BG all over the page

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doombuggy

doombuggy

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OK, after we had a low AMPS reading on Monday (64), I was told to test him twice a day and report to the vet his numbers today. I got a 267 at lunch time on Monday, then a PMPS of 301. Tuesday was 255 and then 213. Wednesday AMPS was 307. PMPS was 95. I then immediately retested, thinking that the reading was wrong. I got 108 then 135. then I called the vet. This was about 5:20pm. They told me to check again at 6pm and if more than 150, give regular injection of 2 units. If not, retest at 9pm. if 150 or more, give 1 unit. If not, give no insulin. 6:10 reading was 126. (pm reading was 118, so no insulin.

i tested him AMPS today and it was 277. What the heck? confused_cat Any thoughts on this crazyness? I am facing the list to the vet now. He wants to increase to 2.5 units, so that's what I gave him today.
 
I would post over on the Lantus forum for dosing advice. They all use your insulin and can guide you. Post as a NEWBIE needing DOSE ADVICE.

They will suggest your putting together a spreadsheet. If you need help, just ask.
 
Is Cedric still eating any dry food, or his he on a completely wet diet now? Was dry food removed recently, or before he started insulin?

It looks like one of two things are happening here. First, when a cat has had consistently high BG for a while, once he gets down to normal numbers the cat's liver panics and thinks that his BG is too low, and dumps glucose into his blood. We call this "bouncing." Eventually his liver will figure out that the normal BG is safe, and stop the bounce, but sometimes it can take a while. Bouncing is absolutely normal for a newly diabetic cat, and dose shouldn't be raised based off of a bounce.

What is really concerning me, however, are those low preshot numbers. I would need more data to know for sure, but I believe the insulin dose is too high. Most cats on a wet, low-carb diet don't need much more than 1u of Lantus. Similar to bouncing, when a cat gets too much insulin glucose gets dumped into the blood as a survival mechanism--otherwise the cat would go hypo. If he's already going low, then 2.5u is way too much insulin, and dangerous. I'm very concerned that your vet raised the dose to 2.5u after seeing those low pre-shot numbers, because the dose should have probably been lowered. Also, Lantus dosing needs to be consistent, on a strict 12/12 schedule. There's room to wiggle with other insulins, but not Lantus or Levemir. A dose needs to be held for at least 3 days to see how it's effecting BG. At least three numbers need to be collected daily to determine the right dose--the AMPS, PMPS, and one or more numbers about halfway between the shots, in either the AM or PM cycle.

I would urge you to read the dosing protocol for Lantus, and possibly print it out to give your vet (that's what I did with mine!)--it's been proven to safely bring hundreds of cats (including my own) into remission: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

I would also urge to set up a spreadsheet to help keep track of your data. This way you can ask advice of the dosing experts in the Lantus forum. They've helped many, many kitties on Lantus to regulation and remission! http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207&start=0

And there's a wealth of information in the Lantus forum that will help you--the stickies are lifesavers! (literally.)http://www.felinediabetes.com/FDMB/viewforum.php?f=9
 
i just spent the last 15 minutes trying to get that spreadsheet to work after signing on to my gmail, but I could not. I gave up. I work 8 hours a day 7 days a week and am not sure where the time for that will come in. He was diagnosed on 4/22 and usually has readings in the 200 range. On Monday, the vet, who has a diabetic cat & dog, suggested the 1/2 unit raise after checking Cedric's reading 2xs per day, last night, we got that strange reading, and I immediately checked it 2 more times, 1 more time 45 minutes later, and one more time at 9pm. I did read the artcile/post about "storage," and was thinking that this might be what is happening. He's reading was high 200's this am, after not getting insulin last night. The vet called me at lunchtime and talked about a strategy for watching his levels.

Cedric eats a 5.5 can of wet food each day. He receives an incredibly SMALL amt of dry food (1/8th of a cup, which amounts to about 30 kibbles AT MOST, and he doesn't eat them all) to hold him over if needed, since I work every day and am only home at night. I have no problem creating my own excel sheet, since the google isn't working, even when i log into my gmail account, but I don't know who I would post it for anyone here to see. :sad:
 
Check your pms. I should be able to help you with your spreadsheet.

