Don't understand frightening jumping numbers?

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Jennifer and Spot (GA)

Jennifer and Spot (GA)

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We have been giving Spot Lantus, 1 unit each shot, and recently giving shots twice daily as of the 10th.
Here's the latest (sorry, no chart).

7:34 AM 4/12 393
6:18 PM 4/12 270

7:20 AM 4/13 70
6:45 PM 4/13 191

7:24 AM 4/14 353
6:50 PM 4/14 554, then we retested, and it was 522

We have lately given him a small amount of food around noon and then around 11 PM.

As far as food goes, we're giving him Fancy Feast classics, Wellness chicken or Merrick's turducken. Also blend in some Nature's Variety raw. Should I get rid of the raw food? Not sure if that could be the trouble. All these foods are on the chart as OK. Mostly we give him Fancy Feast classics.

We are pretty new at all this and are trying to not be vet-dependent, so I'm asking for your help. This last number seems very dangerous to me. Especially since it went so high from just yesterday AM. How high does it get before I call the vet? He does not act like he's sick.
 
Did you give a full 1U when you got that 70 for a preshot number?

If you did there is a good chance that he went very low during that cycle and then the numbers you saw the next day is a bounce off those lows, from his body dumping all its stored sugars to try to save itself from going hypo.

He also could just have bounced even without going super low off that 70 because while we know that is a normal number his body that is use to being much higher for awhile now went WTH? That Feels strange lets bring that back up! Think of it like this you know when it starts getting cooler in the fall after its been really hot all summer when it first hits the 60s we are putting on a coat because we are chilly, but as the fall and winter goes on we get use to those colder temps so when spring rolls around and it hits 60 again we are putting on the t-shirts and shorts because it now feels so warm. That is kind of what their bodies do, they get use to being in the 300s+ then suddenly they hit a normal number and their body thinks its cold and wants a sweater so it dumps a bunch of stored sugar to make things feel right again.

Mel, Maxwell, Musette & The Fur Gang
 
Hi, Jennifer,

Have you given 1u each shot since you went with twice a day injections? Did you shoot that dose at both the AM and PM shot on the 13th? I think I agree with what Mel said already. If you gave insulin, especially on that 70, he may have gone even lower, and what you saw today is his body's reaction to going so low (some people call it "bouncing"). It's a built-in self preservation mechanism when their blood glucose drops below what he has come to see as "normal". It sometimes takes 2 days or longer for the "bounce to clear", meaning you may see higher numbers tomorrow as well.
Even if you don't have a spreadsheet that we can see, please keep track of all the numbers on every test you get. You will need those numbers to make any sense out of what is going on and how the insulin is working. Have you been testing at all between shots? The really important test to get if at all possible is the number that is at the mid-point between tests. In theory, that would be when the BG is at its lowest point in a 12 hour cycle. It isn't an exact science, sometimes it happens an hour earlier or later, but the nadir is the number that lantus dosing is based upon, so you need to know it in order to determine if the dose is right.
How many days have you been shooting 1u twice a day? Consistency in dosing with lantus is very important, and you want to hold that dose for 3-5 days to let him "settle" into it.
If you don't see an improvement after that time frame, then it could be that the dose needs to be adjusted. The more data you collect, the easier it will be to determine if and when you need to adjust the dose.

Hope that helps,
Carl
 
Jennifer

It would help us immensely in helping you if you did a Spreadsheet and put all of your test numbers on it. We don't just look at that cycle...we look at waves and patterns. Your kitty is getting low on this dose...I'm not saying "too" low but low enough that the liver reacts by releasing counterregulatory hormones and glucagon into the blood stream causing his blood glucose values to skyrocket. This is a good thing in the sense that it tells you the liver is doing what it's supposed to do. But in order to get this to flatten out a bit, we need to help you with the dose and to do that, we need a spreadsheet.

Here is the link:

Spreadsheet

If you have any problems, please send me a private message.
 
I have not been testing between shots. He is getting really irritated with the ear pricks as it is. He is irritated with the shots. He is RAVENOUS as of late, also. I wonder how satisfying Fancy Feast classics is?
 
