BG>700

[F1nn]

Hi I’m Melissa. (NEW MEMBER)My 14 yr old cat, Finn (large frame 14 lb) has been on Lantus for 2 mo. Vet has been steadily increasing dose at 2week intervals by 1unit. He started at 2 units and is currently at 5 units.

The last curve done this past Thu had him between 420 & 481 (he was near 500 when initially diagnosed). This a.m. he was acting strangely so I tested BG before giving insulin after a meal. It was 707. Should I be concerned?

He eats a combo of Fancy Feast wet, Purina Naturals Senior 7+ and Blue Buffalo Wilderness. We have limited snacks and changed them to lower carb options. He is still drinking lots of water & urinating a lot. His appetite hasn’t been as robust as pre-diagnosis, but last night he ate a lot more than he had been. We use the Relion BG meter.

Thanks in advance for advice/help!

 

[Sienne and Gabby (GA)]

Melissa -

Can you re-test Finn? I'm hoping that you had a wonky test result since that's a very high blood glucose reading. If Finn's numbers have been consistently high, you may want to stop by a pharmacy and pick up ketostix. These are urine test strips that will allow you to test for ketones. It's a bit of prevention since ketones can occur if numbers are high and they can be dangerous.

I wasn't familiar with the Purina Naturals food. It looks like this is dry food. It's very high in carbohydrates (over 40%) if the nutrition information I'm looking at on the Purina site is accurate. Several of the Blue Wilderness canned foods are at the top end of the low carb range. (We consider low carb as under 10%.) Also, not all Fancy Feast canned foods are low carb. The Classic line -- which is a pate style food -- is typically low in carbs. If you've not seen this food chart, it will be helpful.

I suspect that at least one piece of the issue is the dry food. If you can transition Finn to an entirely low carb, canned food diet, you may see better results with regard to his blood glucose levels. However, I would not switch his food all at once since numbers could drop quickly with an abrupt food change. A fast change can also cause a GI upset.

I'm also attaching a post on helping us to help you. It will give you information on how to set up your signature and a spreadsheet. The information in your signature helps us to not keep asking you for the same information about Finn repeatedly. The spreadsheet will allow you to track Finn's progress and will allow us to follow along and offer suggestions.

 

[F1nn]

Thanks for your reply. Retested Finn and BG is now 453—much better! It’s been 3 hours since Lantus shot. Maybe the hi reading was a faulty one. Feeling relieved!

We do feed Fancy Feast Classics Pate (usually salmon, but lately have tried other flavors to encourage him to eat.

Blue Buffalo Salmon Dry food is lower in carbs than the Purina Senior Plus, so I’ve been mixing them. Blue Buffalo is 40% Protein, 18% Fat 4% Fiber & 9% Moisture whic I believe means it’s ~29% Carb. I know he needs to eat lower carb food, but it’s been a struggle to get him to eat. He lost a pound in the first week after diagnosis.

I will fill out the spreadsheet & attach later. I on my phone & need to do that on laptop

 

[F1nn]

 

[Wendy&Neko]

One observation of what you have posted of the spreadsheet, look like you aren't testing every day? Or in the evenings? Cats tend to go lower at night for some reason, so getting a before bed test is a good one to let you know if you are missing some lows. We also strongly recommend testing before every shot to know it's safe to give. A few times my girl gave me a preshot test of <50, so I was glad I'd tested.

Another phenomenon to be aware of is something we call bouncing, which can give you artificially high numbers for a short while. Here is our definition:
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).

So it's possible if you have a gap in testing, you will miss the low numbers that result in high numbers caused by a bounce.

I'm going to second Sienne's comment on slowly getting rid of all dry food it you can. I've seen many cat go to much lower doses, or even off of insulin once they are on a fully low carb diet.

 

[F1nn]

Thanks for the info. Very interesting to learn about bouncing. Have not been testing daily. Vet said with BG so high, hypo was not a risk. It sounds like you disagree? He has never shown hypo symptoms at least not while I’m awake.

Testing stresses him (& us!) out, so if we can avoid testing daily, we’d prefer that. Vet tried Freestyle Libre on him twice, but he wouldn’t tolerate it—bit it off both times.

 

[Sienne and Gabby (GA)]

I would disagree with your vet. My kitty could start the day with numbers in the 400s, drop into the 40s and be back in the 400s by the next shot time. If all I was looking at were the pre-shot numbers, I would have been increasing Gabby's dose. Based on the actual data, she would have needed her dose reduced.

If no one has mentioned it, one of the ways to get your kitty to be more accepting of testing is treats! There are freeze dried protein treats (e.g., freeze dried chicken) that most cats are more than a little fond of. Regardless of whether a test is successful, Finn gets a treat. It doesn't take all that long for a cat to associate getting a treat with getting his ear poked. Positive reinforcement really does work!

 

[Wendy&Neko]

FWIW, I once tested my cat when she was soundly asleep at night, in the 30's! No symptoms. Most upsetting to me as usually she would at a minimum stand in front of the fridge for food, or a least try to lead me to our testing spot - as she knew it would get her treats and more if she was low. In the early days, most tests I did on my cat were high, over 300 and much worse (over 500), with just the odd number in the 100's, which set off those bounces. In the beginning, testing was very hard for me. Seeing blood could cause me to faint. Over time, I got used to it and Neko would purr through it, as she knew she'd get her reward.

If you haven't seen it yet, this post has lots of tips, ideas, and videos Hometesting Links and Tips

 

[F1nn]

Thanks for the insights!