558 mg and driving me crazy!

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ThomasTheTomcat

ThomasTheTomcat

Member Since 2013
I received my Bozita and Grau order from zoolplus two days ago.

Thomas is receiving Lantus, 1 unit at 12 hours. This evening his sugar was 588. He never was so high.
Today he ate bozita (chicken, no grains), some chicken meat and my mom did the mistake to give him some yogurt.
I am scared right now. I hope it is not from bozita and it is from yogurt.

His higher levels were around 380 , never 500.
 
Hi,

Please try not to fret, I'm sure this can be sorted out.

Are you testing Thomas between shots? Did you do that today? Do you know how low he drops mid cycle?

He may be high because he's eaten something he shouldn't have.
It's unlikely to be Bozita, it has a track record of being a good food for diabetics.
It could be yogurt, or chicken IF they have some kind of additives/flavourings/sweeteners. (Plain yogurt and chicken are fine)

OR, it could be that he dropped lower than he was comfortable with during the cycle and he is 'bouncing' up high as a response to that. Hence my asking about mid-cycle numbers.
If you've changed his food to lower carb then the blood glucose could be dropping, and the insulin requirement dropping too...

Or it could be another factor entirely. Anything from infection to furball...
How does Thomas seem in himself?

Eliz
 
The problem is that I am not at home all day, so I am testing only before the shots.

When I will manage to have a day off I will do him a curve.

His last curve was done on his previous food, not bozita and he seemed fine with one unit bid.

I am kinda freaking out because he was never so high. I will wake up tonight to see his sugar at about 6 hours from the shot.

I don't really trust that this commercial chicken is not injected.

He is active, cleaning himself, playing so he doesn't seem to have a clinical problem except diabetes. Actually he is more active than he has ever been in the last 2 months.

I will lower his insulin a bit. I begin to believe that it is a insulin bouncing, since I changed to bozita.
 
ThomasTheTomcat said:
His last curve was done on his previous food, not bozita and he seemed fine with one unit bid.
I am kinda freaking out because he was never so high. I will wake up tonight to see his sugar at about 6 hours from the shot. .
Click to expand...

It is possible that Thomas's insulin requirements have decreased, and possibly as a result of feeding a lower carb food.

Does the Bozita that you're feeding have an 'analysis' on the label; ie percentages of protein, fat, fibre, ash, moisture/water?
If you post them here I'll do the carb calculation for you.

And what were you feeding before? Do you have a label with the analysis percentages? (If not, maybe I can find that online...)

If we have both of those then we can compare. If the carb percentages of both foods are similar then we need to look elsewhere for Thomas's high numbers.

Eliz
 
Bozita chicken, no grain: protein 9.5%, fat 5%, ash 2%, humidity 82%.

His previous food was certainly higher in carbs: RC diabetic, hills, dry food.

I believe I will lower his next dose.
 
Aha... it is highly likely that the diet change is the culprit....

With the Bozita figures that you gave me the percentage of calories from carbohydrates is 6.5%....

I'll see if I can find the figures for the other food and be back shortly....

Eliz
 
OK, can't find the 'analysis' for that dry food at the moment (my computer is really slow today!), but it is quite likely to be around 30% calories from carbohydrates...

So...

The most likely thing that is happened is that the reduced carb diet has reduced the blood glucose, and hence the insulin requirement. The high numbers you're seeing are quite possibly rebound (what we call around here a 'bounce') from his having dropped too low.

"Too low" could be either dangerously low (hypoglycemic), OR just too low for Thomas's current comfort levels (some cats get used to being in higher numbers and have to 're-learn' what is normal).

If he has dropped too low then his body may also have released counter-regulatory hormones to try to keep the blood glucose high for a while...

There may be another cause of his high numbers but this would be top on my list of suspects.... And yes, a dose reduction would be needed.

Eliz
 
This morning he didn't allow me to test him. I lowered his dose and I will test him when I come back home.
I will try to get a day off to do him a curve. I truly think it is from to much insulin, due to the change of food.

Thank you so much for taking your time to help me :RAHCAT
 
Hi,

There are quite a few folks experienced in using Lantus here if you would like help with working out the dosage adjustments for Thomas..? Most Lantus people here use a specific Lantus dosing protocol which has proven very effective.