Jennifer,
How much is he eating per day? One thing that will make them appear ravenous is low blood sugar. They "know" that eating will raise their glucose, and when they go low, they want FOOD!!!! And they want it NOW!

Eventually, he won't mind the testing, providing there is a reward given. Most of us use low-carb treats as a "payoff". A lot of cats will learn that testing and shots mean treats, food and most importantly, feeling better. He will probably get to the same point, where he actually comes running at test time and lets you poke without a fuss. My cat, Bob, hasn't had insulin since last July. But if I get the meter case out, and unzip the case, he still comes running, sits there looking at me. He knows it means fresh shrimp, which is his favorite thing in the whole wide world. Sometimes I'll give him a shrimp just for coming. Sometimes I check him just so I remember how. Either way, he gets a treat.

Carl
 
ammonzon: I've been giving Pumbaa sardines in water (human food, canned, no salt added, nothing other than sardines in water) for his treats at testing time. I put a little bowl in front of him while he sits on my lap for the testing, and that makes the testing go easier. Plus, I know he is getting a very high-protein treat since he needs to put on some weight and I don't like all of the fat that is in a lot of the canned low-carb cat foods. This might help you with the testing, and help Spot with his ravenous appetite.

If Spot likes fish, and you have a Trader Joe's nearby, the Trader Joe's tuna canned cat food was listed as being very low in carbs, and with more protein than fat in the content. I'm hoping to find time to make a trip to Trader Joe's next week to stock up on that cat food for Pumbaa (sugarkitty) and Larry (civilian).

Good luck...and do do the spreadsheet. If you need any help, I'd be happy to walk you through it.
 
He does not have low blood sugar at 540.

I'm feeding him Fancy Feast almost one can in the AM, then at noon 1/2 can, then in the PM one can, then at 10 PM or so, 1/4 can. I guess he needs more than this.

Shrimp sounds like a good high protein treat. What about cut up baked chicken, no skin?
 
540 isn't low, but he could have gone low before that, and that low may have caused him to climb as high as he did.

Baked or boiled chicken is a great treat, no skin and no seasonings. Since most chicken treats tend to be "breast" I'm guessing white meat is better than dark, but not sure if either actually has any carbs at all. Fresh boiled shrimp is supposed to be zero carbs too.

The quantity of FF you are feeding seems sufficient, but I can only base that on how much Bob consumed while on insulin which was two cans of FF classics and about 3/4 can of Friskees Pates per day. I fed him the cans of FF for breakfast and supper and the Friskees in between meals. He weighed between 13-14 pounds at that time, but he was also pretty inactive both during and after diabetes. An active cat would burn more calories, so would need a bit more food, but just like everything else, ECID.

Carl
 
Per this chart Fancy Feast seems to be rather high on the carbs. And it all depends on what variety of Fancy Feast you are feeding George. Not all canned cat food is low in carbs, unfortunately. Plus, if you look at the dates of the entries on Binky's chart, they are very old. Just like all food manufacturers, pet food manufacturers have been adding low-cost carbs to foods to increase profits, so I don't put much weight into the data on this chart anymore.

I also use this chart to help me hunt for canned cat food that is low in carbs, higher in protein, lower in fat. The information on this chart is more up to date than on Binky's chart.

I also found one cat food that actually states "contains less than 7% carbohydrates" right on the label, and that is Innova EVO turkey and chicken formula.

I bought my cats some Blue Wilderness Salmon canned cat food yesterday, and they really chow down on that. But this was $1.59 for a 5.5 oz. can, and is very pricey!

Hope this helps finding a food that is higher in protein and lower in fat and carbs, to help George.
 
