I am really stumped on this one. I have been working for about two months over the phone with a woman (let's call her Sue), whose diabetic cat Buddy is a mystery. Buddy is a rescue from the streets. He is middle-aged. (Sue does not have internet access.)
When Sue first contacted me, Buddy was on 5U Lantus am and 4U pm. She was not hometesting; the dosage had been set by the vet. It took a couple of weeks, but she bought a glucometer. The first preshot on Buddy was a normal number, so I advised her not to shoot unless his number was over 180. I gave her low dosages to shoot should he go over 180.
Buddy is difficult to test, so Sue does not do it religiously. However, it took a couple of weeks for Buddy to go over 180, but only slightly so. Sue and I talked about what to do, and I advised a food test. Feed him his wet food, and test 2 hours later. She did, and the post-feeding number was normal.
Because of her work, Sue has a crazy schedule. The PMPS is around 2am, and that's when he gets his closely monitored wet food. He doesn't have access to food again until about 12 hours later, around 2pm (the AMPS time), when he is once again fed wet food. Between 2pm and 2am, while Sue is mostly away from the house, Buddy has access to the outdoor (and there is no way to control what he might eat out there) and he also has access to dry food that Sue leaves down for her numerous (very numerous) other rescue cats. She cannot afford to feed wet food to all her cats, and there would be no way to make sure all of them got what they need to eat if wet food was free fed while she is away from home. She also cannot afford to go to a low carb dry food, like Evo or Core.
Here's what's crazy about Buddy's numbers. He will be in the 150 to 190 range at the AMPS, when his diet has been tightly controlled and he has been fasted for 12 hours. Do a food test, and he goes down to normal (40-70s). At the PMPS, when diet has not been tightly controlled, he will be almost normal (120-140), and the food test again takes him down to normal.
I told you about Sue's mixed up AM and PM preshot times so you would understand why I don't think Dawn Phenomenon is a factor. There is no dawn at Buddy's 2pm AMPS time.
I could understand this pattern if Buddy was getting the extra high numbers at his PMPS, after he has had potential access to higher carb foods. But, no, the high numbers come after a strictly monitored low carb dinner, and 12 hours of fasting.
Any ideas anyone? Sue's local vet is not a diabetic specialist, so I don't think s/he would have any good answers to this question. Perhaps she could consult over the phone with Dr. Lisa or some other diabetic specialist that someone might recommend here. With the collective knowledge of this Board being as great as it is, perhaps someone(s) can give Sue and me some ideas on where to go with this.
Buddy has no other apparent health problems. (Changed to say--->Buddy tested FIV+ when he was first rescued, if that makes a difference in anyone's thinking. If there is something specific to be tested for, Sue and I can work on getting that done.
Thanks in advance for all your insights.
When Sue first contacted me, Buddy was on 5U Lantus am and 4U pm. She was not hometesting; the dosage had been set by the vet. It took a couple of weeks, but she bought a glucometer. The first preshot on Buddy was a normal number, so I advised her not to shoot unless his number was over 180. I gave her low dosages to shoot should he go over 180.
Buddy is difficult to test, so Sue does not do it religiously. However, it took a couple of weeks for Buddy to go over 180, but only slightly so. Sue and I talked about what to do, and I advised a food test. Feed him his wet food, and test 2 hours later. She did, and the post-feeding number was normal.
Because of her work, Sue has a crazy schedule. The PMPS is around 2am, and that's when he gets his closely monitored wet food. He doesn't have access to food again until about 12 hours later, around 2pm (the AMPS time), when he is once again fed wet food. Between 2pm and 2am, while Sue is mostly away from the house, Buddy has access to the outdoor (and there is no way to control what he might eat out there) and he also has access to dry food that Sue leaves down for her numerous (very numerous) other rescue cats. She cannot afford to feed wet food to all her cats, and there would be no way to make sure all of them got what they need to eat if wet food was free fed while she is away from home. She also cannot afford to go to a low carb dry food, like Evo or Core.
Here's what's crazy about Buddy's numbers. He will be in the 150 to 190 range at the AMPS, when his diet has been tightly controlled and he has been fasted for 12 hours. Do a food test, and he goes down to normal (40-70s). At the PMPS, when diet has not been tightly controlled, he will be almost normal (120-140), and the food test again takes him down to normal.
I told you about Sue's mixed up AM and PM preshot times so you would understand why I don't think Dawn Phenomenon is a factor. There is no dawn at Buddy's 2pm AMPS time.
I could understand this pattern if Buddy was getting the extra high numbers at his PMPS, after he has had potential access to higher carb foods. But, no, the high numbers come after a strictly monitored low carb dinner, and 12 hours of fasting.
Any ideas anyone? Sue's local vet is not a diabetic specialist, so I don't think s/he would have any good answers to this question. Perhaps she could consult over the phone with Dr. Lisa or some other diabetic specialist that someone might recommend here. With the collective knowledge of this Board being as great as it is, perhaps someone(s) can give Sue and me some ideas on where to go with this.
Thanks in advance for all your insights.
