Dosing advice- ?glucose tocixity

[Kayles.T]

Hi all,

I’m starting to suspect glucose toxicity with Henry.
He seems good in himself, just ravenous and still drinking a lot. He is soooo much better than when first diagnosed!

I’ve just increased from 2.75 to 3 units

He bloats on occasion- we thought it was because he was gulping air during eating and drinking, it’s usually an overnight thing and he’s better in the morning. He’s not too different in behaviour if he’s bloated.

He eats animonda carny a high protein low carb wet food, auto feeder set up with a small amount about 4 times a day and night. He may possibly scavenge during the day and early evening but he’s locked in at night. I’m sure I’ve seen his BG rise on occasion without scavenging though.

Just wondering if there’s anything else I should consider at this point or whether I wait out this dose increase and continue the journey up in 5days or so!

I’d be so grateful for some thoughts!

https://docs.google.com/spreadsheets/d/1FWZ5YfZ12nVaBDVj9qzpGybgQSqqeND60LpHGvwUogI/edit

 

[JanetNJ]

What do you mean he is scavenging food? what food does he have access besides his regular low carb food? Make sure he doesn't have access to anything he's not supposed to eat. You may be holding doses too long. I'm glad you raised it to 3. I wouldn't hold it more than a week before reassessing the dose. I'm not familiar with animonda carny. How many calories a day are you feeding? what his his weight?

 

[Kayles.T]

Thanks for your reply.

He is allowed out during the day and early evening so there is a small chance he could be scavenging food whilst he’s out, but I don’t know how likely that is.
His weight is 5.5kg which is really good for him. In pre-diabetes we were trying to keep him around this weight and not let him get above 6kg. But at diagnosis he was around 4.5kg!

I can’t find any calorie info for the animonda carny but the recommended feeding for a 5kg cat is 245g per day and we are giving him about that (maybe a tiny bit more)

I could keep him locked in for a few days to ensure his numbers aren’t being influenced… he will be super depressed though as he is a former stray he loves being outside!

 

[Suzanne & Darcy]

I agree with Janet about reassessing the dose every week (7 days) (according to SLGS dosing protocol.) It's odd how some cycles he dropped low on that dose of 2.75 when most of the other time he seemed very high on that dose. There's a lot of missing data in the preshot cells of the spreadsheet, so we can't tell if he was just starting from a lower place with lower than expected AMPS or PMPS and perhaps a reduced dose would have been preferred.

If he goes outside during the day, do you mean he may be eating dry food or something else high carb from a neighbor's house? Also, some days we cannot see at all what happened during the day because of no mid cycle tests. That makes me uncomfortable since it was for quite a stretch of days and we have no idea of what happened. It does seem like he needed that increase to 3 units. However, if he really is possibly eating higher carb at somebody else's place during the day, then he could potentially go much lower on a dose when he is not getting that food. And the night time cycles without that food could be totally different than the daytime cycles, with Henry dropping much lower during those evening cycles.

 

[JanetNJ]

Thanks for your reply.

He is allowed out during the day and early evening so there is a small chance he could be scavenging food whilst he’s out, but I don’t know how likely that is.
His weight is 5.5kg which is really good for him. In pre-diabetes we were trying to keep him around this weight and not let him get above 6kg. But at diagnosis he was around 4.5kg!

I can’t find any calorie info for the animonda carny but the recommended feeding for a 5kg cat is 245g per day and we are giving him about that (maybe a tiny bit more)

I could keep him locked in for a few days to ensure his numbers aren’t being influenced… he will be super depressed though as he is a former stray he loves being outside!

You really want to make sure he's not eating for the two hours before the preshot test to make sure the number isn't food influenced. Can he be confined to a yard so you know what he's doing? I know that could be difficult.

If he seems hungry at all it's ok to feed him as much as he wants. Diabetic cats that are unregulated often need more food.... so don't hold back. you've been doing an awesome job of getting lots of mid day tests in the past four days.

question... has he had his teeth looked at recently? I wonder if the high numbers could have something contributing to them like a little infection. is he drooling or pawing at his mouth, or chewing weird?

 

[Kayles.T]

I agree with Janet about reassessing the dose every week (7 days) (according to SLGS dosing protocol.) It's odd how some cycles he dropped low on that dose of 2.75 when most of the other time he seemed very high on that dose. There's a lot of missing data in the preshot cells of the spreadsheet, so we can't tell if he was just starting from a lower place with lower than expected AMPS or PMPS and perhaps a reduced dose would have been preferred.

If he goes outside during the day, do you mean he may be eating dry food or something else high carb from a neighbor's house? Also, some days we cannot see at all what happened during the day because of no mid cycle tests. That makes me uncomfortable since it was for quite a stretch of days and we have no idea of what happened. It does seem like he needed that increase to 3 units. However, if he really is possibly eating higher carb at somebody else's place during the day, then he could potentially go much lower on a dose when he is not getting that food. And the night time cycles without that food could be totally different than the daytime cycles, with Henry dropping much lower during those evening cycles.

Thanks for your reply
I work full time plus on call at a hospital so I’m limited with how much I can test.

