BG at 497 and rising with 2.5 hours to go before next shot.

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EllieKozak

EllieKozak

Member Since 2014
Hello. Can anybody tell me if its safe to give Charlie his insulin 2.5 hours early? I have been doing bg's on him at home today and his numbers are rising and its now at 497. He got his AM shot about 8:30 this am. He was hospitalized last weekend with DKA and I don't want to take any chances! Thank you all
Here is his spreadsheet
https://docs.google.com/spreadsheet/ccc ... _web#gid=0
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

In your circumstances I would give it early.
DId your vet have anything to say as to what could be wrong with Charlie? Does the blood work show any signs of infection?
Charlie is seeing some response recently to the insulin but not much.
Because of the past DKA I would discuss adding R insulin. R is fast action and can be dosed every 4-6 hours.
Also have you discussed changing insulin to like Lantus or Levemir?
But right now you have to keep the BGs down to prevent another DKA
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Did you go ahead and shoot? Hope this helps bring him down! Can you get a test a few hours after the shot so we can see where he is headed ?
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Thank you!! I just gave his 3u. He's acting ok otherwise I'm just a little neurotic when it comes to this. I'm still so afraid that I'm going to lose him. Having a hard time finding a good balance for him. The vets I work with don't think it's an infection. This whole thing popped up almost overnight. He suffered a 3 lb weight loss. He's only 2 his teeth are fine, he's completely indoors and didn't have any abscesses or wounds and hi suture came back clean. Vet is corresponding with an internal med specialist to see if we are missing anything. Any ideas/suggestions are always appreciated. Thanks!
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Rachel I absolutely will. You guys are godsends. <3
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

You MIGHT want to come post on the PZI board. Many post daily condos that provide the numbers they get through the day. Many experienced eyes over there to help with dosing. It may help get your kitty regulated...

Might be a bit slow over there still as the holiday weekend tends to slow us down. And I always post emergencies here in health so they're seen quickly. But you are welcome over there if you'd like to join us!
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

How's Charlie today?
Any update? Did his blood glucose come down at all?

Eliz
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Ah, only just realised that Charlie has a spreadsheet now (Duh, silly me; haven't had my coffee yet this morning...)

It seems very possible to me that the reduced response to insulin you saw yesterday could have been caused by rebound or 'bouncing'.

Rebound/bouncing can happen when a cat's blood glucose drops too low or too fast (or both).
"Too low" doesn't necessarily mean 'dangerously low'. Bouncing can happen even when the blood glucose just drops lower than the cat has become accustomed to. The liver releases glucose to raise the blood glucose level, and can also release counter regulatory hormones the purpose of which is to keep the blood glucose high. This can look like temporary insulin resistance. The effect can take up to a couple of days to clear sometimes.
It's quite possible that the beautiful 103 Charlie got gave his body a bit of a fright and triggered a bounce.

Eliz
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Hi guys. This amps was 507. Spoke to his doc last night and she wanted to increase to 3.5 instead of 3u. I hope his numbers improve today. Thank you all so much. Feeling discouraged and just wish we were able to regulate better.
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

It's very 'early days', Ellie.

Kitties don't become diabetic overnight and it can take time to see results. (If you have a pair of 'patience pants' in the back of your wardrobe this could be a good time to dust them off and pull them on! ;-) )

Is Charlie eating OK?
Are you testing for ketones?
And how does he seem in himself?

Eliz
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

You need to be patient when first starting insulin. The cat has become accustomed to higher numbers, so any dramatic drop or even a fast drop may trigger compensatory hormones to release glycogen from the liver. This gets broken down into glucose and shoots the levels high. It takes about 3 full days for the bounce to settle out.

When you gave 3 units, he dropped over 350 mg/dL the evening of 6/30. If anything, his dose is too high.

That HI on 7/1 was almost certainly a bounce from the 67 the previous night. I would NOT increase the dose any higher or you set yourself up for successive highs until all spare glycogen has been used and exhausted ... and then he may crash and hypo on you.

Think calmly and remember - better too high for a day than too low for a moment. The latter, hypoglycemia, kills quickly. Yes, the former can result in DKA, but that is a slower process and you have time to respond. Just not with a knee jerk increase in insulin.
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Only been doing this a month. But:
The FDB knows more than the vet about dosing.
They started me out with 1U and in a few weeks went up to 4U then back to 3U.
I was chasing numbers like you are.
Through the board, he is now between 1U-2U.

