Any suggestions? Cat's numbers all over the place

I don't know what's going on with him! One day he'll drop down into the 80's at nadir and the next day he's in the 200s. One morning his AMPS will be in the 200s and the next morning it's high 300s. I am so confused. I don't think I should change the dose since it's clear it can bring him to some desirable numbers but it's all over the place. Last year, towards the end of the year, he seemed to be regulated, with days and days in a row of numbers in the 100s and then all of a sudden he was skyrocketing up to the 300s. Any suggestions or is this normal in the sugar dance? I just want to make sure I'm doing what I can for him.

 

Hi April, Hercules also had a very rainbow spreadsheet when he was on prozing, I believe more variable than quincy's. It has gotten a bit better since we moved to Lantus. Some of your high values seem to be bounces. I agree that given you are seen somne green in this dose you should not increase. What is your usual feeding schedule? Perhaps changing the food schedule can help smooth the curve a bit?

You might get more help if you move over to the Lantus/basalglar forum?

 

Thank you for responding! I'm on my cell phone right now but maybe once I'm on my computer I'll move it to the other forum . I was hoping for more answers here but I guess we'll see.

He eats three times a day with one snack - breakfast 630am, lunch 1pm, snack 630pm, dinner 830 pm.

I'm just confused as to why he was doing so good for awhile there and now all of a sudden all over the place.

 

Sorry I cannot of much help, I am not that experienced. But looking at the end of 2020, and beggining of the 2021, i don't see a clear difference . When do you think something clearly changed? can you think about anything else that also changed around this time?

If you are confortable/ able to do more tests? there isn't a lot of data in the evening, so perhaps it might be going lower than you thinking and bouncing in the morning?

 

To be more clear, he was doing much better in October. The only thing I can think of is that he started to get diarrhea and was put on a probiotic. Could that have something to do with it?

It could be bouncing from the night, that's true. Hmmm.

 

I appreciate your feedback!

 

I don't have any experience with probiotics, to know what it does to BG. But diarrhea could be asign of other GI issues, which then can affect BG? When was the last time he has been to the vets?

If it was me, and newbie me, I would try to follow a couple evening to be sure he is not bouncing in the morning. Once that was ruled out, I will increase his dose, making sure I could be around to test in the next few days.

Hope you manage to get him into better territory!

 

The first thing that leaps out is that you may want to spread out your test times. Basaglar is "supposed" to have it's nadir at +6 but nadirs can and do change. For example, you have no idea whether that 85 was the lowest number in the cycle on 1/12. In addition, some cats have either early or late nadirs. If you only get a spot check at +6, you'll never really know how the cycle is playing out.

There are 2 dosing methods that are used with the depot insulins (i.e., Lantus, Basaglar, Levemir). The Start Low Go Slow (SLGS) method has you evaluate the dose every week and if numbers are higher than desirable, you increase the dose by 0.25u. Reductions are given if numbers fall below 90 on a human meter. The other method, Tight Regulation Protocol (TR) is more aggressive and doses are evaluated every 3 days. Reductions are given if numbers drop below 50. It looks like you've held the 0.5u dose for quite some time. If a dose is held and numbers are not in the normal range, it can cause glucose toxicity to develop. The name sounds worse than it is -- it means that yo0ur cat's body starts to treat the higher numbers as the new normal.

As Karen suggested, you may want to consider posting on the Lantus/Basaglar/Lev forum. At the very least, you may want to look over the sticky notes at the top of that board.