BG still really high

[MaryB & Chester]

SO we've been on 1 unit of Lantus for almost two weeks now. My vet is on vacation until next week. I don't want to make any changes without working with the vet. But I'm really worried about Chester's numbers.

I switched over to the Arkray Glucocard Vital last week (I had a friend who had one with test strips she could give me for free). I'm worried that I may need to get something that registers higher numbers - this cuts off at 600 and only shows "HI". But isn't over 600 (AM pre-feeding) ridiculously high? I don't think it's the meter because he gets numbers like that with the AlphaTrak2 as well. I did my first curve this last weekend and the lowest he got was 350-something at +4 (I think - it's in the spreadsheet).

The vet has said that, as long as he's eating and behaving normally, the high numbers aren't cause for significant concern. He's eating fine, drinking and using the litterbox fine, playing and snoozing like always. We feed him (almost) as much as he wants - he's getting about two cans of Friskies divided into four meals about every six hours. Is that enough? It's about all he cares to eat at one sitting, but he's always bugging us for more after about two hours. The vet said we only worry about ketones if he's not eating or if he seems "off". Well, he seems perfectly fine.

Am I worried too much? I've never had a diabetic cat before and I want to make sure I'm taking care of him right.

 

[BJM]

Based on the curve on spreadsheet, I believe you might be safe going up 0.25 to 0.5 units.
The Lantus forum has a sticky post on how to make dose adjustments safely.

Also, your vet is not entirely correct - sustained, high glucose may result in ketoacidosis where fat is broken down for energy with ketones as a result. Please see my signature link Secondary Monitoring Tools for ways to do urine ketone testing and do that today.

 

[BJM]

Is he still eating any dry food? You have notes on the spreadsheet about picking it up.

If yes, that may be a big part of the high numbers. Transitioning to a lower carb food, preferably wet, may help a lot.

A timed feeder such as the PetMate 5 (see Amazon shopping link above), to portion out the food if he is a scarfer may help too.

 

[MaryB & Chester]

We've had the dry food up every night, so he certainly isn't getting into that in the evenings. During the day he may be sneaking some. My husband tries to keep an eye on him, but you can't see everything every time. There's that balance between feeding enough to keep him satisfied and not having to put down a bowl of food every hour. Chester is a bit of a scarfer, but Blackie and Shady are even worse. Opportunistic food scroungers...
Look, I know about wet food and I know things would be even better if there were no dry food in the house. We're just not at that point yet.

I just worry with his numbers still running so high. I know they're pre-shot numbers so they aren't the whole picture, but even his midpoint test is still pretty darn high.
I can just imagine Chester letting me stick a spoon under his business while he's "occupied". Maybe I'll try locking him in the bathroom with the aquarium gravel.

 

[Sandy96]

You def need to get a Ketone test done, with numbers like that he could easily slip into Ketoacidosis. I agree with BJM increasing the Lantus is in order. I know you say you arent at the point of removing the Dry food completely but could you have your husband only put it down at certain times during the day for the other 2 in a closed room let them eat what they want then put it back up (he would have to watch so it doesnt stay down in Chesters reach.) That would help alot without having to remove it from the house for the time being. Can you get or have your husband get more or can you get more midcycle test numbers so we have the bigger number picture?

Dani and Sandy (GA)

 

[Elizabeth and Bertie]

...Look, I know about wet food and I know things would be even better if there were no dry food in the house. We're just not at that point yet......I just worry with his numbers still running so high.

I really do understand your frustration and concern about the high BG numbers, but it may be that your kitty is particularly carb-sensitive, and the dry food just might be the culprit here with regard to those very high numbers you're getting. With my cat, even a fistful of kibble would send his BG into the stratosphere!

May I ask what the obstacles are to your removing the dry food? (Will have a look back over your previous posts).

Edited to add: Just had a look through your previous posts and see that it is indeed hard for you to remove dry food. So, it may well be that a dose increase is needed in order to bring those numbers down.

