Continued very high BG #s - Help received

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D Marchus

D Marchus

Member Since 2017
Hello! I'm still a newbie to this forum and also new to the SLGS routine and am a bit stumped with the numbers my Neo has been hovering at. We had an unusual blip into blue a week ago and shorted his dose and then the #s promptly went back to reds and blacks (using Alphatrak 2 meter). :(

I did a lot more testing this past week and did a test every hour but one today to get some decent data, hopefully enough to generate some suggestions. The longer Neo rides this high, the more worried I get. Thus far he's had no issues with Ketones or Hypo and I'm just trying to figure out a good path forward to hopefully get him down into healthier numbers. Any Lantus pros game to give Neo's spreadsheet a look?

Note: Since Neo's diagnosis in January there has only been one brief spell (9-10 March) that I had hope we may have hit on the right dose. That was at a dose of 2.5 and we had a couple days before things went off the rails again. Granted, I did knee jerk on the doses when his numbers suddenly dipped so radically. This was all pre-SLGS.

Thanks in advance!
Daniela & Neo
 
I would go up to 3.5U

This dose isn't getting him anywhere near where he needs to be.

Also, there's no real reason you need to test every hour, even when you're doing a curve....every 2 hours for 12 hours or every 3 hours for 18 hours is enough
 
Chris & China said:
I would go up to 3.5U

This dose isn't getting him anywhere near where he needs to be.

Also, there's no real reason you need to test every hour, even when you're doing a curve....every 2 hours for 12 hours or every 3 hours for 18 hours is enough
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Thanks very much for looking things over for us! So, you recommend going straight to 3.5 and not bumping to 3.25 first for a week? As for doing the tests every hour, understood. It was a one-time thing that I thought might be helpful this time around because he's had some interesting changes on the odd hours in the past. Still learning.
 
Since his nadirs are still 300+, I think you'd be fine to go up to 3.5

We can do .5 unit increases when they are running that high.....if he was getting yellow or lower, we'd only go .25

You also have to remember it's kind of relative.....when we start out at 1U, going up by .25 is a 25% increase

At 3U, going up by .5 is a much lower percentage increase (my math is failing me at the moment, but I think it's only a 6% increase)....we don't want to go too fast and miss a "good dose", but we don't want to go too slow and have him stay so high any longer than necessary either
 
Chris & China said:
Since his nadirs are still 300+, I think you'd be fine to go up to 3.5

We can do .5 unit increases when they are running that high.....
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Appreciate the dosing explanation.

So, if we go up in the morning to 3.5, I'm unclear on what kind of testing I should do, in addition to AMPS/PMPS tomorrow. Also, I'm assuming a full curve should happen after 7 days but should I be doing some spot checking as well leading up to that?

Thank again Chris & China for sharing your expertise!
 
Depending on when you can test, if at all possible, it's great if you can get at least a mid-cycle on the AM cycle and it's important to get at least a "before bed" test on the PM cycle

That's actually all that's required for Tight Regulation, so since you're doing SLGS, that's more than enough if you can get it

You can do a curve every 7 days before adjusting the dose again

You always test before shooting to make sure they're high enough for insulin at all....then IF you can, grab random tests at different points of the cycle when you can
 
I notice you're not getting any tests on the PM cycle though

Most cats go lower at night, so it's very important to get at least a "before bed" test on that cycle to make sure they're going to be safe while you're sleeping

Also, by not testing on the PM cycle, you're missing a full half of the data about what's going on with his body.

Think of the spreadsheet like it's a puzzle....if you only have pieces in the same places all the time, it's hard to know what the picture is...but if you sprinkle them all over, the picture becomes clearer. Without testing on the PM cycle, we can tell its a cat on one side of your puzzle, but we can't tell if it's a bunny or a dog on the other......LOL
 
Hi there :cool:

making dosing decisions thst are based on both the AM and PM cycle activity offers the best chance of getting the right dose. As it stands you only have half the picture.

I recommend you start collecting some data on the PM cycles. Many kitties run lower overnight. Just sprinkle a few tests here and there, for example a "before bed" test one night and a +6 on another night etc. when you stand back and look at the ss, best not to have any wide open spaces (areas with no data).
 
Ok, with a plan in hand we're moving forward, hopefully to the land of better numbers! Thanks very much.

AMPS 486, gave 3.5

Side question. How do you tag people when writing a message? Can't seem to figure that out.
 
Welcome to the group!

To tag someone use the @ sign and type in their name (e.g., if I type @ and without a space, type your screen name, you'll be tagged: @D Marchus -- usually a prompt appears and you can click on that to fill in the link.)

It's great that you're testing and you may get an invitation to the testaholics club. (I'm a member.) One thought is to reduce some of your AM cycle tests unless you are seeing numbers changing and adding some PM tests as everyone is suggesting. Aside from the issues with testing only one cycle that others have noted is that you're missing half of your data. Right now, you have no way of knowing whether Neo's numbers are high all the time or if he's dropping lower at night and bouncing back up during the day.

