BG nadir reading went up

[Bonnie and Anna]

Hi. I’m new to the FDMB and would like help understanding if something might be going on with my Annabelle. She was diagnosed with diabetes on June 15 and was put on Lantus. Her diet has been Authority chicken pate and Wellness chicken. She gets no dry food. Over the course of the first two months her insulin was gradually stepped up from 1 unit to 4 units. The vet says that her curves over the last two weeks look good and is keeping her on 4 units. Those curves have been posted in her spreadsheet. The last two days we tested her at the time when her curves normally hit bottom - around 1pm. Surprise! Those readings were around 300, but on the two curves we’ve posted her BG was around 100 at that time. The vet said it could be random fluctuations and not to worry. Does anyone have any thoughts on why her BG nadir could be so high relative to the curves and what to keep an eye on?

 

[Chris & China (GA)]

With only 2 tests, it's impossible to know what's going on with Annabelle (you also need to put how much you shoot in the "U" column)

4 units is a huge amount and if she was only diagnosed in June, it looks like your vet has increased her too quickly. We only do increases here in .25 unit increments because insulin is a very powerful hormone and even 1 drop too much or too little can make a difference in some kitties.

It's most probable that what's going on is called "bouncing".....the dose is too high and taking her down to numbers her body isn't used to being at anymore, so her liver releases stored sugars and hormones to bring it back up quickly.

We recommend home testing here...at least 3-4 times a day. Testing at the vet also isn't real helpful because the stress of being at the vet can raise the blood glucose up to 200 points

It's also very important to get tests on the PM cycle....most cats go lower at night

Are you using the AlphaTrak meter? Most of us use human meters so I just wanted to make sure

 

[jayla-n-Drevon]

1 drop can make a HUGE difference with Dre....
Dre can go from 300 to 50 in a few hours ..... and sometimes he stays at 350
hometesting has saved his life ..... literally.
good luck!

 

[Bonnie and Anna]

Thanks for responding so quickly Chris! Let me start at the beginning. Vet prescribed 1 unit of Lantus 2/day and canned prescription w/d on June 16. June 27 vet did partial curve-fed at 7:30- 480 at 10:00, 424 at noon, 431 at 14:00. Vet increased to 2u 2/day. Vet did curve 2 weeks later. We don't have readings, but they were higher. We found FDMB and changed her food to what's in initial post. We did curves on July 13 and 28 as well as other partial curves at home. The two on the SS are the best. The vet and we use the AT2 meter. We have done a few late night tests but the readings have been higher. Vet says it's normal to be higher at night. He says she's not thinking at night! He's upset that we're testing her at all now!

 

[Chris & China (GA)]

Sounds like you need a new vet!! Especially if they're discouraging you from home testing!!

If you had a diabetic child that couldn't talk and your pediatrician told you that you didn't need to test before giving insulin, they'd be guilty of malpractice!! It's the same with our furkids!!

The ONLY way to know what's going on with your cat is to test at home....every day, every cycle.....we have seen cats here that went from 400 to 40 and back to 400 in the same cycle

Your vet has also increased you way too much, too quickly...You could have very well already gone past what would have been a "perfect dose" for Annabelle and now she's stuck in a constant bounce

 

[JanetNJ]

It's crazy your vet doesn't want you to test! It's dangerous to dose without testing. Plus it gives THEN lots more data too! My honest opinion on vets that don't want you to test is that you won't spend as much time in their office. $$$$$

 

[Bonnie and Anna]

Thanks so much everyone! We'll do a full curve tomorrow. We're trying to connect with a traditional/alternative vet. I had a feeling Annabelle was bouncing, but didn't know she could get stuck there. I guess I came to you too late. Till now I've just been reading posts and getting info from the site. I'll share more tomorrow. Goodnight!

 

[JanetNJ]

Honestly the few numbers you have on the spreadsheet arent bad, especially since she's so newly diagnosed. She's not starting super high (mid 200 to low 300) and going down to greens and blues. Just keep gathering data.

 

[Bonnie and Anna]

Hi. Annabelle seems to be more regulated. We did another curve on Annabelle Sept. 17. It is on the SS now. I was out of town for a few days.. so my wonderful hubby held down the fort alone with Annabelle and 4 other critters. Only tested her at 1:00(her nadir) today. BG was 105. We'll do another curve Saturday. I think her feedings were off and she was stuck in a bounce when I was stressing out. Vet was no help. If I understand correctly, if Anna goes hypo with symptoms, he wants to take her off insulin. This makes no sense!!

 

[Bonnie and Anna]

Annabelle got 4 units of lantus at 7pm with a meal. At 10pm she's at 325. Based on her daytime readings, she runs much higher at night, almost like the insulin is hardly working.

 

[Tuxedo Mom]

What you are seeing is a "bounce" where the body releases stored glucose called glucogen when the numbers drop too low for what it is used to or too quickly. She dropped from AMPS of 281 to 85 at +4, which is a pretty good drop. The body gets used to being in higher numbers when a kitty is diabetic and "thinks" the lower numbers are a danger signal which cause it to release the stored glucose. This can bring the numbers up higher for up to 3 days until it clears. If you are using the SLGS (start low go slow) approach then the drop to 85 would "earn" a reductio of 0.25 units down to 3.75 units, since you are using the AT2 pet meter. If you are following the TR (tight regulation) protocol then a reduction of 0.25 units would be taken at 68 or lower on the AT2.

 

[Bonnie and Anna]

Hi everyone, We did another curve on Annabelle on 9/24. Her BG readings seem to be leveling out, except she still goes so much higher at night. Her PMPS BG was in the 400's and 300's at +3 last night and tonight. As you can see her daytime BG readings are never anywhere near that high now. Can anyone tell me what is going on with that? We cook and have dinner between 5pm and 6:30. Could she be hangry? Several people have said I should cut back to 3.75 units, but I'm afraid to because of her higher PM readings. I'm confused!