Erratic BG's

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sanchang1068

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Hi Everyone

My cat was diagnosed about two months ago, but I am on my second diabetic cat. I had one for about 8 years and he passed around two years ago. So, I do know a lot already. I am have a tremendous amount of trouble regulating my cat. Oliver is 11. He first started on ProZinc and if we gave him 1 unit he would sometimes sink too low and sometimes stay too high. We switched to Lantus and I am having the same problem. We did a curve on 1 unit which looked great, but then, 5 hours after the curve was complete, he dropped to a BG of 40. Then, the vet said...only give him 1/2 unit. But, then, he was in the 300's and 400's for almost 3 weeks. So, this weekend (as of Friday night) we switched back to 1 unit. After two doses like this (12 hours apart), he was back in the low 200's and mid 100's, but then right before eating, and 12 hours after having taken his last 1 unit dose, he was only at 110, so I decided to give him 1/2 unit for that dose... didn't work...back up to 300's for that 12 hour stretch (or for at least the four times I tested him)..so, I went back to 1 unit and after two doses on 1 unit, again, he went down and I have kept him at that dose.... but now... I am finding that 6 hours after the dose he is for two days in a row still in the 300's.... Yet it was just a few weeks ago when that very same 1 unit dose had him as low as 40!!!

I need some advice here. My vet thinks at times I miss getting it in and one unit and 1/2 is hard to see... but remember, I did this for 8 years for another cat, so I'm not a newbie. I truly do not believe I can be getting it wrong this many times.

Has anyone out there had trouble like this? I am really at my wit's end!!!!
Thanks,
sanchang1068
 
Hi!
You are using lantus so that means u100 syringes, right? Do they have 1/2 unit hash marks? If not, can you get some that do? That would at least make the 1/2 unit doses easy. Then it's just a matter of eyeballing between the .5 and 1 marks.
I'm thinking that with the too high numbers on the .5 dose, and too low on the 1.0 dose, you might go with .75?

Someone suggested this on another thread - practice with a used syringe and water, and try to draw up 3/4 unit. Once you feel your at the right spot, use a marker or a piece of tape to mark that spot on the syringe. Then use it for comparison against the new syringe you draw the insulin up into. That way your eyeballed 3/4 unit will be consistent.

Hope that helps,
Carl
 
Thanks Carl... Yes, I am using 100 syringes and have the ones w/ the 1/2 unit markings. Right now, it looks like the 1 unit isn't enough, so I'm not sure the answer is 3/4 unit. My frustration is coming from the fact that the BG's have no rhyme nor reason. One time low, one time high w/ no changed variables.

Has anyone out there had this much difficulty?
 
Lantus acts very differently than the PZI you used before. It needs consistent dosing based on nadirs. Have you seen the Lantus support page? viewforum.php?f=9 The starred topics give you great info on how to dose Lantus and how it works.
 
Oh I can feel your pain, I also have a kitty that wanted to make me lose my mind trying to get her regulated, she is also my second diabetic, but it took a lot of trial and error to get her to go down and stay down. Then all of a sudden she seems to be getting tired of all the pokes and shots and we are in new territory all over again, at least this time it is good territory as she is right now testing at 80 which is 24 hours after her last shot of Lantus....

But if it helps at all feel free to look at Musette's spreadsheet in my signature, and you can see that she has led me on a merry chase and even as long as I have been testing her every day is a new day with her...Today she looks like she is headed for remission...tomorrow who knows....afterall cats will be cats and we just have to love them and when it is a sugarcat, dance to the music that only they can hear. :-D

Mel, Maxwell, Musette & The Fur Gang
 
Some kitties just do not seem to be able to get consistent BGs. I tried for over five years with my Bailey and I would still get PSs in the 400 or below 100. My Patches is similar but not as bad. My Tonis, Smokey and Lightning are very consistent. Remember, each cat is different.
 
You didn't mention how long he's been receiving insulin, but if you've just started then sometimes it takes a while for a cat to stop "bouncing" before they become regulated. When a cat has had high BG for a period of time, when they hit a lower number, even if it's in the normal range, their livers release glucose into the blood stream. Eventually, their bodies get used to the lower numbers and they stop giving you those highs and lows and more consistent numbers.

I would also urge you to read the stickies in the Lantus forum. Lantus is dosed differently than PZI, and dose adjustments are made with smaller increases/decreases of .25u. Here's a link to the dosing guidelines for Lantus: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
 
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