It looks like at the lower doses your kitty had flat numbers but now is spiking very high. It looks like bouncing to me and it does take a few days to get it to settle down. Nothing pink or red with him anymore with the higher doses but just blue and yellow.
Unless, he is eating a lot more food than before.
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

I see another recommendation for a pair of loaner patience pants. So, here from my vast and never ending lending closet of patience pants, a pretty red pair for you and Charlie.


Sending you big hugs too sweetie. I know, we all want our kitties to get better right away. But, it takes time and I hope these patience pants remind you to slow down and just keep loving on Charlie. He knows you are trying to get him better.

We're here to support you in anyway you need.
 

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Re: BG at 497 and rising with 2.5 hours to go before next sh

Hi guys. So I took Charlie in to work with me again today to recheck a urine sample. He is negative for ketones (YAY!) and he is up one lb from his hospitalization for DKA last weekend. I know that I must be patient with this situation, and believe me, I have to keep reading "the letter from your cat" on here because so much of it is so true. I still am very concerned about how high his numbers get an hour or two before his next shot. Someone had asked if my schedule would permit every 8 hour shots and the only way I would be able to do that would be to take him to work with me every day. I have been taking him all of last week and again today but I think he is getting more stressed out going back and forth to work and I think I am doing more harm than good by making him sit in a cage all day :( but on the other hand, I am petrified to leave him home alone because of the way I found him in his DKA state 9 days ago. My job is too far to go home at lunch time to check on him. Does anyone think I should increase his dose? I don't want his peak number to get too low, it once got to 67 and I panicked. I just want to do what is best for my sweetheart. This is killing me.....thank you all so much for your compassion, it has helped me more than you could know! I have updated his SS and total urine results with the hopes that I could receive some direction as to what would you do? I am going to post this on the Prozinc page as well in the hopes that I can get as much info and feedback as possible. Thanks again
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

In some cats, ProZinc does not last the full 12 hours and that may be the case for yours. One option includes switching to a longer acting insulin such as Lantus or Levemir.

There is also being creative with the dosing, such as shot splitting or using a small amount of a bolus insulin. The difficulty with the latter 2 options is that you can run into problems with timing, too much overlap, or nadirs lining up and unintentionally overdosing.

If you are 1) confident with home testing, 2) have a spreadsheet up and completed, and 3) have the low carb diet going well, what you might test is a 2 + 1 split shot dosing schedule on a day when you can monitor and give 2 units at the regular time, then 2 hours later give the 3rd unit. This basically sets you up to shoot 4 times a day - pre-shot and +2, morning and evening. It means being very strict with the timing and it can really limit your schedule. If that is something you want to attempt, please post in the ProZinc/PZI forum, as it is a more advanced technique that should not be attempted by new users.
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

BJM thank you so much for the advice! In your (and anyone elses!) opinion, based on Charlies numbers, would you transition your kitty to Lantus? Are there any drawbacks to using Lantus and if he should switch over, is it done gradually, is there a certain protocol or basically monitor bgs closely when starting? His doctors have mentioned on a few occasions that being so young that there is a good chance that he could go into remission. Does this seem possible to the experienced diabetic kitty parents out there or am I being unrealistic? I have researched and read the food lists on here and anywhere I could find any info on lowest carb foods. What is the majority of successful remission or well balanced kitties eating? Charlie is not a picky boy! Thanks again for all your help! As far as trying the split schedule shots, my job does not allow me to accommodate that schedule. I work at an animal hospital and if worse came to worse I could bring him every day but when I do bring him, his numbers are higher than when he is at home, he gets very stressed there.
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Hey Ellie....

I am new at this and so I am not comfortable giving advice, but I can say, while Skooter never had DKA, he had very high numbers when he was first dx'd. Consistently in the high 400s/low 500s. I can totally understand how frustrating and scary it may seem. My initial reaction was wanting to increase his dose, which made sense because if the dose isn't working, OBVIOUSLY we must increase it to make the numbers go down!