And there is a lot of information about Lantus contained in the 'Stickies' at the top of the Lantus forum page here:
viewforum.php?f=9

What's your name by the way?

Eliz
 
My name is Alexandra :-D

I read more about this Somogyi rebound and it seems that it usually takes 2-3 days for the sugar level to go down after this kind of rebound, although the insulin dose is lowered.

I lowered his dose and I will try to get a day off to perform him a curve this week.

He is hungry, but alert and active.

I will post his curve in here for opinions confused_cat
 
Looking forward to seeing some test numbers.
It is possible that since he was sitting in the 300's before that even dropping to a yellow or blue could cause him to be bouncing.
That would not be somogyl.
That would just be normal bouncing.

It will really help when you are able to get another test or two. I know it's difficult when you are gone all day.
 
I just tested him : 350 mg

His highest values were usually around 360 mg (before changing to lantus).

A week ago I tested him around 7 hours after the shot: 144 mg. This value was achieved with 1 unit of lantus. His food was not bozita at that time.

He changed to lantus 12 days ago. Changed to bozita 3 days ago.
 
When the count back started on the screen I was so scared that I will see 500 again :) This night I will sleep better than the last one.

I will definitely start a spread sheet and post his curve in here. I just hope to get a day off soon this week. I don't want do "curve" him at the clinic because he stresses a lot.
 
Hi Alexandra, :smile:

That 144 (at close to the peak of the insulin cycle?) was pretty much up the top end of the normal blood glucose range.
And switching from dry food to wet low carb food could have meant that Thomas dropped a lot lower than that after the diet change.
(What glucose meter are you using? Is it Alphatrak, or a 'human' glucose meter? (they read differently))

We see quite a lot of 'bounces' here but not all of them are 'somogyi'. Cat's often 'bounce' without their numbers remaining high after the event. As Rhiannon said, it is possible for cats to bounce just from dropping into a blood glucose range that is uncomfortable for them, ie lower than they have become used to.
(Rhiannon referred to 'yellow' and 'blue' numbers; that's because many folks here put their cats' numbers onto a spreadsheet that we have here, and the numbers are 'colour coded' to make it easy to see the patterns. If you wanted to put Thomas's numbers onto a spreadsheet then I'm sure someone here would be glad to help with that.)

Some cats bounce up high from a low number but are still responsive to the next insulin shot. Some cats, like mine, seem unresponsive to the next insulin dose, but will respond to the one after that. And some cats (especially if they've dropped into very low (potentially hypo) numbers) may seem resistant to insulin for a couple of days or more. It really does seem to be a 'every cat is different' thing... Cats, eh? They do like to give us puzzles to solve.... :roll:

It will be interesting to see what difference the diet change makes to Thomas. You never know, Alexandra, maybe he will even be one of the lucky ones who goes into remission at some point...?

Eliz
 
oh yes, a curve at the vet is just a waste of money and too stressful for Thomas.

Perhaps you could get in the door/out the door tests.... helps create a bigger picture of what's going on. It doesn't just have to be a +6 ( midcycle)
Nadirs can wander and each cat is different. ( my own cat had nadirs at +2, +3 ~ right at onset)
It would be good if his "normal" numbers were lower than the 300's.
We'll know better what he's doing when you get the ss started.
 
Elizabeth and Bertie said:
(What glucose meter are you using? Is it Alphatrak, or a 'human' glucose meter? (they read differently))

It will be interesting to see what difference the diet change makes to Thomas. You never know, Alexandra, maybe he will even be one of the lucky ones who goes into remission at some point...?
Click to expand...

I am using a human glucose meter.

I really hope that one day he will go into remission. For now I will wait to see how his diet changes things.

rhiannon and shadow said:
It would be good if his "normal" numbers were lower than the 300's.
We'll know better what he's doing when you get the ss started.
Click to expand...

My purpose is to keep him under the renal limit. We will know better after the curve.
 
Last evening Thomas had 350 mg.

Today, he was alone at home all day. I have 4 more cats so I can't leave him food around the house. With no one to feed them I skipped his insulin this morning.