You don't need to leave out dry food. You can add a little water to the wet and leave it out, or you can freeze it and let it thaw during the day.
 
Hi Doombuggy and Cedric, and welcome,
Sue and Julia have given you good advice and I agree that you should post on the Lantus Forum. Lantus works very differently from the other insulins. The people on the Lantus Forum follow a Tight Regulation Protocol that requires time and patience, but that has had much success in stabilizing cats with FD and in getting many of them into remission (or, as we say, Off The Juice--OTJ).

There are detailed instructions for setting up a Google spreadsheet in the Tech Forum. The template is not difficult to set up, just follow the directions. When you join the Lantus Forum, you will be encouraged to set up a Google spreadsheet so that people can see at a glance how your kitty is doing.

When you post on the Lantus Forum you will get lots of eyes on your problem and those who are expert in Lantus dosing can help you. The most important thing to remember about Lantus is that the dose is not based on the bg number at pre shot, but is based on the nadir (the point in the cycle when the lowest bg occurs, usually around +6--6 hours from the insulin shot).

Good luck and welcome to you and Cedric,

Ella & Rusty
 
I completely understand the work issues. I also work about 60 hours a week, with a full time job, and a part time job. And grad school on top of that. But getting those tests really only takes a minute for each one, so it doesn't eat into your time too much! I used to do Bandit's shots at 7am/7pm, and I was gone all day in between. I would set an alarm for 1am so I could get the test 6 hrs in, and then go right back to sleep. On the weekends I worked at night, so I would get a curve (a test every two hours for 12 hours) during the day. It was such a small amount of time to spend to insure Bandit was getting the correct dose. And now that he's in remission because we found the correct dose, I only test once every week or two, and I don't have to worry about giving shots.

Any amount of dry food can keep Cedric from being regulated. It's dumping carbs into his system, which turns into BG. As Sue suggested you can leave out wet food and add some water, or you can freeze it. I have an auto-feeder while I'm at work, and I freeze the food and the feeder releases it at Bandit's feeding time. We do this because he has food control problems, and will instantly eat any food in front of him, regardless of how much there is or if it's frozen. This, of course, makes him sick. :-|

And I completely understand the hesitance to listen to people on the internet over your own vet. My old vet, the one who diagnosed Bandit, had diabetic cats and dogs also. She was on point about almost everything--She recommended I ditch all dry food and put Bandit on a low-carb, wet only diet and gave me a list of low carb Friskies, Fancy Feast, and Wellness flavors. She told me I needed to hometest because stress will throw off BG numbers in the office, and showed me how to do it. She wrote me a prescription for Lantus, one of the best insulins out there for cats. However, her dosing advice was not correct, because she simply wasn't familiar with the Lantus dosing protocol (specific to this type of insulin). She was dosing based on general protocol for all types of insulins. After getting nervous about Bandit's rising dose recommendations (the higher the dose, the more you risk a hypo incident), I ended up doing my own research into Lantus dosing and eventually ended up here. I'm so glad I did, because the Lantus experts here taught me what I need to know to send Bandit into remission. When I changed vets, I printed out the Lantus protocol and took it in. My new vet was more than willing to follow it, because she simply hadn't heard of it (and she is a very, very good vet who keeps up to date). Now she uses it for all of her diabetic patients.

Remember, and this is really important, that when you get rid of the dry completely Cedric's BG could drop significantly, so you you need to lower the dose before you remove the dry. Most cats need much less insulin or possibly go into remission when the dry is gone.
 
I was finally able to get the spreadsheet up and working. Stress level going down a bit. Please let me know if you can see it, as I changed the setting from private.
I have been trying to split up his canned food feedings a bit - give him 1/4 of the 5.5 can at 6am, then 1/4 when I leave for the office at 7:30. I give him 1/4 when I get home (anywhere between 4:45 and 5:15, depending on what day it is - I go to the chiropractor once a week, and also run errands sometimes). then the rest around 8p. He usually gets injected at 6:30 or so. On the weekends, I am usually working at Walt Disney World during the day, but sometimes need to be there at 6am for work. I guess because I am new at this, it takes about 10 minutes for me to do a BG reading. I think the part he hates the most is me putting that heating pad on his ear - maybe it's the noise of the kernals, who knows what is going thru his walnut brain. But then he gives me hugs and wants to be brushed....he's so spoiled.