The wonderful people here helped me realize/learn about the cycles, bouncing and all the fun that comes with regulating....I trust the people here with my cat so much, that he is now down a whole unit in a very short amount of time. I am hoping once he switches over to all wet, he will be able to go down even more.

I had my own lil mini meltdown tonight and I got so much support and reminders about how our cats didn't become diabetic overnight, so we can't expect them to get regulated overnight....our cats have been battling the levels before they were dx'd and now they are having insulin, diet changes (whether it be how often they are fed, what they are fed, etc)....we need to give them time to get used to the changes and catch up with it.

I would listen to the advice given by the more knowledgeable people on this site, they really know what they are talking about....

Sending lots of healing vines to you and Charlie..... :YMHUG:
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Either Lantus or Levemir would likely last longer than a non-depot insulin.

Remission is possible. If you follow a tight regulation protocol, you have the best chances of success.
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Hi Ellie,

EllieKozak said:
Are there any drawbacks to using Lantus
Click to expand...
Most folks here find that Lantus works best if dosed 12 hours apart, and a dose is held for a time to see the full effect of it.
Lantus is a 'depot' insulin (there's info about that in the Stickies in the Lantus forums). It's probable that Charlie would get better duration from it.
With Prozinc/PZI it's possible to be flexible with the timing of the shots, and also with the dosage. (It can be dosed according to a sliding scale if that suits the cat.)

There are two Lantus forums here at FDMB.
The 'Lantus TR' forum is for those using an established Protocol to try to keep their cats tightly regulated. This can require quite a bit of testing to do well, so doesn't suit everyone. But there is an understanding (I've not seen the data so can't provide it) that cats on tight regulation protocols have a greater chance of remission.
The 'Relaxed Lantus' forum is for those who aren't following the TR Protocol. The 'Start Low Go Slow' (SLGS) approach is often used there. The 'Relaxed' forum also sees it's share of remissions.

It may also be the case that Charlie's response to Prozinc improves over time. He certainly can respond well to it on occasion. Sometimes it takes a little while for the newly diagnosed cat's body to 'learn to utilise' an insulin ('Glucose toxicity' may be a factor here). Although his duration from the Prozinc seems to be shorter than is typical at the moment, it's possible that the duration could increase.
(I'm sorry, I don't feel I've been at all helpful!!!)

EllieKozak said:
..and if he should switch over, is it done gradually
Click to expand...
Because of the duration you're currently getting with Prozinc it seems to me that it should be possible to just switch insulins at normal shot time.

EllieKozak said:
His doctors have mentioned on a few occasions that being so young that there is a good chance that he could go into remission.
Click to expand...
We don't see very many young diabetic cats here, so I don't know if it's more likely that a young cat will go into remission (and I guess that may depend on why the young cat became diabetic in the first place?) There is another member here with a cat who became diabetic very young, Kpassa (and her cat Mikey (not in remission (yet!)).

Chin up, sweetie, it's still very 'early days'...

Eliz
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

Thank you again. And I realize I may be asking the same question sometimes, you all seem so understanding and so much patience! Eliz, I SO wish I could find out how he became diabetic! I had noticed weight loss, that is what prompted me to bring him in in the first place. One vet I spoke to said to consider an MRI (xray showed normal). After his $2000.00 vet bill for DKA, I cant swing a MRI at the tune of $1000.00 just yet. Does anybody know how I can reach out to Kpassa and Mikey? If Charlies numbers are still sketchy I will switch to Lantus! Thanks again!
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

When someone replies to a post, there is a tiny icon under the name on the right panel to private message them.
Or, you can use the User Control Panel to message them.
Remember, no off-board advising per the rules, so if you have a question, post, then copy the link and ask them to respond there.
 
Re: BG at 497 and rising with 2.5 hours to go before next sh

You did ask what some OTJ (off-the-juice, insulin being the juice) kitties are successfully eating to keep them in that good BG range (40-120 on a human glucometer).

Well, my Wink eats the Fancy Feast pate style foods, also sometimes called the "classic" style and he eats the Friskies Special Diet Turkey & Giblet pate style food. The only reason he doesn't eat the other Friskies Special Diet pate foods is because he doesn't really like fish. Plus he gets some Pure Bites Freeze dried chicken treats. That's it. He's still got those good BG levels going for him so far. Fingers crossed, anti-jink.
 
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