Don't despair. My cat had totally awful numbers at first. And I felt awful too because I couldn't seem to get any good BG numbers for him. I couldn't forsee things ever getting any better; but they did! And things will get better for you too. Honestly.

Hang in there!

 

[squeem3]

SO we've been on 1 unit of Lantus for almost two weeks now. My vet is on vacation until next week. I don't want to make any changes without working with the vet. But I'm really worried about Chester's numbers.

Have patience Regulation cannot happen right away. It is something that takes time to achieve. Now there are some cats who have gone into remission within weeks of starting insulin and the right diet but others need months if not longer. Every cat is different :smile: Personally, my diabetic never got well regulated after 4 years on insulin and diet and the advice/support/help of this board. It was frustrating at times but all that really mattered (to me anyways) that he was happy and healthy and was living the good life

The vet has said that, as long as he's eating and behaving normally, the high numbers aren't cause for significant concern. He's eating fine, drinking and using the litterbox fine, playing and snoozing like always.

Sounds like a happy otherwise healthy cat to me :smile: Those high blood glucose numbers will come down as you get closer to the right amount of insulin. 1 unit of insulin may not be enough right now. Dose increases for Lantus are done in 0.5 units increments.

We feed him (almost) as much as he wants - he's getting about two cans of Friskies divided into four meals about every six hours. Is that enough? It's about all he cares to eat at one sitting, but he's always bugging us for more after about two hours.

That sounds about right but maybe try feeding every 4 hours or so to see if that helps. Is your cat bugging for more food or just attention?

The vet said we only worry about ketones if he's not eating or if he seems "off". Well, he seems perfectly fine.

Ketone testing is a good idea. It doesn't need to be done daily, IMO. Whenever you catch your cat in the litter box, grab a fresh sample of urine (use a cup or long handled soup ladle) and dip a ketone test strip into it.

Am I worried too much? I've never had a diabetic cat before and I want to make sure I'm taking care of him right.

You're doing fine so far :thumbup This board will help you regulate your cat's diabetes.

 

[MaryB & Chester]

I hate to say it, but I feel like my husband is the biggest obstacle to switching everyone over to wet food. Money is a close second.
I work during the day and my husband takes care of our home. He is primarily responsible for feeding everyone. He's already complaining about having to feed Chester (my sugarcat) and Sophie (who has really bad teeth) four times a day. The pressure to feed and manage all six for set feeding times is not something he's interested in trying. Neither of us think we'd have any luck leaving canned food out for most of the day for everyone because it wouldn't last most of the day. Blackie and Shady are opportunists extraordinaire...I foresee a lot of overeating and puking and fighting. I love my husband and he does care deeply for my cats, but the daily responsibilities can get overwhelming.

Money is the other issue. I know that, down the road, wet food avoids certain expensive vet bills and treatments. But it comes with an upfront cost that we just haven't been able to agree on. Chester, Blackie and Twinkie would definitely go through two cans of food a day each, maybe more. Let's just say seven cans for the three of them. Sophie, Shady and Rizzo would eat about a can and a half each, round that up to five between them. That's 12 cans of Friskies a day. At 50 cents a can, that's $6.50 per day, about $46/week, about $200 per month. Right now we can buy a big bag of Iams for around $30 that lasts us over two weeks, so call that $60 a month. Plus Chester's two cans a day plus Sophie's one gives us...$45+60 = $105 per month. If my math is off, please tell me.

Food costs will almost double. In my heart, my kitties are worth any expense. In my wallet, we are a family of four living on one income, paying for a car, a home, child support, student loans, food and utilities. Maybe we shouldn't have so many cats. Maybe so. I know there are the bigger cans of a few flavors of Friskies pate that are a little more economical - 13 oz vs. 5.5 oz so a little more than two cans worth but those cost close to a dollar a piece so there's not a lot of savings there.

I guess I'm just frustrated. Trying to give Chester the best care that I can while maintaining a good relationship with the other beings that live with me and pay all the bills all the time. I will talk to him about getting a pre-lunch test for Chester so we have a better number picture.

