? Back in the 600's

KatieL09797

KatieL09797

Member Since 2025
Hi everyone,

A couple of days ago, Benny was getting some good glucose numbers for him but in the past 24 hours he has taken a turn. Yesterday morning, his pre-breakfast and insulin glucose was 149. He's never been that low when I have tested him at home. He had an appointment with a specialist yesterday that turned out to be super disappointing and we got home. His pre-dinner and insulin glucose was back up to 441. Throughout the night, he was soo sleepy, nearly catatonic. By the next morning glucose check, he was 474 which is not his worst but was not a great sign to me. As the day has gone on, his energy has not kicked in at the usual time, his +5 number was 638. I called the hospital that treated him for his DKA because they have been responsive to me and they advised me to give him a .5Ul of his Lantus so I did at +5 since the morning dose. Tested him again at +8 and he was 631. He seems to have a bit more energy but still not back to what he was for the past few days.

I have taken the advice of the forum and bought some Fancy Feast Gourmet Naturals to try and transition him over to a less carb heavy food. I'm going to have half of his dinner be the Fancy Feast.

He's back to peeing at least 7 times a day and has struggled to have a stool several times. I just don't think there is anything in his system because his glucose is so high. He can no longer hop up on counters or even the toilet seat he is so muscle-wasted and tiny. I'm just so afraid I am not doing enough for him and this specialist appointment was just another huge let down.

We have an appointment with another specialist at a training hospital next week to see if they can help us so I am just in another holding pattern until then.

Edit: Just wanted to update that I got bloodwork back that was done yesterday and luckily we are not dealing with ketones. Unfortunately his red blood count is low and we will be rechecking tomorrow. I think it is because of his low weight but his internal specialist believes it is something separate from the diabetes.
 
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Oof, that sounds really hard. I'm sorry you're dealing with that.

I'm not equipped to give dosing advice or be any kind of authority, but I will say that changes in dosing don't always seem to lead to fast or immediate changes in BG. I know it's hard to see your cat feeling so icky, but I don't think that 631 means that the new dose isn't helping. It may be too soon to tell.

What are you seeing the specialists for specifically? Sorry, I don't think I've seen your posts before.

Also - if you're looking for advice, I strongly recommend that you add the "?" prefix to your subject line. It's a busy forum and our most experienced users tend to scan through for quick indicators like that.
 
Allie & Gen said:
Oof, that sounds really hard. I'm sorry you're dealing with that.

I'm not equipped to give dosing advice or be any kind of authority, but I will say that changes in dosing don't always seem to lead to fast or immediate changes in BG. I know it's hard to see your cat feeling so icky, but I don't think that 631 means that the new dose isn't helping. It may be too soon to tell.

What are you seeing the specialists for specifically? Sorry, I don't think I've seen your posts before.

Also - if you're looking for advice, I strongly recommend that you add the "?" prefix to your subject line. It's a busy forum and our most experienced users tend to scan through for quick indicators like that.
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Hi Allie,

I am new to the forum as of yesterday but have been reading for a few months. I am seeing an internal medicine specialist because we had a horrible vet experience that has lead us to this point. The hospital recommended a specialist for him because they said he was difficult for even them to regulate.

We just started 2Ul tonight so I’m hoping we see a little more improvement in the coming days.
 
@KatieL09797
Hi Katie sorry no one replied back to you on the Feline Health Board. I just sent all the members I tagged a direct message and asked them to look at your post.
I also told them you posted on the Lantus Board today and copied it and showed them it.
Diane
 
Welcome. I’m sorry you needed to find us. Dianne is right that you are feeding a high carb food. That will make his bg higher. I’m glad you are transitioning to fancy feast . Did he have crystals? Is that why he was put on CD? Max was on it after blocking once at 5 years old but I switched to all wet food.

Your cat is very hungry due to uncontrolled diabetes. He needs more than double the amount he used to eat and lots of water to keep those nasty ketones away. Did yiur vet tell you to only feed twice a day? That’s wrong. He needs to eat as much as he wants as often as he wants except two hours before you give insulin. That’s to make sure his bg is high enough to shoot.

Lantus is a depot insulin. It will take at least 3 days to see if the dose is enough. Any drop under 68 would mean too large a dose since you are using a pet meter. . If not getting into better numbers you would increase.

Lantus is dosed based upon how low it takes him. That occurs between 4-7 hours after insulin often. So mid cycle tests are important. It usually starts to work around two hours after shots so if you can get a +2 it will give you idea about how the cycle will go. So try nd get a second test at night as well as during the day.

Your signature says custom dosing. Does that mean your vet is advising you?
 
Hello and welcome. Here is the link to your post on Feline Health yesterday, for background for people: New Member, Recent DKA 11/19-11/25 - Katie & Benny

Normally we don't jump up by 1 unit at a time. Especially since he saw some numbers in the 100's on 1 unit. We would go up by at most 1/2 unit, more like 1/4 unit. Please keep a very close eye on him tonight.