Suze,
The "new" chart of Binky's only lists the "elegant medley" FF flavors, which are not "low carb", and for some reason all have veggies added to them (like cats graze in the garden in the wild!). The "old" binky's chart is where all the other varieties, including the "classics" are found. Yes, Binky's lists are not up to date, but hundreds if not thousands of cats have been using those charts and those foods since they were written, and they keep going OTJ after eating FF classics, Friskees Pates, Sophisticats, Special Kitty, and other store brand canned foods. The other chart you linked is extremely useful as well, except if doesn't really have any, or very few, varieties that you can find at the grocery store on it, unfortunately.
I did find one discrepancy on it though. The Purina DM, which is at the top of the list, lists it's %'s on Protein, Fat and Carbs as 39/58/3, while Binky's lists it as
46/47/7. Not sure why that is, unless Purina has made significant improvements in between the dates the lists were published.

Jennifer,
Here's the link to Binky's "old canned food" chart. Like Suze said, it isn't up to date, but we still use it all the time.

http://binkyspage.tripod.com/CanFoodOld.html

Carl
 
Carl, thank you. I never looked at Binky's old list because I don't trust the manufacturer's to not have added cheap carb fillers in the meantime. I wish those charts had ingredients listed, so that we could compare over the years and see what changes.

And trust me, I think Binky did a wonderful job collecting and sharing all of that data. I know that was no easy job! But even yesterday, when looking for some of the Friskies cat food that was supposed to be low in carbs, the ingredients list potatoes or rice now, and I just refused to buy them, even though my cats have eaten Friskies canned for years, and it would be much more affordable than what I have been buying.
 
Chicken is a great treat. You can boil it, steam it, or even feed it raw.
My Oliver and even Apple Blossom liked little raw chunks of chicken, but Shadoe would not eat raw so I lightly steamed her pieces.

If you think of a bouncing ball when thinking of your cat's numbers between shots, you will see what others meant about going too low. The test you get at shot time may be 540 but if the dose is too high and pulls your cat's numbers down too low around the middle of the cycle, maybe after 6 hours, the numbers could bounce up high again by the time for the next shot.
 
Carl & Bob in SC said:
I did find one discrepancy on it though. The Purina DM, which is at the top of the list, lists it's %'s on Protein, Fat and Carbs as 39/58/3, while Binky's lists it as
46/47/7. Not sure why that is, unless Purina has made significant improvements in between the dates the lists were published.
Click to expand...


Carl, there was a significant improvement made to the formula. The newer list is more accurate. Here are Purina DM's ingredients in 2006 (same formula when Binky's charts were done in 2002):

Ingredients (Canned)

Liver, water, beef, corn gluten meal, trout, fish meal, animal fat preserved with mixed-tocopherols (form of Vitamin E), wheat flour, soy protein isolate, powdered cellulose, carrageenan, calcium carbonate, potassium citrate, choline chloride, potassium chloride, L-Lysine monohydrochloride, salt, taurine, ferrous sulfate, Vitamin E supplement, zinc sulfate, niacin, thiamine mononitrate, manganese sulfate, calcium pantothenate, copper sulfate, Vitamin B-12 supplement, pyridoxine hydrochloride, riboflavin supplement, biotin, folic acid, Vitamin D-3 supplement, calcium iodate, menadione sodium bisulfite complex (source of Vitamin K activity), sodium selenite.

E-4573
Click to expand...

Here's the ingredients today (same as the 2010 list):
Ingredients (Canned)

Liver, poultry by-products, meat by-products, water sufficient for processing, chicken, salmon, oat fiber, salmon meal, guar gum, potassium chloride, carrageenan, salt, Vitamin E supplement, calcium phosphate, taurine, thiamine mononitrate, zinc sulfate, ferrous sulfate, niacin, calcium pantothenate, copper sulfate, Vitamin A supplement, manganese sulfate, menadione sodium bisulfite complex (source of Vitamin K activity), pyridoxine hydrochloride, riboflavin supplement, Vitamin B-12 supplement, biotin, folic acid, Vitamin D-3 supplement, potassium iodide. I-4573
Click to expand...

Note the only source of carbs in the new formula is oat fiber.