 

[BJM]

Ok. Within the fiscal limitations, can you upgrade the dry food to something with a higher protein content such as Wellness Core or Evo Cat and Kitten. They aren't optimal due to the lack of moisture, but at least the protein content is better. Pop over to Cat Info for more information about nutrition in cats. Sometimes pennywise is leaves you having to choose euthanasia because you can't afford to treat.

What about acquiring some timed feeders to spread out the feeding. This frees him up from needing to do it and if there are several feeders going off at the same time, but spread out, it should let everyone get some food. Also, freezing some of the canned reduces the scarfing scenario too. You can add some water to the canned to increase the volume, without fattening anyone up.

Baby gates may be used to section off rooms - it takes about 4, overlapped, to completely block a doorway, or they learn to climb over them. This would let you feed the special needs cats separately. Craigslist or E-bay, etc, may have some used ones for less than new.

Sometimes, when you upgrade to a better food, you may be able to feed less, too, so while it looks like its more expensive, if you calculate cost per 100 calories, canned may work out OK. Check out PetSmart's Great Choice and WalMart's house brand pate's; they are similar to Friskies.

 

[MaryB & Chester]

Thanks for your support and patience with me. I get overwhelmed easily and I'm a bit of a pessimist by nature. I appreciate everyone putting up with me.
I will definitely look into ketone strips. He seems fine now but I know that cats can crash (with various illnesses) very quickly.
Thank you.

 

[squeem3]

For ketone testing, you want Ketostix:

KetoDiastix can also be used. This one tests for both ketones and the presence of glucose. Urine glucose readings will always be high because glucose builds up in the urine since the diabetic cat last used the litter box so it should not be used to determine how well the diabetes is regulated.

Try to get a fresh urine sample for ketone testing.

There are some blood glucose meters that also will test for ketones. I think these use separate test strips for blood gluocse testing and ketone testing.

Iams dry food is one of the worst foods you can feed to a diabetic. According to Binky's dry food chart, all the Iams foods are over 20% carbs :shock: High carb dry foods puts a huge strain on the pancrease which is why so many cats end up diabetic. Not to mention that dry food can cause all sorts of health issues which are dicussed more in detail at http://www.catinfo.org

Since you have other cats who are not diabetic and money is a concern, can you try to feed a better quality lower carb dry food? Wellness Core, Innova EVO, and Nature's Variety Instinct are low in carbs and are the preferred brands to feed to a multi-cat household that includes diabetics. These brands come in large bag sizes, 12 pounds is the biggest size I think. Nature's Variety occasionally has coupons for their products. You can sign up on the Nature's Variety web site to receive coupons via email. Wellness used to offer coupons but I don't think they do anymore. Petco and Pets Supplies Plus sometimes has Wellness and Nature's Variety on sale.

 

[MaryB & Chester]

I just picked up some Wellness CORE to mix with their Iams for a small bag's worth. That only costs $10 more for a big bag than what I'm feeding now and if it's better for Chester then I know it's better for everybody. He's still going to get his cans, but maybe we won't have to worry QUITE as much if he sneaks a bite or two when we aren't looking. There are a couple of other foods that look very interesting as well, but I just want to start somewhere and Pet Supplies Plus is right on my way home from work.

Picking up Ketostix today on my shopping run. I think I'm going to have to go with the clean box/aquarium gravel. I don't think I'm going to have much luck following him around with a big spoon...Can I reuse the box later if I clean it out really good? I think gravel is cheap enough to throw away, but I don't want to pitch a good plastic litterbox if I don't have to.

BG was "better" this morning (545 is all relative). I bumped his insulin dose from 1 to 1.5 anyways. I talk to the vet tomorrow and I'm absolutely positive she'd tell me to bump it anyways. You guys have me convinced that (at this point) it's relatively safe...I'll buzz over to the Relaxed Lantus board if I have any questions.
Thanks for putting up with me!

 

[BJM]

Depending on what you use, it is possible to clean the gravel for re-use. It is very time consuming and you should use a filter over your drain or you could plug it.