Blood sugars WAY out of control ----- HELP!!

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CindyJ

CindyJ

Member Since 2017
I posted this yesterday and have since attempted to do a spreadsheet for all of Baxter's BG levels so far since he was diagnosed on 3/7/17. (I attached it to my signature and hopefully you can see). He is on on the Lantus Pen. I have second-guessed myself whether I was injecting right (but did right in front of the vet and it was OK). Also questioned whether the insulin was good (used a different pen and same results). Ugh! What is going on? Seems like the insulin is not working at all. As mentioned in my post yesterday, I'm feeding him canned/grain-free Purina Pro plan, but I have been mixing in some CatSure (which I thought was OK with diabetic cats, but maybe not). He eats twice daily. Please help! Clearly, just increasing the insulin is doing no good. Should I re-start at 1 unit twice daily and then increase by .5 units after one week? I am testing using the AlphaTrax2.

Thanks everyone for any feedback and help. This is very frustrating and scary.
Cindy
 
Hi Cindy - Great job getting the spreadsheet going. Quick questions for you:
Dose is only 1x / day? No U's in the PM would suggest shot only in the AM. Lantus is usually given AM / PM (12 hours apart).

Also - I don't see pre-shot numbers - best to get a reading prior to the shot and a few times through the cycle. Lowered numbers suggest Lantus is working but it would be good to get a few complete 12 hour cycles of data for veterans to comment on dosage. Generally, the dose should be held for several cycles before slowly increasing. If you have held the dose, but have no data - might be best to insert a few additional rows (one for each day).
 
Cindy --

Which flavor/variety of ProPlan are you feeding Baxter? The carbs range from 1 - 24% depending on which ones your using.

Please let us know if you are giving a shot only once a day. If so, with cats, you need to give insulin twice a day. Their metabolism is faster than a humans and twice a day dosing is necessary.
 
Hello and welcome.

What are you feeding Baxter? Is he on an all wet Low carb diet?

From your comment above it appears that you are only shooting once a day is that correct?
 
He is getting Lantus twice daily .... every 12 hours. 7a and 7p. I guess I have mainly checked his BS during the day. I feed him Purina Pro Plan grain-free formula ocean whitefish and salmon entree. How do I determine the carbohydrate content ? Protein is 11% crude fat 5.5%, crude fiber 1.5% no carbs listed in ingredients. But what about Catsure supplement?? Don't use??
 
I will check this link out. Do you I think I need to start the insulin dosing over again starting at one unit twice a day and increasing by a half a unit after a week or so ? I will update my spreadsheet for PM dosing and also do some evening blood sugar checks . Thx
 
I think your vet has taken your dose up too fast and by too much without enough testing to know what each dose is doing.

If Baxter were my cat, I'd probably drop back down to 2U and test using "our rules" and let's see how he's really doing.

You'll want to get a test in before every shot....so an AMPS (AM Pre-shot) and PMPS (PM Pre-shot).....that lets you know that they're high enough for insulin at all

Then (if at all possible) get a mid-cycle somewhere between 5-7 hours after the AM shot and at least a "before bed" test on the PM cycle to make sure he's not dropping too low at night. Most cats do go lower at night so those PM cycles are really important to be testing.

Without doing daily testing, it's impossible to know if he needs more insulin or less......If the days you happened to test are also days that he's bouncing, it's not very helpful

It could be that he's going a lot lower at night and then his liver is releasing stored sugars and hormones to bring him back up quickly (bouncing)....since you've only been testing about once a week and only during the daytime, there's no way to know for sure.

The fact that he was getting some better numbers on the lower dose makes me think he'd do better starting out almost all over again, so I'd really like to see what kind of numbers he gets on 2U twice a day and have you testing at least 4 times per day

After 3 days, that should tell us a LOT
 
Thank you!! Great advice and I will do. Thank you so much and I'll keep you posted!
Cindy
 
Do you have syringes that are marked in half units? Since we do not increase doses by a full unit, it's easier to be more consistent with dosing if you have syringes that are in half units.

It might help you to look at some of our spreadsheets. However, some of us are testaholics so do as we say and not necessarily as we do. (The exception is if your kitty is in low numbers -- then you have to monitor carefully to make sure numbers aren't dropping too low.) The more data you have, the better you will understand Baxter's patterns. Learning when Lantus onset and nadir typically fall gives you greater insight into his response to insulin.

Were you able to find Baxter's food on the chart that Carol linked? If the food isn't on the chart, there's a way to approximate the carb count. Unfortunately, if the information isn't on the chart, it usually means you need to contact the manufacturer since they typically list the guaranteed analysis (min and max values) rather than the "as fed" values which is what is the important information.

