Frustrated!

Status
Not open for further replies.
Giomax

Giomax

Member Since 2018
I bought a glucose testing kit today--meter, strips, lancets. After a few attempts at poking I got a reading (5 hours post second insulin injection): 415! He's on six (6) units of Lantus a day! Three (3) units in the morning and three (3) in the evening.

I don't have a signature set up yet--sorry. But Max is 13, diagnosed in October, has been on Lantus ever since, starting at two units a day, now up to six. He just doesn't seem to be improving!

He and his brother get dry food in the morning and a can to split at night (with some kibble in the bowl for midnight snacking--before I got the testing kit I was always worried about hypoglycemia since he was getting so many units a day and I couldn't test). Maybe I should switch to all canned food?

His eyes are getting worse. He has drops for them. He's always twitchy now (legs, feet, head). The sugar is hurting his body and we can't seem to get it under control. I just want him feeling better! He's been on six (6) units a day for a month now. How is he still over 400?
 
How were the increases in dose done? From 2U to 3U to 4U, etc? Or in smaller increments?

Getting the dry completely out of the picture will only help. Dry foods are too high in carbs for diabetics so if you can get him onto a low carb canned food only, it may very well help his numbers....but before you do a diet change, make sure you're testing! Dropping the carbs can quickly drop the numbers so it's important for his safety.
 
Chris & China said:
How were the increases in dose done? From 2U to 3U to 4U, etc? Or in smaller increments?
Click to expand...

Started at 1 unit twice a day
Glucose curve said BG TOO HIGH
Upped it to 2 units twice a day
Fructosamine test said BG TOO HIGH
Now at 3 units twice a day
Waiting on test results

From October til now. He just had his second fructosamine test yesterday. Will get the results back for that on Wednesday.
 
Hi and welcome!
Hereis a link to suitable foods. Choose ones with carbs 10% or less.. make sure you are resign when you change over to the low carb food as the blood sugars will drop.
http://www.felinediabetes.com/FDMB/threads/links-to-food-charts.174182/

Also if you could setup a spreadsheet to document the blood sugars,that would be very helpful for people who are helping you and great for you too! Here is the link. If you have trouble with it post and ask for help.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Always test before giving the insulin and test during the cycle to see how low the insulin takes your kitty. Around +4 to +6 hours after the shot is a good time. We decide the dose on how low the insulin takes the cat not what the preshot is.
If you are not testing inbetweenthe cycle your kitty could be dropping really low and then bouncing up high at the end of the cycle. Twitching can be a sign of low blood sugar.
 
OK....you went up too quickly.....a VERY common mistake that we hear a lot here.

Cats are small creatures and insulin is a very powerful hormone.....we only recommend changing the dose in .25 unit increments so we don't bypass what could be a "perfect" dose.

With my own cat, even a couple of drops more or less could make a big difference in her numbers.

I'd start testing Max before every shot and then get at least 1 test somewhere mid-cycle on the AM cycle (like 5-7 hours after the shot) and then on the PM cycle, get at least a "before bed" test. Most cats go lower at night, so it's important to get that "before bed" test to keep them safe.

If you can test more often, that's even better!! As soon as you can, start keeping track of his test numbers on our spreadsheet and we'll be able to help you get the best control possible!

Here are the Instructions on setting up the FDMB spreadsheet but if you need help with it, just let us know! I can set it up for you in about 30 seconds after I get some information from you.
 
The vet also said the twitching could be too much blood sugar going to his brain. He said that can be a side effect. I just tested Max a little bit ago (about 5 hours post Lantus shot) and his reading was 415.

This was his first at-home test ever. As soon as I start testing more, I'll do the spreadsheet.
 
He seems to be loaded with sugar. His eyes are getting worse, he still pees loads, all the vet tests are reading too high, and now the home test is reading high. I think the vet is doing whole units because Max is so "sugary". Even at 6 units a day he's still showing glaring signs of high blood sugar.
 
Without those mid-cycle tests, there's no way to know what's really going on. Too much insulin can look like not enough!!

When they're getting too much insulin, it can drop them too low.....then their body reacts to try to "save itself" by releasing stored sugars and hormones to bring them back up quickly. Without those mid-cycle tests, it's impossible to know for sure what's going on with Max.

3U twice a day isn't a horribly high dose....we've had cats on much higher doses here, however it IS higher than most cats need though but if he's eating dry food, that's enough to raise the blood glucose up to 200 points.

Testing done at the vets office is unreliable and often useless. The stress of being at the vet can raise the glucose up to 200 points too.....the vet see's those high numbers and increases the insulin thinking they need more, when in fact, they may need less!

We've seen a lot of cats that could go from 400 to 40 and back to 400 by the next shot time. Without that testing, you'd never know the cat was dropping too low
 
I don't think my vet's a fool. He's told me time and again that he won't do random BG checks while my cat is in the office since stress can raise the numbers and the test would likely be completely inaccurate. Rather than "spot checks" we do fructosamine tests in-office every few weeks. The fructosamine test will tell you what your cat's BG has been like over the past several weeks.

"When fructosamine is measured, it helps determine the average glucose level for the previous 2 to 3 weeks. Fructosamine testing is often the preferred method for monitoring the glucose level in cats because it is not affected by stress, which can cause a sharp increase in the blood glucose level in cats."
 
Chris & China said:
Too much insulin can look like not enough!!
Click to expand...
I'll add the often forgotten addendum to that ... "if kitty was started on too high a dose or increased by too large amounts without testing to know it was safe to increase". In some cases of constantly high numbers, it can be safe to increase by 0.5 units at a time. Are you using syringes with 1/2 unit markings on them?