My close friend Rita went into the hospital to see if she had ovarian cancer. Thankfully, she had a fibroid that was benign - no Cancer! But to make my day worse, mom called to tell me she was in a car accident. She says she is fine, but I was sorry I was not still living in Philly to help her out. So what I REALLY need right now is a little Damon from the Vampire Diaries! That should get rid of the stress!

If youcan see the sheet, let me know what you think. Julia, thansk for the links I will print them out tomorrow at the office and share with Dr. Josh. Printer still not hooked up yet (oh did I tell You I bought a house last month? 1st time homebuyer with the worries that come with it....)

Thanks for your imput on this stressed out gal and the kitty that chose her...
 
Hi there!

I can see your spreadsheet fine! Good job, I know it can be a pain to get that working.

Did you say what kind of wet food and dry food you were feeding? I also agree that you should check out the lantus support forum, and if you are comfortable, post that you are a newbie looking for dosing advice, as someone already recommended.
 
oh no worries, we've all been where you are. it is so stressful at the beginning. i was having a meltdown one day and suddenly thought "i've only been doing this testing for 4 days. it's already better. what am i crying about?!" and when you have family and life issues going on too . . .

it gets so much easier and it gets easier pretty quickly. i used to take about 1/2 hour to test - now i can do it in 30 seconds while i'm yakking on the phone! hang in there. there are many people who work who can give you ideas on how to make it work. i have set an alarm and gotten up during the night if i was afraid of punkin going too low. it's not as bad as it sounds once you get quick at the testing.

make sure you're giving a treat after every test. people told me that their cat would come to be tested - and i bout died laughing. i was having to track down my cat, then wrap him in a beach towel to hold the crazied devil down. that went on for about a month before he gave up. but seriously, at the moment he is perched on the arm of the sofa, sitting on the testing equipment because he wants to get the test over and get the food that comes with it! i don't know when the transformation happened, but he resigned himself to it and we all survived.

we'll all be glad to help you, really - we all get how hard it is. and we can tell you it gets better. hugs!
 
Hey there! Just like every cat is different, every vet is different.

Some vets are really open to taking a look at the protocol and your spreadsheet and will open the door to communicating and working with you, some others, not so much. There is a whole variety of experiences on this board with vets, some fantastic, some not. You are already ten steps ahead because you are home testing, so you are the first person who will see if something changes with your kitty. Keep doing it, you will find a routine that works for you and your kitty, and it will get easier.

I completely understand where you are coming from, I really trust my vet and it was really hard for me to start transitioning from the instructions my vet was giving me to what I was seeing here. One of the best things you can do (broken record) is test. The more data you have, the more informed you will be about what is going on with your cat, and the more informed your vet can be too (nothing says you can't send the spreadsheet to your vet to keep them up to date- I do all the time).

Testing and doses and everything that comes with fd can feel very whelming at first, but you've already jumped a huge hurdle- you've come to people who have all been there and asked for help. Keep asking questions! You are doing great so far!
 
I think because he's been diagnosed for about a month now, it's a matter of a few things to get his numbers regulated. for the most part he seems to be int he 200 range (which I realize is not ideal). I think we are trying to get him down to a consistant 100 range, and it's happening, but sporadically. This am I tested him first, before food, and got his lowest reading of 143. I fed him then retested 30 minutes later and got a 251. I gave him his full dose, but was a bit surprised that 1/4 of a 5.5 oz can could raise his reading by 100 pts.

I forgot to give him his dry food (which isn't much anyway) so we'll see how he reacts when I get home today. I am set to go to Wal-Mart after work to return his unopened 33g lancets and get more test strips. i probably won't get home until 5:50 - let's see how he takes it! :lol: I did give him another 1/4 can before I left, but I'll bet he'll be hungary!
 
doombuggy said:
So what I REALLY need right now is a little Damon from the Vampire Diaries! That should get rid of the stress!
Click to expand...

