Can't regulate my diabetic cat, Dee Dee.

[Claire and DeeDee]

She's 15, was diagnosed 5 yrs. ago. Then developed hyperthyroidism 1-1/2 yrs. ago. She's on Lantus and Methamazole pills for thyroid. The vet said hyperthyroid will make diabetes harder to regulate. She gets both meds twice/day. Early this month I stopped giving her dry food, " Taste of the Wild" grain-free. She's on wet Friskies, cooked chicken and salmon (human food). Her sugar readings are now going from hypo to hyper in the same day--e.g., a.m. 59; p.m. 459. Today -- a.m. 515; p.m. 41.
Normally she gets 1.5 units Lantus twice daily.
I thought of trying a fresh battery in the meter, although it seems to work otherwise. I feel at my wits end. Any suggestions, feedback is most appreciated!

 

[Idjit's mom]

Hi and welcome to FDMB Claire and Dee Dee. I'm glad you are here and hopefully we can help you get Dee Dee more regulated.

Having hard data to look at is going to help advising members give you input and suggestions.

First, please create a signature so that Dee Dee's information is available with each of your posts.
Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.

Then set up the spreadsheet we use here and enter as much data as you can, at least a few weeks worth so we can see the patterns and trends.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

I can understand your frustration with the BG fluctuations and if you would test before every injection, as well as a few times during each day and night cycle, advising members can review and help out.

 

[Chris & China (GA)]

Her sugar readings are now going from hypo to hyper in the same day--e.g., a.m. 59; p.m. 459. Today -- a.m. 515; p.m. 41.

If you're getting Pre-shot numbers too low to shoot (which you are) that's a good indication that the dose is too high!!

I'd reduce her dose down to 1U and start testing before each shot and at least once somewhere mid-cycle on the AM cycle (between 5-7 hours after the shot) and at least one test on the PM cycle (before bed....more if you can)

It looks like Dee Dee is bouncing from being so low. Most of the time, our cats are diabetic for quite awhile before we notice enough signs and get them diagnosed, so their body's have had time to get used to living in higher blood glucose numbers. When we start to get them down into "normal" numbers, their liver kind of freaks out thinking "Oh no!! This isn't normal!! I like it high!!"....and so it releases stored sugars and hormones to bring it back up quickly. But as you can see, it's not too accurate....instead of just releasing enough to take them to where they usually are, it goes overboard!!

But all you can do is wait it out. It can take up to 6 cycles for those sugars and hormones to get back out of the system.

Eventually, the liver will re-learn that it's OK to be in those lower numbers and hopefully won't react quite so much...the bounces won't be as high and won't last as long!

Getting our spreadsheet started and filling in the numbers you can for the past week or two will really help us to help you. If you need help with the spreadsheet, feel free to send me a private message. I'd be happy to set it up for you. Just click on my name and choose "start conversation" to send a PM.

 

[Red & Rover (GA)]

You've received good advice from Chris.
Switching to a low carb food can have a dramatic effect on insulin dosage. It looks like she needs less. It's so good that you are testing.

 

[Bron and Sheba (GA)]

I agree with Chris. Your kitty is bouncing from the low numbers and you need to reduce the dose.
Good job you are testing.
Can you tell us what type of meter you are using please?

 

[Claire and DeeDee]

I agree with Chris. Your kitty is bouncing from the low numbers and you need to reduce the dose.
Good job you are testing.
Can you tell us what type of meter you are using please?

Hi Bron, Sorry for delayed response. My 80th year is next month and I'm usually an exhausted caregiver. I'm using a Walmart RiliOn "Prime" meter. Wondering if a new battery will make a difference in readings. The one in use is at least a year old. Thank you so much for confirming Chris's words and for your concerned advice and encouragement!

 

[Claire and DeeDee]

I agree with Chris. Your kitty is bouncing from the low numbers and you need to reduce the dose.
Good job you are testing.
Can you tell us what type of meter you are using please?

You've received good advice from Chris.
Switching to a low carb food can have a dramatic effect on insulin dosage. It looks like she needs less. It's so good that you are testing.

Hi Red, Sorry for delayed response. My 80th year is next month and I'm usually an exhausted caregiver. Having Hyperthyroidism is adding to the problem of regulating her Diabetes. Wondering if a new battery will make a difference in readings. The one in use is at least a year old. Thank you so much for confirming Chris's words and for your concerned advice and encouragement!

 

[Claire and DeeDee]

Hi and welcome to FDMB Claire and Dee Dee. I'm glad you are here and hopefully we can help you get Dee Dee more regulated.

