Blood Glucose Rising after Injection

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Scdal

Scdal

Member Since 2020
I called my vet this morning because Phoenix's blood glucose has been rising the last 3 days. He has been on insulin for 10 days now. The vet told me to email him the readings every day but he has never responded or changed the dose since we started the insulin. The first 3 or 4 days on insulin was great and the numbers were steadily dropping. Since then, they have been climbing.

This morning at 8 am before insulin was 364.
I fed him and waited until 9:30 and gave the insulin. At 1:30 pm. Glucose 421
At 5:30 pm. Glucose. 463

He is drinking a lot of water and starting to pee a lot more. The thing is, he is eating a whole lot more. I am letting him eat throughout the day because he has gotten so skinny. He seems to be feeling okay and is going outside but he comes in and starts drinking again.

My vet emailed me at 7pm tonight instead of calling me. He told me that I could increase the insulin dose tomorrow if I wanted to or wait until Monday when he would be back in the office. Also, the vet is only having me give the Lantus once a day.

I know I need to set up a spreadsheet but I have been very busy today. Hopefully. someone can help me with it tomorrow. Any advice on the insulin would be appreciated. What would make his glucose levels rise after the injection?
 
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Lantus needs to be given twice a day in a cat to be effective. If you are only giving it once a day you are leaving the other 12 hours with no insulin and you will get numbers all over the place.
I’m not sure your vet knows much about Lantus and he doesn’t sound very interested to me.

I would not increase the dose. You need to start giving it twice a day. However until you get the spreadsheet set up and your signature setup ( which only takes 5 mins) we can’t really help you. But if you are willing to get those set up we can help you a lot and get Phoenix’s BG stabilised.

to get the signature done go to the top right of this page and press on your user name. Find signature and press on that. Tell us yours and Phoenix name, date of diagnosis, type of insulin and meter you are using, food fed, weight, any other medications and illnesses and save.
For the spreadsheet if you can’t do it I will tag Chris who will gladly help you. @Chris & China (GA)

Can you tell us how much insulin you are giving and the type of food fed and your cats weight please.
 
Scdal said:
I know I need to set up a spreadsheet but I have been very busy today. Hopefully. someone can help me with it tomorrow.
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I'd be happy to set it up for you. Only takes me about a minute once I have some information. Just send me a private message by clicking on my name and choosing "start a conversation"

Scdal said:
the vet is only having me give the Lantus once a day.
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No insulin lasts 24 hours in cats. Lantus is a "once a day" in humans, but cats have a faster metabolism and need shots every 12 hours.
 
Scdal said:
What would make his glucose levels rise after the injection?
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It's hard to say until we can see more of the data when you get the spreadsheet going, but here are a couple of possibilities (also see the question at the bottom of this post, which could be very important):

1) Bouncing. You've only seen high numbers lately, but it's possible that at some point (possibly late at night), he hit a low number you didn't catch. Then, his body reacted by dumping sugars into the blood to counteract the unfamiliar low and BG went up. The tricky thing about these bounces is that they can last a long time, up to three days, even from just a brief dip into low numbers. So they're hard to diagnose without a lot of data, but depending on exactly when your recent high numbers were seen, it's definitely a possibility.

2) Some other health condition increasing his numbers. Always possible, and always a worry with a diabetic cat, but if you aren't seeing other signs of trouble, we'll put that aside for now.

3) He really does need more insulin. Also possible! While most cats need fairly small doses (~1U is typical) most of the time, some need more. But again, we'll need to be able to see some data before deciding that (see point 1 above), and given the way Phoenix has been dosed so far (1X/day) it's not the first guess.

One question: you have prednisone in your signature. I don't have any personal experience with that med, but I believe it's one of the steroid meds that can induce diabetes in cats. Was that a one-time application, or is there a consistent dose that Phoenix gets? That info may be a very important piece of the puzzle here.

Hopefully, we'll be able to figure this out soon, and get Phoenix feeling better!
 
Another of your threads, for more of the history, from the Lantus forum: Cat Drooping Head

I'm glad the drooping head issue seems to have resolved once the Clavamox was removed, but re-reading that thread and this one I am confused. In that thread, you were giving 4U of Lantus, then today in Alex's thread in this forum you posted:

Scdal said:
When my cat's numbers starting rising, the vet didn't respond even when I called the clinic after 3 days of rising numbers.

He emailed me last night and told me to raise his insulin dose by 2 units or wait until Monday when he is back in the office.
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Does this mean your vet wants you to give 6U of insulin, 1X/day? :eek: Or did you reduce after the discussion in the thread on Lantus, and he wants you to re-increase?
 
The prednisone was only given after diabetes was diagnosed. When he first got sick, they had to sedate him to do blood work. They gave him isoflourine gas which he had been given before. My old vet had retired and I had never used this vet before. After he woke up and got home, he started wheezing and couldn't swallow his food like he used to.

