glucose levels of over 500 consistently - help

[babbie & otto]

Otto my 14 year old boy was diagnosed in January, had lost weight,urinating alot and ate everything in site and had ketones. We put him on canned Royal Canin diabetic. I tested as best as I could but he was consistently dehydrated and the blood wouldnt come out. He stayed in the 4-500 range and the vet had him on 3 units of Lantus. I did research and switched to Evo but it gave him diarhea, went to an internist who put him on Hills D/M and 5u. He no longer had ketones. He looked better but still starving.Stayed on the Hill for 2 weeks. Then I read the Hills has high carbs so we switched to FF classic. Hes been on it for 2 days and I have tested him 3 times. This morning he was 648! Need help on the food issue - can I feed him as much as he wants?
Can I feed mid day? Should I calm down and wait for his levels to go down on FF? Any other tips? Thanks in advance for any advice. I love this boy and will do anything for him.

 

[ursa68]

I can't offer any advice, really, but want you to know you are not alone! I have been having one heck of a time getting my kitty regulated. It's so depressing to see those 500s all the time. I have been trying to be patient and wait for the new insulin I'm trying to work. From what I know, and it looks like your boy has already had some issues with ketones, be sure and keep testing for them. You can buy Ketostix and test at home. Most everyone here feeds FF pates, and I think most would say that giving smaller meals throughout the day is best. My kitty has lost a lot of weight, so he gets as much as he wants. I'm also doing subqs at home every other day, and I believe that is helping keep his kidney levels good and no ketones while I'm waiting for his numbers to go down. There are numerous reasons why he is not responding to the Lantus.... but I'll leave that to the experts to explain.

There are a lot of very experienced and kind people here, and you are sure to get some good advice. Also, you should probably post on the main forum, that way more people will see your post.

Just be sure to breathe and be patient!

 

[BJM]

Oops - you've posted in the Health Links / FAQs about Feline Diabetes section, where few people are going to see your post!
Generally, we like folks to post in the Welcome to the Group section first. We can see about moving this later. Post moved to Health.

Feeding: if he grazes, you can put the food down twice a day and let him nibble on it between shots.
If he's a fast eater, freezing some and putting it down to be eaten as it thaws helps spread out the food intake so he doesn't get too hungry and so his glucose doesn't spike before the Lantus can work. If you're home, you can feed mini-meals every couple of hours.
Adding some water helps provide volume as well as offset the dehydration that can happen with high glucose.

Testing: its absolutely great you are testing! The most important thing is that dose adjustments are based on the nadir, the lowest glucose post shot. This typically happens in the +5 to +7 hours after giving Lantus, although it can move around a bit. Something that can happen is that an unfamiliar low glucose or a sudden drop in glucose will provoke hormones to release stored glucose and raise the number back up. This is called bouncing. This may be why you are seeing high numbers at pre-shots.

Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.We have a dandy grid for tracking the glucose numbers so you can see what is happening.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

 

[Lisa and Witn (GA)]

I posted under your other topic. Right now, Otto is hungry because his glucose levels are not under control. His body is not processing food correctly. Your dose may be too high. You may want to consider starting over at a low dose and gradually increasing it until you find the optimal dose. Start over at 1 unit twice a day. Stay at this dose for a week, testing before every shot. After 1 week, you will have enough readings to determine how well the dose is working. If an increase is needed, only increase it by 1/2 unit. Stay at the new dose for another week before increasing it again. It takes at least 1 week for a cat's body to adjust to the new dose.
There is a condition called Somogyi effect or rebound that occurs if the insulin dose is too high. What happens is that the cat's body produces extra glucose to counteract the high dose and prevent hypoglycemia. That is why the BG levels are high. By starting over at a lower dose and gradually increasing it by small increments, you will be able to find the optimal dose that will keep Otto's diabetes under control. You will also find that his appetite will level off when his BG levels begin to lower.