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Kiwi F

Kiwi F

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I'm starting a new thread to make sure people know I have new questions. I did post this under our old topic "Newly Diagnosed, Need help soon!" by Kiwi F. All the previous information is in that thread. I need to make a decision in the morning, and can use help.


NEED ADVICE:

Kiwi's bg was down to 304 the day we changed him from Hill's W/D to Wellness Turkey. Since I had a lot of trouble poking him that day, and he was very upset, (and his bg had been going in the right direction for a week, and I expected that to continue), I gave him a break from testing for two days (which was obviously a mistake). Tonight, before dinner, his bg was up. This brings up my first question.... he tested at 446. I tested again to be sure (new poke), and it was 411. How do I know when numbers are right (and which one is right?)?? Second question: he was clearly more distressed over the test than usual.... could that raise his bg? If so, how much? (Because an alarm went off while we were getting him ready, he had about 10 minutes to be upset... plus the alarm itself being loud and irritating).

Big question: We've waited to give him insulin to switch his diet first. We switched him on Tues. Is that enough time? Should we start insulin tomorrow, since his bg is actually higher? Also, any thoughts as to why is bg might be HIGHER after a few days on Wellness, when he seemed to be steadily decreasing on Hill's W/D? Any ideas about what might be going on???

These are his past tests: At vet, at dx - over 600. Third day on Hills W/D (day we got our ReliOn meter): 503. Fourth day: 410. Fifth day: 390. Sixth day: 396. Day we switched to Wellness: 304. Now, fourth day on Wellness: 446 (or 411). or more details, see earlier posts. We're checking him before he eats dinner, each time, for consistency.

Also, if I check him before breakfast, would that reading be lower because of the time of day? Can it be compared with the previous readings, done at night? I wish I could go back and test him the last two days, so I had more information to go on. I guess I was overly confident the drop would continue, and expected a lower number today. The other confusing thing is that he seems to be feeling better than he was a couple days ago. He's not drinking too much water, has normal appetite (not too much or too little), he's more active, he's purring more, was running around the house today, and keeping himself cleaner (even more so than his earlier improvement). Can anyone give my their thoughts on what is happening? And am I right to think its time to start the insulin tomorrow?

Kim and Kiwi
 
Hi Kim! Welcome! Here is your previous post on health. I'm not seasoned enough to give dosing advice, but I am glad you're here. People will be along shortly to help!
 
If it were my cat, I would start insulin ASAP. A BG of 300 is what's called the renal threshold, or the level at which a cat's kidneys can handle the extra glucose. Numbers that stay above 300 can begin to cause organ damage, so you will need to get the numbers down, ideally to below 200. If you're going to try the tight regulation protocol, you will aim for lower,into the normal range of under 120. A drop of 50 -100 is about what's expected from a food change, and it looks like that's where you are with the Wellness vs. the W/D.

Some cats will have slightly different numbers at different times of day. If you look at Mikey's spreadsheet, you will see that he tends to throw lower numbers in the evening.

What dose of insulin did your vet prescribe? I'm not a dosing expert, but can say that anything over 1 unit is probably too much for a cat on an all-wet, low carb diet and with no underlying medical conditions. If your cat is small, .5 might be the way to go. I'm sure someone with more experience can help more with dosing.

A weekend is a good time to start if you can be home to get some mid-cycle tests as well as pre-shot numbers. Lantus takes a couple of days to make a big difference as it builds a storage "shed" under the skin before it really starts to work in the cat's body. If you go to the Lantus ISG forum, there are some sticky threads that have a TON of great info to help you get started.

Good luck to you and Kiwi!
 
HI Kiwi, I agree with Mikey - with blood glucose readings of 400+ I would start insulin if you have it. You can start at .5 unit for 3-5 days to see how your cat reacts to it then increase it if its not dropping. Since Lantus does take time to build a shed or reserve you want to keep at a single dose for at least 3 days before you change it. Every cat is different so you will have to see how your kitty reacts. My cat's blood glucose #'s were all over the place her first three weeks on insulin and didn't settle down until down until the 4th week. Jan
 
It is good to make the food change first to see if you may not need to start insulin at all or to start at a lower dose, but with numbers in the 400s, I would definitely start insulin right away, and also be testing for ketones.
 
I have to retiterate: PLEASE TEST KETONES! (I had a scare last week that could have become quite serious had I not caught them fast!)
 
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