG has been between 12 pm and 6.

Good start on the spread sheet, Christina. The folks here will be of great help to you. Sorry about Oscar's additional medical considerations. Try the Fancy Feast Pates. They have less carbs than the Classics. Other, more experienced folks, will be able to advise. Welcome to the group!

 

[Christina and Oscar]

Good start on the spread sheet, Christina. The folks here will be of great help to you. Sorry about Oscar's additional medical considerations. Try the Fancy Feast Pates. They have less carbs than the Classics. Other, more experienced folks, will be able to advise. Welcome to the group!

Thank you. Getting a handle of everything is time consuming. He has been eating the Fancy Feast Classics Pate'. I really hope I have the right food. I did research it before getting it.

 

[Christina and Oscar]

Do you have an idea how much of the high carb dry food he's eating each day vs the wet food? That can make a huge difference in how much insulin is needed. If he's eating and will do so about the dry, I would try removing the dry food gradually. Since you have the Libre on, you can catch if he starts to go lower.

He’s was eating about a 1/2 cup a day and is now eating about a 1/4 cup a day. Sometimes less.

 

[Summer and Susie (GA)]

yes. He has been eating the Fancy Feast Classics Pate'. I really hope I have the right food. I did research it before getting it.

Sorry, I got confused. I was thinking the Classics were not the same as the Pates but, yes, that is a good food. In fact, that is what I feed Susie. Others on this site feed other foods but the Pates are pretty low in carbs which is what you want. Cute picture of Oscar. I am in Florida, too. I agree with Wendy. If you can slowly get him off the dry food that will be a good start. Post every day here so folks can see what is happening with the numbers. I am a "newbie" so can't really advise but will be looking forward to following your progress here, Christina.

 

[Wendy&Neko]

The W/D is 25% carbs and appropriate diabetic foods are 10% carbs and under. 1/4 cup is still quite a bit so I'd continue to slowly remove it.

Since he has a history of diabetic ketoacidosis, are you testing him regularly at home for ketones? You should be testing once a day while he is in high numbers. You can test with either a dipstick in the urine or a blood meter, details here: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters
It'd also be good if you could put DKA and the date diagnosed in your signature, as recent DKA is a consideration in our dosing suggestions.