Having hard data to look at is going to help advising members give you input and suggestions.

First, please create a signature so that Dee Dee's information is available with each of your posts.
Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.

Then set up the spreadsheet we use here and enter as much data as you can, at least a few weeks worth so we can see the patterns and trends.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

I can understand your frustration with the BG fluctuations and if you would test before every injection, as well as a few times during each day and night cycle, advising members can review and help out.

Hi Lou, Sorry for delayed response. I've been an exhausted caregiver, and next month is my 80th yr. I will create the signature and spreadsheet. Thanks much for your guidance and advise. Gratefully, Claire

 

[Idjit's mom]

Hi Claire, I'm glad to see your response. Regarding the spreadsheet so that Bron and Chris can see the blood sugar levels from the tests you are getting, and view the patterns from cycle to cycle, day to day it's best to have the spreadsheet set up so you can enter the data.

@Chris & China (GA) Chris is a whiz at setting up spreadsheets and I know she would help you out on that score. Then all you would have to do is enter the insulin dose and testing data.

Are you using a computer, a tablet (if so what kind?) or a cell phone to get online and communicate with us here?

If you could set up the signature-- it's easy to do-- then we can see DeeDee's information every time you post (what kind of insulin, what dose, what meter, what food etc.) and we won't have to ask over and over, or check back through subsequent posts for that information.

A fresh battery for a meter once a year is a good idea, just to be on the safe side. They aren't terribly expensive and are available in most big grocery stores or at Walmart. CR2032 is what we have in our ReliOn meter, it is a round flat battery.

But I agree with the other ladies, I think you are seeing bounces because the dose is too high. Did you reduce the dose to 1 Unit as Chris advised?

Claire, I know that you are feeling pretty tired, but with the help of these experienced and knowledgeable members I think you are going to be able to help DeeDee and in the process a weight is going to be lifted from your shoulders.

 

[Claire and DeeDee]

If you're getting Pre-shot numbers too low to shoot (which you are) that's a good indication that the dose is too high!!

I'd reduce her dose down to 1U and start testing before each shot and at least once somewhere mid-cycle on the AM cycle (between 5-7 hours after the shot) and at least one test on the PM cycle (before bed....more if you can)

It looks like Dee Dee is bouncing from being so low. Most of the time, our cats are diabetic for quite awhile before we notice enough signs and get them diagnosed, so their body's have had time to get used to living in higher blood glucose numbers. When we start to get them down into "normal" numbers, their liver kind of freaks out thinking "Oh no!! This isn't normal!! I like it high!!"....and so it releases stored sugars and hormones to bring it back up quickly. But as you can see, it's not too accurate....instead of just releasing enough to take them to where they usually are, it goes overboard!!

But all you can do is wait it out. It can take up to 6 cycles for those sugars and hormones to get back out of the system.

Eventually, the liver will re-learn that it's OK to be in those lower numbers and hopefully won't react quite so much...the bounces won't be as high and won't last as long!

Getting our spreadsheet started and filling in the numbers you can for the past week or two will really help us to help you. If you need help with the spreadsheet, feel free to send me a private message. I'd be happy to set it up for you. Just click on my name and choose "start conversation" to send a PM.

Hi Chris, Sorry for the delay. I've been an exhausted caregiver who will be 80 next month. Your response was fantastic-- you seem like a pro who kindly explained much more than vets. It helps to understand what's going on physiologically. I'll get on the spreadsheet now and will message you if problems arise. Having Hyperthyroidism is a factor in Dee Dee's problems with regulation, but the suggestions I've received from you seem wise. With much gratitude, Claire

 

[Claire and DeeDee]

Hi Claire, I'm glad to see your response. Regarding the spreadsheet so that Bron and Chris can see the blood sugar levels from the tests you are getting, and view the patterns from cycle to cycle, day to day it's best to have the spreadsheet set up so you can enter the data.

@Chris & China (GA) Chris is a whiz at setting up spreadsheets and I know she would help you out on that score. Then all you would have to do is enter the insulin dose and testing data.

Are you using a computer, a tablet (if so what kind?) or a cell phone to get online and communicate with us here?

If you could set up the signature-- it's easy to do-- then we can see DeeDee's information every time you post (what kind of insulin, what dose, what meter, what food etc.) and we won't have to ask over and over, or check back through subsequent posts for that information.

A fresh battery for a meter once a year is a good idea, just to be on the safe side. They aren't terribly expensive and are available in most big grocery stores or at Walmart. CR2032 is what we have in our ReliOn meter, it is a round flat battery.

