BG: Confused

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Sunshine and BA

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B.A. was tested at vet during routine testing 2 weeks ago. BG was 250. Fruitosamine (sp?) was 260.
Saturday: 290
Sunday: Fasting 243
Tonight before Dinner 224
Urine: 2000+ glucose, not keytones
Before bedtime after 3 evening meals: 161, thought error retested 160
Urine: Missed trip to litterbox, so didn't get to test!
Plan to hospitalize tomorrow, start insulin and monitor for tolerance........This 161 and 160 is a big drop from the 200's, right? I'll test tomorrow, but I'm wondering what I really should do!!!! Obviously will share with vet, but now I am questioning should we wait before starting insulin. Any thoughts?

Thanks,
Sunshine
 
The lower BG level after eating may mean that her pancreas is producing insulin, just not enough to get her into a normal range. Yes, please do share with the vet.

It could be that a short course of insulin, carefully administered and monitored, could give her pancreas enough time to heal and get back to work.

As I recall, you can't change food because of p-itis and IBD. Therefore, a delay to see whether she will become diet controlled isn't what you are considering. Delaying because you see a spark of life in her pancreas could cause further damage to the organ as it struggles to perform.

Yes, please, discuss it with you vet. However, if it were my cat, I would go forward with the insulin.
 
Agreed with Venita. My only concern is that often cats are prescribed too much insulin when kept at the vet to start the course. (Higher bg levels because of stress, strange noises, strange food, no Mommy, etc.) I think that I read earlier that your vet was insisting on this, and I can understand the reasoning. Just be careful when you get B.A. home. Test before giving the amount of insulin prescribed. You may find that the overall numbers are quite a bit lower at home, and you may need to adjust the insulin amount downward.
 
If she's responding this well to diet change then I question the need to hospitalize her and start her on insulin just yet....
 
Thanks again, the supportive helpfulness of this group is so encouraging........thanks so much!!!!
This morning's fasting BG was back up in the 200's. Vet has meter, so I'll post exact numbers tomorrow.

Took B.A. to vet at 8:00ish along with her favorite blankets, water bowl, food bowl, food, and meds. I asked to get her settled. She was give the kitty suite all to herself with a large cage on he bottom level, door left open to roam if wanted. She immediatedly checked the room out, then settled into her "home bed" after lots of kisses. I'm trying not to feel rejected or have hurt feelings, I think she liked her resort away from home. :oops: I'm so impressed with our vet. She asked what kind of attention BA likes, said she would put a space heater if the room if I wanted it (cold midwest day), went over my home schedule and asked questions. Reviewed BG's/UA's; Keep meter to check against vet monitor.

Vet called about an hour ago. Tested BG after I left, slightly higher than fasting morning BG. Gave l.5 units of Lantus, lowest BG in 60's. No hypo systoms, UA, glucose 250+. Plans to use 1 unit tomorrow and test throughout day. My meter and clinic is within 0-3 difference. Thinks one injection daily will be sufficient for now. Usually do a curve couple weeks after starting insulin but thinks I can monitor at home and talk with her about any needed changes. Said BA is resting in her bed, exploring room, calm. Keeping feedings on my requested schedule. Feels pleased with how eveything is going. I'll pick her up tomorrow after work.....be so excited and SCARED too. This is her first night away from home when she was spayed 17 years ago.

Sunshine
 
Ok, so it went pretty well!

But we still don't know if that dose is valid for her at home or not, and lantus is NOT a once a day insulin....if she gets more than 12 hours duration then I'd wonder...

Jen
 
Jen & Squeak said:
Ok, so it went pretty well! But we still don't know if that dose is valid for her at home or not, and lantus is NOT a once a day insulin....if she gets more than 12 hours duration then I'd wonder...
Jen
Click to expand...

I still don't get the impression the vet is saying she was reaching for the idea dose, she has focussed on avoiding hypo crisis.............if she gets more that 12 hours you would wonder..........???? if needed, if what???? please add more. I'm sure I'll be testing her at home. What do you (an othres) typically do as far as testing with initial dosing? Test past the 12 hour time and see if BG's are increasing. Are you thoughts if used once daily, BG will be eratic? Like the high from eating a sneakers bar and the low a couple hours later?

Sunsine
 
Ok, so the thing is, if lantus only lasts 12 hours in her body, the other 12 she'll be running high. So treating her only half the day really doesn't make sense. You have to find the line between overdosing her and underdosing her, which is why testing at home is so incredibly important. IF her blood glucose levels at the clinic were not elevated, and if 60 is the lowest she went, then that dose may be good. But, it takes a few days for the full effect of lantus to be seen so you need to be cautious, and if blood glucose levels warrant she needs insulin twice a day.

Does this make sense?
 
Hello Sunshine! I apologize if anyone else already gave you thing link or explained about Lantus and how it works. Please read this link (and then read it again a couple more times :mrgreen: ): LANTUS & LEVEMIR: INSULIN DEPOT - AKA - STORAGE SHED

Basically Lantus works by having a constant level in the body at all times. Hence the "storage shed" terminology. When you only give Lantis once a day you will be fighting every day to bring the level back up. You can compare it to some medications that needs to work up the a certain level before you feel the effects. It takes a few days to "fill the shed". It has been said that Lantus can last a little more than 12 hours, therefore you can have a little bit of overlap between shots. Almost all of us on this message board that are giving Lantus are on a 12/12 cycle. We shoot Lantus every 12 hours. You want to test the BG prior to shooting so that you do not give any Lantus when the BG is too low. You also feed after you shoot so that the Lantus has some carbohyrated to work with. It is very important that your cat eat when on any insulin (to prevent hypoglycemia).

My vet was not familiar with Lantus and when I took Webber in for his very first shot and monitoring they gave him 4Units. For a 12.5 pound cat with BG's in the 300's that is an enormous amount. The dose actually lasted >24 hours in Webber. After wonderful advice from "Lantus oldtimers" on this message board I ignored my vets advice to give 4Units once a day for two weeks. I started Webber off on 0.50 units twice a day. A little more that a month later he is officially off the insulin. Of course not all cats are going to respond the way Webber did, but Lantus has the most promising evidence of remission in cats who are started early.

There is soooo much more that I could share with you but not too much at once. ;-) It is wonderful that you are going to be hometesting and I encourage you to learn as much as you can about Lantus (read the link I gave).

Here is a link that explains the Protocol that we follow for Lantus: LANTUS & LEVEMIR: TIGHT REGULATION PROTOCOL

It does sound like your vet has BA's best interst at heart. Most of these vets just need to learn a little more about how cats should use Lantus.
 
Jen and Paige,
Thanks for the info. Weekend has been crazy, I've read some of the lantus info and need to read more. I've read some of the info on Lantus, need to read more. This weekend has been exhausting. I do plan to talk to the vet about dosing. Finding the line between overdosing and underdosing is a frightening concept to me....do most find it without hypo crisis. I'll be so glad when I'm a few weeks out and this isn't as scary!!!!

Sunshine
 
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