Getting Low Numbers

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bstoriale

Member Since 2014
Hi all,
I am new here, so a quick background on me and my cat. My cat, Snack, is 10 years old. He was diagnosed in May and the vet I saw first didn't really give me too much information, she never mentioned home testing and had me start with 2 units of Lantus twice a day, when I took him in for a BG curve she then changed her prescription to 4 units twice a day. About a month ago I noticed Snack was weak in his hind legs and took him to a different vet. She said it was due to his diabetes not being well regulated. She suggested home testing and a change to a lower carb diet, but to keep the dosage level at 4 units twice a day. So this has been my first week of home testing and Snack has started a new diet of the canned Friskies Classic Pate. He seems to have regained some of the strength in his back legs and overall seems to be feeling better. However I am confused by the numbers I am getting as I test his blood sugar at home, (I am using the Relion Micro). I have been trying to adjust his dosage according to what his blood sugar is reflecting, but I am not sure if I am supposed to be doing that and just really don't want to hurt my cat. If you could take a look at his numbers, any advice would be appreciated.

https://docs.google.com/spreadsheets/d/ ... =299278865

Thanks, Brittany
 
Re: Confused and unsure

Hi Brittany. You will need to "share" your spreadsheet so we all can view it. I think the "share" link is on the top right of your spreadsheet. Once you get that changed, we will be able to see your numbers.
 
Re: Confused and unsure

You need to change your spreadsheet setting to share, but you are correct on the part of not adjusting the dosage for the number.

Since I cannot SEE the numbers I am going off your post. With lantus it is a depot insulin and you need to stick to a dose for several days to see if it's right, too low or too high.
 
Re: Confused and unsure

Log in to Google Drive
Open the spreadsheet
In the upper right corner, click share

For those of us on Android cell phones, it may help if you also do this:
From the menu, click File, Publish
 
Re: Confused and unsure

Hi Brittany,

I can see your spreadsheet OK. :thumbup

I'm only a novice user so I don't make any comments about dosing, but I will say that your instincts appear to be spot on in responding to the low numbers. Lantus is what is known as a depot insulin and the effect builds up with each dose. It's great that you're home testing and you did really well to catch that 47 - it's a very low number. At minimum, I would let your vet know straight away how low Snack is going on his current dose.

It would help to have a little more information, specifically:

- What should Snack's ideal weight be and how much does he weigh now?
- Were you feeding a high carb food before? In particular, was it a dry diet? (The change to low carb food can have a dramatic and quick lowering effect on BG numbers.)
- Has Snack ever tested positive for ketones?

This information will help more experienced members to give you better guidance.

Also, I strongly recommend clicking on the link below and downloading a copy of the Management of Diabetic Cats (with Long-acting Insulin) PDF. It's the published, peer-reviewed Roomp-Rand study on the use of long-acting insulins and home testing in the treatment of feline diabetics. The PDF has comprehensive instructions on how to set starting doses (based on ideal weight and any previous history of response to insulin) and criteria for adjusting doses during treatment of diabetic cats. My vet and I found it very helpful to use it as the basis for Saoirse's treatment with Lantus. Maybe it would be helpful to use the document as a basis for discussion with your vet about Snack's insulin requirements?

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

I'd also suggest that you go back to your first post on this thread, click on the 'Edit' button and change the Subject to something like "Confused and Unsure - Getting Low Numbers". If you click on the question mark post icon it will also draw more attention to your post. When you've done that, click on 'Submit' and it will update the thread title.

With respect to Snack's weakness, the symptoms you describe sound like diabetic neuropathy. When a cat is unregulated, the high blood glucose levels can affect a cat's nervous system hence the weakness. It can be treated with vitamin B12. I'd suggest asking your vet to check Snack's B12 to see if he has a deficiency.
 
Thanks for the advice :smile:

Snack is about 17 lbs now and the vet suggested getting him down to about 11-12 lbs. He had been dry food until recently after I read on this site about the benefits of canned foods. I started home testing the day I started giving him canned food because I read that it could cause a large decrease in BG numbers. To be completely honest, I have never tested for ketones at home, but I think when he was first diagnosed back in May he tested positive at the vets office.
 
That's really helpful information, Brittany. Hopefully some experienced members will be along soon to help you further. Saoirse was never ketone-prone, but I know from what I've read here that there are extra considerations needed for the treatment of cats that have tested positive for them.

You can home monitor for ketones in Snack's urine using Ketodiastix urinalysis test strips.
 
Lets get your spreadsheet into your signature:

Go to the top left of the screen.
Click on User Control Panel.
Click on Profile
Click on Edit Signature
A text box displays.
This is where you paste the public, shareable, link for your spreadsheet.
 
Honestly, what I would do, if it was Hidey, is I would start fresh. I would start with .5 units stick with that for a few days and try to get a test in around 5 or 6 hrs after (that way you can find nadir-lowest point). If it's still high slowly adjust. Once again, I have never used lantus but have read several posts on lantus and how it works, and also how many people miss finding the right dosage because of the way it works in the body. You want to find a good amount that you will be able to give every 12 hrs, that is key.
 
I'm not one to give dosing advice but since this cat tested positive for ketones and is 17 pounds, I would not cut back to .5 units. Now I haven't looked at the ss yet but to go from 4 units to .5 with a large cat doesn't make sense to me. I'll look at the ss now as perhaps I am missing something.

I'm back. I see there was a 47 on 2 units so either .5 or 1 units would likely be good. I use lantus so don't know how the insulin being used here works.
 
Elise

He is a Lantus cat.

And I would also start over at .5 now that the dry is out of the diet. My guy that just went into remission was on dry and 11u bid with very poor clinical signs, took him off dry, started him over on insulin and 8 months later he was in remission. He wasn't just big he was HUGE when I adopted him, 37 lbs huge, he's still a big guy even at a slim and trim 17 lbs he's a monster kitty. Very tall, broad and long.

Mel and The Fur Gang
 
Oh, I thought I saw a different insulin. Thanks for telling me that. How do you manage to get the cat's weight down? Max has gained nearly 1 1/2 pounds since diagnosis. He had been off dry food for at least 4 years before that. The food he was eating was wet but high carb, ff sliced, science diet ideal balance. You get the drift. I often need to feed him to keep his BG up. He is a lazy cat but entitled since he is 17 years old. He won't play at all and the most exercise he gets is walking to his food dish or litter box. He currently eats ff classics, fd chicken or turkey greats, baby food to chase his BP med each morning. His BG did not miraculously come down with the food changes. Thanks.
 
Best way to help lose weight, is reduce calories. Monitor how many calories your feeding and slowly cut it back. Also adding water to the food helps as well. I add about 1/2 can of water to my cats food to help fill them up quicker, and that way I also know their staying hydrated well.
 
Ok thanks everyone for the advice. I'll start him over at 0.5 units and see how that affects him. How long does it approximately take (I know every cat must be different) before the BG numbers reflect the new dosage?
 
With Lantus, the numbers usually gradually shift over 5-7 days for the first dose and 3-5 days for any later adjusted doses ... except for bounces.

Bounces happen when an insulin either drops the glucose like a rock OR drops it to a level which is very unfamiliar. The body goes on red alert and triggers compensatory hormones which release stored glucose (glycogen).

You may see this, so don't be surprised if you get an unexpectedly high number. And don't panic either; the bounce usually calms down over up to 3 days. Unless you get more than a trace of ketones in the urine or a blood test, you just wait it out. (See my signature link on Secondary Monitoring Tools for tips on urine testing if needed.)
 
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