While few of the cat food formulas have changed enough to alter the carb content since Binky's list were done, it is very important to pay attention to the ingredients as well to catch changes like this. I periodically check the ingredient labels on whatever foods I buy to make sure there have been no significant changes to the formulas. Anything grain free is going to be low carb as long as vegetable fibers and starches aren't high up on the ingredient list. That's one of the reasons why I'm hesitant to recommend Friskies, especially when Special Kitty and Sophistacat have similar grain free choices in the same price range. There's no way of knowing if the carb levels are staying under 10% over time, since they can increase the rice content and no one would actually be able to tell because the ingredients would stay the same.

Here is a list of the grain free, low carb flavors of fancy feast: http://felinediabetes.com/glutenfree.htm
 
Jennifer, I agree with the others that you are likely missing low mid-cycle numbers. You really need those mid-cycle tests, because the higher numbers and low preshot are an indication the dose is too high. Too high a dose can actually keep BG higher than too low a dose at times, because the liver dumps glucose into his blood when he hits a low number. If you don't catch that low number (which will be in the middle of the cycle), than his preshots will seem to be going up and up.

You said you aren't getting mid-cycle tests because he doesn't like it--this is not because he is in pain. Cat's have very few nerve endings in their ears and if you're pricking the right spot (not the vein), then he's likely more upset at being restrained than the poke. You may need to wrap him in a blanket to get all of the daily tests you need for a while until he gets used the testing and tolerates it. If you give a low carb treat after EVERY test (whether successful or not), it speeds up the acceptance process. Also, a little neosporin + Pain relief on the ear afterwards also might help out. You're not using your lancets more than twice, are you? After two pokes, they get dull and can be a little painful if you continue to use them. You never want to use a lancet more than twice, just like you don't want to ever use a syringe more than once because they get dull.
 
I said he is getting irritated with the testing. Not pain. Very irritated. He was pretty good in the beginning but now he's got it figured out. I give him a chicken treat but that doesn't stop him from trying to bolt and unhappy growling. We are actually at the point where we can usually get his blood pretty quickly, though sometimes it still takes 3 times. Even so, he is really upset.

My husband is not often home during mid-day to test, and I am not at home all day. Not sure if it is a great idea to test some days, other days we don't (for mid-day testing). Today we got more bouncing numbers. We are doing everything people have said to do (we feed only canned Fancy Feast classics, and give 2 shots a day, 1 unit each, Lantus, approx 12 hrs apart) and his number today is higher than it was at the vet's when he was first diagnosed and not on any insulin.

I know someone on here always writes, It's a process, not an event. Ok then. It's a process, not an event.
 
If you're having to poke repeated times, check the gauge of the lancet. It can be difficult to get blood with a 30-31 gauge lancet, whereas the 26-27 gauge lancet is likely to be more successful.
 
Well, we did change it from 1 unit a day to 2 units. That is because most people here posted that 1u a day was not a good treatment. Should I cut back to .75 in the AM and .75 in the PM? I don't know how I know how much insulin to give him.
 
if she was getting 1u once a day of s.i.d and you wanted to go to shooting twice a day or b.i.d then you should have halved that 1u and shot .5u every 12 hours. By going to 1u twice a day you in effect doubled her dose. The normal starting dose for most cats is either .5u b.i.d. to 1u b.i.d

Personally I would drop back to .5u b.i.d and hold that dose for 3-5 days then run a curve and see where that gets you, you can always up the dose if it isn't enough but you can't get it back out of the cat once it has been shot.

When in doubt you can always post your numbers here and ask for help in dosing.

Mel, Maxwell, Musette & the Fur Gang
 
MommaOfMuse said:
if she was getting 1u once a day of s.i.d and you wanted to go to shooting twice a day or b.i.d then you should have halved that 1u and shot .5u every 12 hours. By going to 1u twice a day you in effect doubled her dose. The normal starting dose for most cats is either .5u b.i.d. to 1u b.i.d

Personally I would drop back to .5u b.i.d and hold that dose for 3-5 days then run a curve and see where that gets you, you can always up the dose if it isn't enough but you can't get it back out of the cat once it has been shot.

When in doubt you can always post your numbers here and ask for help in dosing.

Mel, Maxwell, Musette & the Fur Gang
Click to expand...

I agree with Mel.
 
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