The vet accidentally admitted that they had injured his throat while intubating him. The wheezing cleared up after a few days. They had recommended a pancreas powder to sprinkle on his food. Unfortunately, this irritated his throat and esophagus. He started coughing real bad.

I took him to another vet ( the one I am seeing now) who sedated him again. They needed to do blood work for pancreatitis. This time, he developed asthma and pneumonia. He almost died from not being able to breathe. He had to be kept on oxygen for a week and breathing treatments for 2 weeks.

He has improved tremendously and now the insulin is the main concern. He still has to chew his food a lot to eat but he is doing a lot better. I have been told that he may never be able to gulp his food the way he used to.

I have cut the prednisone down to every other day and trying to wean him off it. I tried to stop completely last week but he quit eating. Now, he is eating great. I am going to try not giving the prednisone again. He is back to normal now and going outside to watch the ducks. He has lost a lot of weight. Both he and I have been through the wringer the last month. Phoenix had hardly been sick a day in his life until now.

.
 
Nan & Amber (GA) said:
Another of your threads, for more of the history, from the Lantus forum: Cat Drooping Head

I'm glad the drooping head issue seems to have resolved once the Clavamox was removed, but re-reading that thread and this one I am confused. In that thread, you were giving 4U of Lantus, then today in Alex's thread in this forum you posted:



Does this mean your vet wants you to give 6U of insulin, 1X/day? :eek: Or did you reduce after the discussion in the thread on Lantus, and he wants you to re-increase?
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Yes, he wanted me to give him 6 units. I did not do it.
 
Nan & Amber (GA) said:
One question: you have prednisone in your signature. I don't have any personal experience with that med, but I believe it's one of the steroid meds that can induce diabetes in cats. Was that a one-time application, or is there a consistent dose that Phoenix gets? That info may be a very important piece of the puzzle here.
Click to expand...
Yes its a steroid and can induce diabetes. Dont know if that has happened in this case but it is a possibility. :(
 
Scdal said:
Yes, he wanted me to give him 6 units. I did not do it.
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I'm very glad of that!

What a terrible time you and Phoenix have been going through! I'm so glad he's still with you and hopefully starting to come out of this.

I think the next priority for you would be to get a spreadsheet going to put all your data into-- that will really help us in figuring out what is going on in terms of his diabetes. The more I hear of your story, the more worried I am that your vet is not really guiding Phoenix's diabetes treatment well. Have you sent @Chris & China (GA) a PM about setting up the spreadsheet?

I'm not sure about stopping the pred if it's helping him to eat. Again, I haven't used it, so I'm not terribly familiar with it, but I think I'd hold off on any changes until we can figure out more of what is going on with the diabetes/insulin situation. Since it can raise BG numbers, it may be one of the things that is keeping Phoenix safe with that big dose of insulin, and removing it all at once may be dangerous. Hopefully others will chime in with more experienced opinions, that's just my take from what I know.
 
TempestsMum said:
bless you both! You really have been through the wringer. But clearly you are both troopers and getting through all this amazingly well! Now you can relax a bit as you will have plenty of support in here. :):)

I can relate to your situation in a slightly different way., I keep horses and almost lost one due to an oesophageal stricture caused by someone feeding him dry food. Similar to what you are dealing with, with the throat issues, it took a bit of trial and error but I experimented with different food consistencies to find out what was easiest for my guy to swallow. So I soak his food and add in extra water so it slides down easier. That may help your kitty a bit, a tablespoon of water in wet food wouldn’t hurt any..

ok so I just wanted to give you a wee welcome and went off on a tangent lol

welcome to the forums :cat::):cat:
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I see you are in Ireland. I am originally from Manchester, England. My family moved to Texas when I was a child. Except for my immediate family, all my relatives are in England.
 
I am glad I didn't increase his insulin dose to 6 units. I gave him his regular 4 units this morning and his glucose levels are dropping.
I wonder if maybe the last few days I got fur shots and didn't realize it. It is hard not being able to go into the vet's office for instructions. The vet came out to my car and showed me on his arm how to pull the skin up and give an injection. That is not at all like trying to inject a cat. I am just glad I didn't increase his dose.
I know we can't do it, but I wish there was a way to get a list of good veterinarians in each city and country. If Phoenix wasn't recovering from his other ailments, I would be looking for a new vet.
 
How much has he dropped? What glucose numbers are you getting?

A lot of us have had the experience of a vet who doesn't know feline diabetes very well. They just don't get very much training on it in vet school, so if they don't see a lot of it in their practice, there isn't a lot of opportunity for them to get experience. But that doesn't mean they aren't good vets for other issues!
 
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