But I agree with the other ladies, I think you are seeing bounces because the dose is too high. Did you reduce the dose to 1 Unit as Chris advised?

Claire, I know that you are feeling pretty tired, but with the help of these experienced and knowledgeable members I think you are going to be able to help DeeDee and in the process a weight is going to be lifted from your shoulders.

Thanks much Lou for your prompt reply. I really appreciate your understanding and sympathy. I did get 2 new batterys, same as yours, and will switch. I am using a laptop to communicate with you. I will get back to you after I do the signature and spreadsheet. Much gratitude, Claire

 

[Claire and DeeDee]

Hi Chris, Sorry for the delay. I've been an exhausted caregiver who will be 80 next month. Your response was fantastic-- you seem like a pro who kindly explained much more than vets. It helps to understand what's going on physiologically. I'll get on the spreadsheet now and will message you if problems arise. Having Hyperthyroidism is a factor in Dee Dee's problems with regulation, but the suggestions I've received from you seem wise. With much gratitude, Claire

Hi Chris, I tried sending a conversation to you but didn't see a "send" button. I was asking for help to set up a spreadsheet. I appreciate your offer to help. Much appreciation, Dee Dee's mom, Claire

 

[Red & Rover (GA)]

"Start a conversation"
Scroll down. It's below the message box.

 

[CandyH & Catcat]

believe it or not, I saw a card of SIX 2032 batteries at GOODWILL of all places, for about the same price as one of them at a grocery store

 

[Claire and DeeDee]

"Start a conversation"
Scroll down. It's below the message box.

Thanks Red, got it!

 

[Chris & China (GA)]

From PM

Lantus should be given at the same dose both AM and PM

It's dosed based on how low it takes them, not the Pre-shot number, so just because you see a higher PS, don't increase the dose

Can you get more tests in? I don't know if you work full time or what, but if possible, please get a test somewhere between 5-7 hours after the morning shot and always get at least a "before bed" test on the PM shot. Most cats go lower at night so it's important. If you can't test during the daytime, it's even more important to get a few tests on the PM cycle.

Don't forget to put the link to your spreadsheet into your signature so people can access it!

Looking forward to seeing a picture of DeeDee in your avatar soon too!

 

[Claire and DeeDee]

Hi Chris,
Thanks much for responding so quickly. Boy, the instructions from vets for using Lantus were much less specific.
I haven't figured out how to put the link into my signature and how to "save" it. I will try to post a photo of DeeDee - she's very pretty. I feel sorry that I haven't been treating her diabetes properly. Having hyperthyroidism makes it more complicated as far as being regulated. Much appreciation for the instructions for managing her. So glad I joined the message board! Thank you for your time and concern. Claire

 

[Chris & China (GA)]

I haven't figured out how to put the link into my signature and how to "save" it.

Just open your "signature" box, copy the link and paste it in at the bottom under your other information you already have there.

Click on your sign on name (top right) and choose "Signature" and the new box should open for you to add it to.

Boy, the instructions from vets for using Lantus were much less specific.

That's pretty normal....the sad truth is that vets only get 5 hours of diabetes education in school and that covers all types of animals. Once they've graduated and are in practice, they don't have time to stay up to date on the latest treatments for every disease in every type of animal they see. That's why message boards like this are so valuable. Not only do the people here have the time to research for new treatments, they have the day in/day out experience in their own cats so they know what works....and what doesn't!

The hyperthyroid shouldn't cause any more problems with the diabetes...we've had quite a few other hyper kitties. It's all a matter of sticking with the protocol, raising the dose when needed and test, test, test!!

For now, here's your spreadsheet if anybody else wants to look until you get it into your signature

https://docs.google.com/spreadsheet...eZP7_Y9MPcTysXMY_GsdOqXmmU/edit#gid=361360320

 

[Claire and DeeDee]

Hi Chris,
I had assumed that vets learn about different diseases in animals as M.D.s do for human diseases. Why don't they know more at least about diabetes since it's pretty common in cats? I almost lost Dee Dee with a vet who obviously didn't know much about diabetes. The emergency vet and an internist vet saved her.The internist was in Albuquerque (60 mi. away). It cost much money that I didn't have, as you can imagine.

You (and others on the MB) must spend a lot of time to have your expertise. I asked my current vet if she knew about diabetes and she acted offended by the question. A previous vet instructed me to increase or reduce the Lantus according to the numbers of each test, and to test only when she didn't eat a full meal. Otherwise give the normal dose without testing. Today I did a before bed test and she was lower.
Per your advice, I'll follow the protocol and not be too concerned about her hyperthyroid. Enough to worry about without that.