What Benny is doing after that 149 is what we call bouncing:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
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It's perfectly normal and annoying to us!

Are you home testing him for ketones? You should be doing that daily at home with recent DKA. Tips to catch and test a urine sample There are also blood ketone meters.

How is Benny's appetite?

One last thing, we have a subject line format we ask people to use, so we can easily find you and see if you need urgent help: POSTING GUIDELINES PLEASE READ. This forum is busy and we want your posts to stick out.
 
Hi tiffmaxee,
He was originally surrendered to the rescue we adopted him from with what they thought were urinary crystals. The rescue volunteers said they put him on the c/d food and he was immediately feeling better so that was what we stuck with. The hospital advised us to only feed in the morning and evening. I used to feed him multiple snacks in the day but changed that after the DKA. I do think this current internal specialist is open to more meals through the day but she didn’t emphasize the importance of carb percentage so we are kind of going our own with the Fancy Feast just because I’ve seen so much success in this forum. His glucose is always high so I’m never worried about it being high enough to give him insulin or dropping too low. He’s also a ravenous eater so that isn’t a worry either.

With dosing, I am following what the internal specialist is recommending just because we are still pretty new to Lantus. He was on Prozinc for the past two months with no success. I will definitely try to get the +2 and +6 glucose amounts to see how we are doing.

Thank you for the reply!
 
Wendy&Neko said:
Hello and welcome. Here is the link to your post on Feline Health yesterday, for background for people: New Member, Recent DKA 11/19-11/25 - Katie & Benny

Normally we don't jump up by 1 unit at a time. Especially since he saw some numbers in the 100's on 1 unit. We would go up by at most 1/2 unit, more like 1/4 unit. Please keep a very close eye on him tonight.

What Benny is doing after that 149 is what we call bouncing:

It's perfectly normal and annoying to us!

Are you home testing him for ketones? You should be doing that daily at home with recent DKA. Tips to catch and test a urine sample There are also blood ketone meters.

How is Benny's appetite?

One last thing, we have a subject line format we ask people to use, so we can easily find you and see if you need urgent help: POSTING GUIDELINES PLEASE READ. This forum is busy and we want your posts to stick out.
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Hi Wendy,

I did have a sneaking suspicion his glucose bounced because he is soo used to such high numbers. I have been testing him for ketones with the urine test strips. I have the strips that check for glucose and ketones. Also his most recent bloodwork from yesterday found no ketones which is a relief. I currently test him with a glucometer multiple times a day which he is great about.

Benny has been a ravenous eater since the beginning of his diagnosis which is always a surprise to people because he is soo skinny.
 
Good for you on testing ketones. Could you add the ketones test result on the spreadsheet, maybe the Remarks column. Something like "ketones neg". With recent DKA we'll keep asking if we don't see the testing happening.

With his numbers so high, his body can't properly absorb the nutrition in his food. DKA is usually a combination of not enough insulin, not enough calories, and some systemic inflammation or infection. Was any inflammation/infection found on diagnosis?

I found this a good read:
 
Wendy&Neko said:
Good for you on testing ketones. Could you add the ketones test result on the spreadsheet, maybe the Remarks column. Something like "ketones neg". With recent DKA we'll keep asking if we don't see the testing happening.

With his numbers so high, his body can't properly absorb the nutrition in his food. DKA is usually a combination of not enough insulin, not enough calories, and some systemic inflammation or infection. Was any inflammation/infection found on diagnosis?

I found this a good read:
Click to expand...
I’ll add that to the spreadsheet. I have some bloodwork from his hospitalization that I’ll add as well.

It didn’t sound like there was any inflammation or infection found at diagnosis. He had just gone about 2 months on an insulin that was not working for him which led to the DKA. The hospital performed an ultrasound and they ruled out IBD/IBS, any organ trouble, and we went to a cardiologist this week and got a echocardiogram and they gave him a clean bill.

I absolutely agree with you that his numbers are so high that he can’t receive the full benefits of his food. No one we’ve been speaking to seems to be thinking about that and keep trying to find an alternative reason to the weight loss.
 
Reading from above, please go back to the multiple small meals during the day. The only two large meals per day was what used to be done with the old style insulins that hit hard and fast. Small meals is better for a fragile pancreas. It's what human diabetics do.

As far as the C/D goes, there is a good read on this website: Cat Urinary Tract Diseases: Cystitis, Urethral Obstruction, Urinary Tract Infection written by a vet specializing in feline nutrition. One week after Neko was diagnosed with FD, my other cat had his first cystitis episode. He was put on C/D. Neko kept trying to steal it. It was a mess trying to police feeding times. I asked what food would work for both conditions and the vet said a raw diet. So I switched. Then I read the page I linked and realized any low carb wet or raw food option that was lower in phosphorus would work, with plenty of water added. Fancy Feast is higher in phosphorus. But there are lots of other commercially available foods with low carb and lower phosphorus if the Fancy Feast doesn't work for him.
 
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