This evening he had 501 mg. He only only ate bozita and chicken in the morning and bozita in the evening ( 1 hour before the test).

I know that a curve would help more, but I wanted to keep you updated.
 
Are you testing for ketones?

You can buy ketostix at most any pharmacy. You will need a urine sample.
With numbers that high and no insulin, you need to monitor for ketones as they can progress quickly to DKA which is very costly to treat at the vet and very life threatening.
 
He had urine and blood tests last week and he was negative for ketones.

He always receives his insuline. This was a very unique event.
 
re-cap of what you've said.


11/23 pmps 558
11/24 pmps 350
11/25 pmps 501

pm stands for pm shot time... ps = preshot number....

you said you were feeding and testing and hour later.... It would be better for you to test, shoot, feed at the same time ( except when you aren't sure your cat will eat such as when they feel bad )


ideally numbers are under 200 ( with a human meter) to be below renal threshold.
The 144 you got was actually a good number, not a scary one.


It sure would be good to get more data. I know you are gone all day.
Would you be able to set and alarm and get one in the night?
It would also be good if you could do the pm shot... and get a test 2 hours later. Maybe that would be before you go to bed.
 
rhiannon and shadow said:
..

you said you were feeding and testing and hour later.... It would be better for you to test, shoot, feed at the same time ( except when you aren't sure your cat will eat such as when they feel bad )
Click to expand...

My mom got home first and feed him. I tested him before the shot.

I wonder: I shot at 7:30 am

He eats his food distributed all over the day and he eats more calories at 12:30 am (when the insulin peaks).

His next shot is 19:30 pm. He eats than, but I usually go to sleep around 10 pm (his last meal). He has no caloric input during the night. Maybe he gets to low during the night? The vet suggested me to distribute his food and try to shot only in the morning.
 
there are many cats here that go lower at night. And yes, the absence of food can contribute to that.

I only have my one cat.
I put two bowls of food down when I go to bed. I add 1-2 tablespoons water to the canned food to help it last longer and not get crusty.
You might need to find a way to isolate him so he has more opportunities to eat.
If your mother is around, she could also give him a meal or two at other times. It is less stressful on their pancreas to get mini meals rather than fed only twice a day.

Mine is now in remission and I try to get her to eat a little every 4-5 hours..... because I want to keep her in remission as long as I can.


Lantus really needs to be given every 12 hours. It is a depot insulin. The insulin accumulates in the body ( what we call the shed). When you skip a shot, the shed drains a little.
Lantus and Levemir are Depot Insulins where one shot builds upon the previous so you have a cumulative effect. Think of the depot as a bucket of water that you keep adding a set amount into. At some point, it will overflow. You can decrease the amount of water you put into it but you won't see the results of that (e.g. No water going over the top) for a bit.
Click to expand...
If the dose is too high, then we lower the dose so that it can be given 2x a day.

It is hard to evaluate if Thomas's dose is too high.
After all, the 144 is a much better number and the goal is lower than that. Any number below 50 gets a dose reduction for a newly diagnosed cat.


Here is some information about lantus.
new to lantus
 
During the day he eats : 7:30 at the shot
12:30
17:30
19:30 at the shot
22:00

It is hard to isolate him because he wants to sleep with me, all of them do. :cry:
 
rhiannon and shadow said:
try to not feed him 2 hours before shot times... it can influence the number.
Click to expand...

Thank you for the tip. I'll "instruct" mom, since she is the feeding boss during the day. I think I will wake up at midnight specially to feed him, because one of my cats is a "foodminator".

I just read this in the link you gave me:

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus or Levemir. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience: "Fluctuations are very common in this phase before BGs start to stabilize under consistent dosing: a typical curve of cat over the first 1.5 months on Lantus can be seen here: Lantus Starting Graph".
http://www.tillydiabetes.net/en_6_protocol2.htm
Click to expand...
 
that's what we were talking about with bounces.
You don't have a lot of data yet...
Thomas could be spiking up (bouncing) in the 500's in reaction to that 144... and other numbers in the 100's during mid cycle.
His body isn't used to bg's that low any more.... and you want him to get back to "normal" bg numbers.
If you wake up in the middle of the night, try to grab a test. FD is definitely a sleep deprived club.
 
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