Good luck with the dose increase. Also, remember that with SLGS, you want to evaluate the dose every week.
 
D Marchus said:
Hello! I'm still a newbie to this forum and also new to the SLGS routine and am a bit stumped with the numbers my Neo has been hovering at. We had an unusual blip into blue a week ago and shorted his dose and then the #s promptly went back to reds and blacks (using Alphatrak 2 meter). :(

I did a lot more testing this past week and did a test every hour but one today to get some decent data, hopefully enough to generate some suggestions. The longer Neo rides this high, the more worried I get. Thus far he's had no issues with Ketones or Hypo and I'm just trying to figure out a good path forward to hopefully get him down into healthier numbers. Any Lantus pros game to give Neo's spreadsheet a look?

Note: Since Neo's diagnosis in January there has only been one brief spell (9-10 March) that I had hope we may have hit on the right dose. That was at a dose of 2.5 and we had a couple days before things went off the rails again. Granted, I did knee jerk on the doses when his numbers suddenly dipped so radically. This was all pre-SLGS.

Thanks in advance!
Daniela & Neo
Click to expand...

Good morning,

I have been on here just over a year and I know how your feeling right now, we have all been in your shoes. The folks on here are amazing and life savers, you'll need to trust them.

Questions, I was reading your profile, are you feeding dry food? If so dry food is the kiss of death to our kitties. My cat Willow can sniff out one nugget buried in the carpet. One nugget sends her into the black. We use to feed our other cats dryfood and Willow wet, Willow would always somehow get some. We ended up pulling all dryfood from our house. Our two other cats protested for over a week. They refused to eat wet food until they got really hungry and now they will eat wet food. It was a battle to get them off the dryfood because its crack for kitties.
If your giving dry food your going to need to stop and get your kitty on wet only. There is then the problem of finding what will your kitty like. We were on BFF tuna and Willow decided she was allergic to tuna! We are now back on fancy feast chick patty only. The turkey says it is lower carbs than the chicken and Willows numbers says a different story.

Also when you switch from dry to wet only you will see your numbers drop fast so your going to need to be prepared with gravy food. When giving gravy to bring up their numbers use only the juice and test in 15 minutes.

Good luck and hang in there.
 
@Willow yes, I understand that about the dry food but he simply refuses all offerings. Also, Neo's diabetes diagnosis came after I had to take him into the emergency room for not eating. We had to fight to get through a fatty liver issue then too and it was a challenge...feeding tube, early self-removal of said tube (by Neo), etc. He's been back to full appetite for about a month and I'm not ready to rock that boat overmuch. The dry food he's eating now is very low carb, high protein, and he loves it. Right now we're happy with that. I do continue to test the wet food waters but I think part of the problem is he relates the texture and smells to when he was sickest. I'm hoping a little more time will make a difference!
 
D Marchus said:
Hello! I'm still a newbie to this forum and also new to the SLGS routine and am a bit stumped with the numbers my Neo has been hovering at. We had an unusual blip into blue a week ago and shorted his dose and then the #s promptly went back to reds and blacks (using Alphatrak 2 meter). :(

I did a lot more testing this past week and did a test every hour but one today to get some decent data, hopefully enough to generate some suggestions. The longer Neo rides this high, the more worried I get. Thus far he's had no issues with Ketones or Hypo and I'm just trying to figure out a good path forward to hopefully get him down into healthier numbers. Any Lantus pros game to give Neo's spreadsheet a look?

Note: Since Neo's diagnosis in January there has only been one brief spell (9-10 March) that I had hope we may have hit on the right dose. That was at a dose of 2.5 and we had a couple days before things went off the rails again. Granted, I did knee jerk on the doses when his numbers suddenly dipped so radically. This was all pre-SLGS.

Thanks in advance!
Daniela & Neo
Click to expand...

Hi Daniela, I'm not an expert at all but I am on SLGS too and I have the same problem with dry food . Two months ago my cat was addicted 100% of dry food but slowly I succed to translate him to wet food, even if that food is not suitable 100% for diabetes because is MC ( >10% carbs) but I noticed a littlle progess in his numbers. He still refuses the food <10%carbs.
Sometimes, he refuses wet food because he is still addicted to dry food, but anyway 90% of daily food is wet.
As experts say, you should increase the dose. If I were you I increase with 0.25 ui.
Good luck!
 
D Marchus said:
@Willow yes, I understand that about the dry food but he simply refuses all offerings. Also, Neo's diabetes diagnosis came after I had to take him into the emergency room for not eating. We had to fight to get through a fatty liver issue then too and it was a challenge...feeding tube, early self-removal of said tube (by Neo), etc. He's been back to full appetite for about a month and I'm not ready to rock that boat overmuch. The dry food he's eating now is very low carb, high protein, and he loves it. Right now we're happy with that. I do continue to test the wet food waters but I think part of the problem is he relates the texture and smells to when he was sickest. I'm hoping a little more time will make a difference!
Click to expand...