Three units is not a horribly high dose for a cat eating dry food. We had one cat here on 5.5 units each shot, and the caregiver thought he wasn't getting any dry food. She removed the dry from the house and he dropped to zero units over a period of a couple of really intense days of testing.

Congrats on getting your first home blood sugar tests in. That the best step to help keep him safe. What type of blood glucose meter did you get? The problem with fructosamines is that they are averages. Cats can be hypoing one moment and bouncing (dumping counterregulatory hormones into their system to compensate) the next moment. The average wouldn't show that. However, they are better than no home testing. Home testing is also cheaper.
 
I'd love to get rid of the dry food! I'm just afraid Max will go low while I'm at work and won't have anything to eat to hold him over until I come home. I'm currently feeding them Purina Naturals. Is there a dry food somewhere that's not quite so high in carbs?
 
Many of us use autofeeders, such as the Petsafe 5, to keep wet food cool and have it available later in the cycle to keep kitty safe.
 
Giomax said:
I don't think my vet's a fool. He's told me time and again that he won't do random BG checks while my cat is in the office since stress can raise the numbers and the test would likely be completely inaccurate. Rather than "spot checks" we do fructosamine tests in-office every few weeks. The fructosamine test will tell you what your cat's BG has been like over the past several weeks.
"When fructosamine is measured, it helps determine the average glucose level for the previous 2 to 3 weeks. Fructosamine testing is often the preferred method for monitoring the glucose level in cats because it is not affected by stress, which can cause a sharp increase in the blood glucose level in cats."
Click to expand...
Fructosamine testing is not better than regular glucose monitoring. It is helpful at diagnosis and in cases where the pet owner is not willing/able to do home monitoring. The statement you pasted in is in reference to testing at the vet's office. Since glucose levels can spike due to stress from being at the vet, glucose tests at the vet are not a very reliable way to determine the impact of an insulin dose. Regular home monitoring is the best way to get an accurate picture of what is going on. A cat can be having wild glucose swings from very high to very low, and their fructosamine can look okay since it is just an average.

I requested a fructosamine test on Mia at the point that I had decided I wanted to change her insulin. I was just curious about it, and the internal medicine specialist we used to see said that though it is not necessary when regular home testing is being done, it can be taken into consideration as just another factor/indicator. The results came back that she was very well regulated, but because I was home testing, I knew that she was still having periods of time every day when her glucose was too high, over the renal threshold. So, I went ahead with changing insulin, and the change was remarkable. Her numbers are now so much better, much more consistently. So, I feel that our case is an example of why insulin/dosing decisions should not be based solely on a fructosamine test.
 
Giomax said:
I'd love to get rid of the dry food! I'm just afraid Max will go low while I'm at work and won't have anything to eat to hold him over until I come home. I'm currently feeding them Purina Naturals. Is there a dry food somewhere that's not quite so high in carbs?
Click to expand...
Purina naturals is about 38% carb. Not a good choice. You could try epigen 90, Dr elsley's clean protein chicken or young again zero carb.... But the best choice is to make wet food available. Low carb no gravy.
 
FurBabiesMama said:
Fructosamine testing is not better than regular glucose monitoring. It is helpful at diagnosis and in cases where the pet owner is not willing/able to do home monitoring. The statement you pasted in is in reference to testing at the vet's office. Since glucose levels can spike due to stress from being at the vet, glucose tests at the vet are not a very reliable way to determine the impact of an insulin dose. Regular home monitoring is the best way to get an accurate picture of what is going on. A cat can be having wild glucose swings from very high to very low, and their fructosamine can look okay since it is just an average.

I requested a fructosamine test on Mia at the point that I had decided I wanted to change her insulin. I was just curious about it, and the internal medicine specialist we used to see said that though it is not necessary when regular home testing is being done, it can be taken into consideration as just another factor/indicator. The results came back that she was very well regulated, but because I was home testing, I knew that she was still having periods of time every day when her glucose was too high, over the renal threshold. So, I went ahead with changing insulin, and the change was remarkable. Her numbers are now so much better, much more consistently. So, I feel that our case is an example of why insulin/dosing decisions should not be based solely on a fructosamine test.
Click to expand...

I was actually referring to testing at the vet's since that's what we were talking about. I know home monitoring is the best, but haven't been able to do that until now. The user I was talking to had concerns that my vet was doing regular BG testing in his office to determine the next course of action. He doesn't. He only does fructosamine tests every couple of weeks to get a more accurate picture than he would if he was doing a "spot check" in the exam room. I'm home testing now, so I should be able to get some daily numbers myself without having to worry about stress affecting his levels.
 
Giomax said:
I don't think my vet's a fool.
Click to expand...

The vet we go to has four doctors. They are all excellent veterinarians. They also tend to specialize in certain areas. We've used them for decades and have figured out who to see for what issue. I don't think any of them are fools. If you think about it, though, unless you go to a specialist, they are really like seeing a general practitioner. They see it quite a bit around here where vets are not particularly specialized in diabetes.

This is a group of kind, patient, and supportive people who understand how frustrating this all can be. I am sure nobody was trying to insult your vet or upset you.
 
Agreed! I don't think my vet is a fool either - she's an excellent vet. However, at this point she knows I know more than she does about managing feline diabetes, especially in my very tricky cat. At one visit a new vet to the practice was shadowing her and she told that new vet that if she (new vet) wanted to know anything about treating FD I was the client to ask. :)
 
Like Kris, I have a good vet, but she acknowledges that I know more about feline diabetes than she. We have spent much more time learning about it and living it than most vets, so any reasonable, humble vet is going to see and acknowledge that they cannot have the same depth of knowledge.
 
Status
Not open for further replies.
Back
Top