 
Thank you. I am getting syringes on half units. I'm going to go back to 2 units twice daily and check blood sugars more often. Especially at night. Also...... i'm wondering if I'm injecting in the right spots for best absorption on him . The vet told me kind of either side of the spine towards the back but a lot of info I'm seeing now says either side of the flank but to avoid the scruff of the neck . And I noticed the information on this site for injection sites . So I'm gonna try injecting in different areas and of course rotating
 
CindyJ said:
I feed him Purina Pro Plan grain-free formula ocean whitefish and salmon entree
Click to expand...

Although there's no number except for calories per can on the Whitefish and Salmon entrée, it looks like it's probably in the same 4-6% range as the others
Capture.PNG
 
You don't have to avoid the scruff. In my experience, there is minimal difference in absorption. But, of course, every cat is different (ECID). I've been shooting Rusty in the scruff for over 7 years. He has long hair and it is an easy place to find "skin" when you pull up on the hair.
Good luck with going back down in dose and working up systematically, as per our protocol.
 
Hi Cindy, welcome to the group!

I agree with the suggestion to drop back to 2u. Getting syringes will let you be more accurate on the dosing. This sticky has lots of good information that will help you get the right syringes and learn how to draw up the dose from your pen. If you watch the video on drawing up the dose, you can hear my sweet punkin in the background, wondering where his dinner was!

The high numbers you are seeing could be from too high of a dose. Too much insulin can cause the cat's blood sugar to go high. There is also a formula to figure out an approximation of the carbs if you can't find it on the link. I'm going to tag Marje @Marje and Gracie who, I believe, has that formula. You're talking about a canned food, right?

The CatSure lists maltodextrin as its 3rd ingredient. I looked up maltodextrin and found this:
While technically a complex carbohydrate because of it's low-sugar content,maltodextrin has a glycemic index of 130 (table sugar is only 65). A high glycemic index means that it goes through the digestive system and into the bloodstream very quickly.Sep 9, 2014
Ingredient Investigation: What is maltodextrin? | Live Well in the ...
cumberlink.com/...is-maltodextrin/article_5e08f308-3799-11e4-8d18-0019bb2963f4.ht...​

In other words, it looks like it's straight sugar that goes into the bloodstream quickly. I don't think you want that for a diabetic cat. It also could be another reason for Baxter's high blood sugar.

Most people concentrate on giving their cat low carb canned cat food or raw and use either plain cooked meat (baked plain chicken breasts, for example) or freeze dried meats as a treat. Treats are given anytime you've gotta poke for a test as a little reward to help Baxter get used to the testing. Treats aren't meals, so keep them small! A 1/2" cube of meat is enough for a pokey treat.

Here is a thread called "Where Can I Find?" that might be able to help you find information that is on this site, and that we commonly use.

Glad you're here! Ask as many questions as you have - we all remember how hard it is to begin. Hang in there and things will get so much easier!
 
Thank you very much and you're right about CatSure. Oh my.... don't think that was helping.
 
No worries, this is one big old learning experience. Just hang in there and keep asking questions. We'll help you get Baxter regulated and doing a lot better than he is now.
 
Thank you again. That means sooooo much to me!! I know you will all help me. I love Baxter so much. ❤
 
Hi Cindy.

Glad to see you got your spreadsheet set up and your data entered. That really helps us help you.

I cannot stress enough the importance of ALWAYS testing before you give insulin (that would be the AMPS and PMPS - Morning Preshot and Evening Preshot). That is the only way you can be sure it is safe to give Baxter his shot. Since we think he is getting too much insulin now, he could be dropping low at night, when you aren't testing at all, and one of these mornings he might be too low to shoot, but you won't know if you don't test.

Are you checking him for ketones? With those high numbers, it's never a bad idea to test. You can buy urine test strips in most Pharmacies. We can give you tips on how to get the test. My Cinco didn't care if I stuck the strip in his urine stream, even before he went blind, but some cats aren't so accommodating.

I know it's frustrating that you aren't seeing any progress, but most of the time you don't see changes right away, especially with the depot insulins. Keep in mind, the depot has build up before the cat is getting the full benefit of the dose. If you change the dose too quickly, the depot can't keep up.

You can help Baxter if you just keep reading the info here, give consideration to our suggestions, and keep asking questions.
 
I looked on the phosphorus food charts from Tanya's CKD website because she also lists carbs. I found "Pro Plan Adult Finesse Ocean Whitefish and Salmon Entree Classic". Is that what yours is? If so, it is 2% calories from carbs. If you scroll all the way down to almost the bottom of the linked food chart to where the first number is 2.36 (first column of numbers is phosphorus and it is recorded in ascending order).

If it's not that one, if you can call the manufacturer and ask for the typical nutrient analysis in "as-feds" or "dry matter basis" and get the values for fat, protein, fiber, ash, and moisture, I can calculate the carbs for you. You can't use the guaranteed analysis numbers on the can.

I would also stop giving the Catsure. FDs should not have maltodextrin.

Welcome to FDMB!!!
 
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