I don’t think he’s eating at someone else’s house as we have a tracker on him and he doesn’t seem to be going consistently to a house. And he spends a lot of time at home next to the feeder waiting haha.
I just think if he was out and there was something on the floor he wouldn’t hesitate to nibble at it!!

 

[Kayles.T]

You really want to make sure he's not eating for the two hours before the preshot test to make sure the number isn't food influenced. Can he be confined to a yard so you know what he's doing? I know that could be difficult.

If he seems hungry at all it's ok to feed him as much as he wants. Diabetic cats that are unregulated often need more food.... so don't hold back. you've been doing an awesome job of getting lots of mid day tests in the past four days.

question... has he had his teeth looked at recently? I wonder if the high numbers could have something contributing to them like a little infection. is he drooling or pawing at his mouth, or chewing weird?

Thanks for your reply

I’ve got a week off work so I’m trying to utilise it!

His teeth seem fine- no odd behaviours and he lets me look at them.

His am pre shot is definitely not food influenced as he’s locked in the house. He’s not locked in before his pm pre shot but he’s often in the house for most of the afternoon (as his tracker tells me!)

I’ll keep him in for a couple days to get a better idea of his numbers. He literally claws at the windows and howls to try and get out so I do worry about him getting stressed being kept inside! I’ll let him have supervised visits to the garden!

Thanks for all your thoughts- it’s much appreciated

 

[JanetNJ]

Thanks for your reply

I’ve got a week off work so I’m trying to utilise it!

His teeth seem fine- no odd behaviours and he lets me look at them.

His am pre shot is definitely not food influenced as he’s locked in the house. He’s not locked in before his pm pre shot but he’s often in the house for most of the afternoon (as his tracker tells me!)

I’ll keep him in for a couple days to get a better idea of his numbers. He literally claws at the windows and howls to try and get out so I do worry about him getting stressed being kept inside! I’ll let him have supervised visits to the garden!

Thanks for all your thoughts- it’s much appreciated

good to know that for sure the am number is accurate. I think you are right that it could be a case of glucose resistance/toxicity. In that case I might suggest raising .25 every 3-5 days. The longer he's stuck in those high numbers the harder it is to get it back down. For my own cat i used to adjust every 3 days or so, but it's ok to be a little more cautious... totally your call. If it were MY cat i'd raise tomorrow or tonight esp since you are home this week to monitor. Id really like to see him out of those high red and black numbers.

 

[Kayles.T]

good to know that for sure the am number is accurate. I think you are right that it could be a case of glucose resistance/toxicity. In that case I might suggest raising .25 every 3-5 days. The longer he's stuck in those high numbers the harder it is to get it back down. For my own cat i used to adjust every 3 days or so, but it's ok to be a little more cautious... totally your call. If it were MY cat i'd raise tomorrow or tonight esp since you are home this week to monitor. Id really like to see him out of those high red and black numbers.

thanks so much- great to hear your thoughts

I’ll keep him on 3units tonight and get some overnight tests done, then that’ll be 6 cycles at 3 units and I’ll be happier to consider increase by .25 tomorrow morning. I’ll see how I feel..

thanks again

 

[Kayles.T]

good to know that for sure the am number is accurate. I think you are right that it could be a case of glucose resistance/toxicity. In that case I might suggest raising .25 every 3-5 days. The longer he's stuck in those high numbers the harder it is to get it back down. For my own cat i used to adjust every 3 days or so, but it's ok to be a little more cautious... totally your call. If it were MY cat i'd raise tomorrow or tonight esp since you are home this week to monitor. Id really like to see him out of those high red and black numbers.

So we had some delightful numbers last night on the 3 units! And then what looks like a bounce this morning! He has certainly drunk a lot less which is nice to see, I’m going to keep him locked in whilst I see how his numbers react to a bounce…

 

[JanetNJ]

So we had some delightful numbers last night on the 3 units! And then what looks like a bounce this morning! He has certainly drunk a lot less which is nice to see, I’m going to keep him locked in whilst I see how his numbers react to a bounce…

In glad he’s feeling better. I’d give it another increase. Don’t hold an inadequate dose too long when you’re trying to break a glucose toxicity.

 

[JanetNJ]

So we had some delightful numbers last night on the 3 units! And then what looks like a bounce this morning! He has certainly drunk a lot less which is nice to see, I’m going to keep him locked in whilst I see how his numbers react to a bounce…

There are some values not showing on your chart. You may have more than just a number written in the space. Could you move the extra notes to the blank space next to it so that the preshots show on your chart?

Edited to say…. I now realize you may have written the word none in there?

 

[Kayles.T]

There are some values not showing on your chart. You may have more than just a number written in the space. Could you move the extra notes to the blank space next to it so that the preshots show on your chart?

Edited to say…. I now realize you may have written the word none in there?

Hiya,

yes unfortunately I’ve not got anyone else to test on the odd occasion I can’t get home in time- this will change soon though as I’m training someone up to help!

I will look at changing the dose sooner rather than later!

Thanks for your help
Kayleigh