Hi
I completely fee your pain with the dry food and the vet ordeal.
The photo is what we have to add to our wet food for our two other kitties or they refuse to eat. It adds the texture like dry food.

Maybe try mixing wet with a littl dry and ween him off slowly. The problem is if they stay in the red and black for too long they can get keytones and that can and will kill him if not resolved quickly. Willow had keytones, we were testing her pee every time until she was back in safe numbers.
When I say I get the nightmare with the vet I mean it, we went through hell with Willow, our todate total vet cost is $15k, four vets told me to put her down, she had turned yellow and liver and kidneys were shutting down. We were bouncing between two vets for 24 hour care. At one point I lost it on the vet because what they were doing was making her worst. I had to take over, took her home and spent one week of 24 hour care with force feeding every hour until she got better. She too only wanted dry food, I had to get her off and it took a lot of work.
Again I wish you the best,
 

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You are completely correct -- for a cat just over dealing with hepatic lipidosis, the first goal is to keep Neo eating well. Likewise, cats are experts at developing an aversion to anything they associate with feeling bad, food included. If your plan is to transition your kitty as slowly as possible to canned food, that makes excellent sense. If you've not had a chance to look at Dr. Lisa Pierson's website, she talks about the slow process of transitioning off of her cats to a canned or raw (I can't remember) food diet.

 
@Willow, your ordeal was considerably more complicated than mine! Trying to do right by our fur babies is downright hard at times. :(

@Sienne and Gabby, I looked at Dr. Lisa's website a little while back. Probably need to revisit, thanks.
 
Willow said:
Good morning,

I have been on here just over a year and I know how your feeling right now, we have all been in your shoes. The folks on here are amazing and life savers, you'll need to trust them.

Questions, I was reading your profile, are you feeding dry food? If so dry food is the kiss of death to our kitties. My cat Willow can sniff out one nugget buried in the carpet. One nugget sends her into the black. We use to feed our other cats dryfood and Willow wet, Willow would always somehow get some. We ended up pulling all dryfood from our house. Our two other cats protested for over a week. They refused to eat wet food until they got really hungry and now they will eat wet food. It was a battle to get them off the dryfood because its crack for kitties.
If your giving dry food your going to need to stop and get your kitty on wet only. There is then the problem of finding what will your kitty like. We were on BFF tuna and Willow decided she was allergic to tuna! We are now back on fancy feast chick patty only. The turkey says it is lower carbs than the chicken and Willows numbers says a different story.

Also when you switch from dry to wet only you will see your numbers drop fast so your going to need to be prepared with gravy food. When giving gravy to bring up their numbers use only the juice and test in 15 minutes.

Good luck and hang in there.
Click to expand...
Young Again that he is feeding is not the same as regular dry food. It's only 1% carb. I credit this dry food with helping get my cat into remission.
 
JanetNJ said:
Young Again that he is feeding is not the same as regular dry food. It's only 1% carb. I credit this dry food with helping get my cat into remission.
Click to expand...

Thank you for sharing! Yes, I tried to get the best alternative in dry food to get us by for now.

Bummed at the moment. Upped Neo's dose this morning to 3.5. His #s stayed really high today...normal? Tonight, of all times, had a fur shot! That's bound to set us back. :(
 
It's normal for some cats to take a while to respond to a dose increase. There is a phenomenon that we have dubbed "New Dose Wonkiness" - it's described in the first 2 posts of this thread.

Do read the second post of that thread as well - it talks about bouncing. Bouncing can cause cats to have 3 days of non-stop high numbers. Sometimes cats are high from New Dose Wonkiness, sometimes from bouncing, and sometimes because you haven't gotten to a good dose yet. You have to be a bit of a detective with a diabetic cat to figure out what's going on sometimes.

I totally agree with Sandy & others above about trying to get one test in during the pm cycle. That can often be very revealing as cats often have their lowest numbers in the pm cycle. If Neo is high (like over 400) when you're trying to do a curve, maybe wait 4 hours in between tests and if you get a yellow number, then you could test more often.

Here is a thread that can help you find information that we commonly refer to in this group: "Where Can I Find?" Many bookmark it for the future.

Welcome to the group - it takes a while to get a good understanding of what's going on, so keep asking questions until you feel like you've got it!
 
@julie & punkin (ga), thank you very much for your incredibly useful tips!

Looks like I've been stumbling around doing things all wrong so far. Sorry! I read a ton when I first joined FDMB and it's clear I only scratched the surface. I hope everyone will be patient with me if I make a few more mistakes. It's a lot to take in.

The "Where Can I Find?" page is so very fantastic and I plan to dive deep...in doses. ;)
 
some cats take longer than others to regulate. Some also need a much higher dose to get to the "breakthrough" dose that finally starts the ball rolling into downward numbers. I'm curious why you chose to lower the dose this morning? I'm really glad you've started taking more mid day numbers when you can. It's important to get those preshot numbers, but it's so so helpful to get those mid cycle numbers so that we get a more complete picture of what's going on.
 
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