I could *always* use a little Damon from the Vampire Diaries! :twisted:

But don't worry, testing will get easier and faster the more you do it. It used to take me a longer in the beginning, too, until I figured out exactly what worked the best with Bandit. And he got used to it more, too, and struggled less. The heating pad is supposed to help, not hinder. Bandit never liked the rice socks...I used to heat a damp washcloth up in the microwave and put it in a small ziploc bag and use that. After I got better at poking, all I had to do was rub his ear a little until it felt warm. Or catch him when he's napping and his ears are already nice and toasty! :-)

I use 26g lancets with Bandit. It was way too hard to get a drop with the 31g-33g, which is what I started with. Why don't you try out the 26g and see if they work for you? I was running off the logic that the smaller the lancet, the less Bandit would feel it and struggle, but it turned out to be the opposite. The higher gauge worked better because the faster I got the test over with, the less he struggled!

*hugs* I hope things start looking up for you! Hang in there.
 
doombuggy said:
I forgot to give him his dry food (which isn't much anyway) so we'll see how he reacts when I get home today. I am set to go to Wal-Mart after work to return his unopened 33g lancets and get more test strips. i probably won't get home until 5:50 - let's see how he takes it! :lol: I did give him another 1/4 can before I left, but I'll bet he'll be hungary!
Click to expand...

This makes me nervous...can you post an update when you get home tonight? I just have a feeling his dose is too high and I'm worried he's going to drop.

I know I sound like a broken record, :dizcat but I would really recommend ditching the dry food, and starting over at 1u using the Lantus protocol based off your daily tests (AMPS, PMPS, and a +6).
 
doombuggy, the food didn't cause that big spike, that's the action of the lantus wearing off around +12ish and the BG rising naturally. the food would've caused some rise, but not that much.

I'm going to second Julia's comment - if you get rid of any dry food you'll see better BG numbers, and you might not need so much insulin. If you want to leave out food, you can mix the canned food with water, freeze it in muffin tins and just set it out. We call the dry food "kitty crack" because they like it = but it all makes the cat's BG soar and it stays that way for a long time. so every time he eats dry food it's raising his BG more than it needs to be.
 
Looking at your spreadsheet, it looks like you really started seeing different numbers around the time of the dental. A dental cleaning can remove bacteria and help with inflammation/infections that can also raise glucose levels. You only have 1 curve from the 1u dose, which is only a small snap shot of how he was doing on that dose. You know from what you are seeing now that some days are high and some days are low, so you really don't know if that pattern was an all the time thing or an every other day thing. That make sense? Especially with the wide swings you are getting, and the possibility of tapering off the dry food, I really advocate you going down to 1u twice a day and keep track of those numbers. For your kitty to be getting dry food mid day and still hitting those lows on only 2.5u means that with no dry food, he may need a *much* lower dose. Every cat is different of course, but if my Oscar gets a kibble or two of my dog's dry food - his numbers go wanky for at least a day, sometimes more.
 
Re: BG all over the page - update

Julia, you wanted an up date. Got home from getting his test strips at Wal-Mart at 5:30 and did a reading: 51
Called the vet and to them I think I have been doing the readings wrong, as some of them have been done after food, and I think myabe they should be done BEFORE anything. I am checking him again at 6pm (as long as this thunderstorm blows away, it's distracting him). I like the idea of starting back at 1 unit, starting over so to speak.
 
so he's 51 after eating? is this about 10 hours after you gave him his insulin shot? if so, that tells us he likely has been hypoglycemic today - cats on lantus often don't show the typical symptoms of hypo, which is why we test test test!

btw, yes, you want him to not have any food for at least 2 hours before testing, otherwise you're getting a blood glucose number that's been affected by the food. if a cat drops too low the first line of defense is to give them high carb food.

i think what people might be wondering is if you were to completely eliminate the dry food, there is always the possibility that he could be controlled by only eating low-carb wet food. as in, maybe he would be a cat that wouldn't have to have shots. but you don't know that yet - the way to find out is to get those mid-cycle tests and eliminate the dry food.
 
tested at 6pm and it was 61. It must have gone up b/c of the treat he got for the test (lol). Will test again leter to see if ok to give small dose.
Going to update spsh.
 
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