I see now that eliminating dry food (no-grain) recently from DeeDee's diet was an added factor in her bouncing up and down. She needs less insulin with the lower carb diet.

For accurate testing, should I replace the meter battery if it's older than a year or more?
Do you agree that I should expect DeeDee to be on insulin for life, according to vets? I hoped she would go into remission with proper care.
Your China is a very lucky cat to have you for her mom! Forever indebted, Claire

 

[Chris & China (GA)]

For accurate testing, should I replace the meter battery if it's older than a year or more?

It's a good idea...or even having a back up meter in the house. I know one member here that accidentally put her meter in her microwave instead of her rice sock. OOPS!!

Do you agree that I should expect DeeDee to be on insulin for life, according to vets? I hoped she would go into remission with proper care.

There's really no way to know which cats will go into remission and which ones won't but the sooner treatment is started, the better the chances. We've had one cat here that was on insulin over 8 years and went OTJ for the rest of it's life.

Your China is a very lucky cat to have you for her mom!

Unfortunately, I lost China on Christmas Eve morning last year but thanks to the people here who stayed to pass on their knowledge, she lived another 5 1/2 years after her diagnosis and was the most tightly controlled cat on the message board for several years.

Many of us continue here even after our sugarcats have passed because we feel like we need to "pay it forward".

If you see (GA) in someone's name, that stands for "Gone Ahead" or "Guardian Angel".

 

[Chris & China (GA)]

In reply to your PM:

This may seem obvious, if I get a normal sugar reading - it was 95 this a.m.- do I still give Dee Dee the usual dose (1 unit)? Last night the preshot reading was 192. The spreadsheet says normal is 100 to 199 (a vet quoted 73 to 134).

Normal on a human meter is 50-120, not 100-199. As for the 95 this morning, it looks like getting Dee Dee onto a low carb diet is really helping! When you're getting Pre-shots too low to shoot, it usually means the dose is too high. You might want to drop her down to .75

In the future, if you get a PS you're not sure about shooting, stall, don't feed and post for help. Test again in 20-30 minutes to see if the number comes up without the influence of food.

At first, we'll tell you not to shoot under 150 unless you have somebody here that can stay and monitor you through the cycle until we know Dee Dee is safe. Gradually, you lower that "no shot" limit. Once I had enough data and experience with China, I'd shoot anything over 50 (we did Tight Regulation....You'll need to decide if you're going to do TR or Start Low, Go Slow)

She is usually hungry during the night, so I put food out for her. I guess it's not only hunger but her sugar is getting low. Make sense? -- similar to diabetic humans who will eat a candy bar or have some juice when they're low

Yes, it's totally normal for a cat to go looking for food when their blood glucose is low, just like humans. One way I could always tell China's was running too low was the way she was almost panicking to get some food. I mean there was the normal "it's time for breakfast!! Where is it??" begging, but this was much more "desperate".

Is there something I can read to know more about the difference between diabetes in cats and humans?

They're actually very similar...Normal BG for humans is 50-120 ...just like cats. Humans need to eat a low carb diet...just like cats! There's all kinds of information on treatment in the "Sticky's" at the top of the forum.

Don't forget you need to keep your spreadsheet up to date and get the link into your Signature too. People need to be able to see it so they can give you the best advice.

Just an FYI....we aren't supposed to give advice privately which is why I moved all this over here. The board is "peer-reviewed" so things need to be kept out in the open. I actually do agree with this rule though because no 1 person can know everything. Somebody may notice something on your spreadsheet that may make a difference. Someone else might remember something from Dee Dee's history that changes the advice you'd get....If one person gives you advice that others don't agree with, they will explain why they're saying something different. We all do our best, but you don't want to get "locked in" to listening to only one person.

 

[Claire and DeeDee]

Thank you Chris. I just read this. I will post on the Board from now on (got sidetracked when you emailed the spreadsheet). It makes sense all around. What you and I have conversations, they can help others to learn more too. Dee Dee seemed on track this a.m. at PS 95, but her p.m reading was 449. Don't know what's going on. The Message Board is really well designed and practical! Thanks much.

 

[Chris & China (GA)]

Dee Dee seemed on track this a.m. at PS 95, but her p.m reading was 449.

Did you give insulin at that 95? If not, it's not a surprise that she went a lot higher by the next shot time.

If you did, it's possible she went a lot lower in the cycle today and then "bounced" high again....but without having your spreadsheet updated (and in your signature), I don't have any idea what happened today.

There's a lot of people here that will want to help, but you need to keep that spreadsheet up to date and get the link into your signature