HELP! Suddenly jumped to 589

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Desi Mom

Desi Mom

Member Since 2021
Destiny was fine when I went to bed last night. Ate well all day and was active. She ate 90% of the food she gets during the night. Early this morning she threw it all up though and is clearly not feeling well. Her BG jumped up to 589, which she has never been that high before. She isn't eating and is barely drinking. I am encouraging her to drink water to hopefully get her to pee to I can test for ketones. I went ahead and gave her 1 unit of glargine on time this morning and will test again in a hour to see if her BG has come down at all. Why would she suddenly jump to 589 out of the blue?

She had has further complications with her toe healing. It just looks scabbed over though and doesn't look to be infected.
 
There are a couple of possibilities. Destiny's numbers may have dropped even lower than her +3 last night. If that's the case, your AMPS may be a bounce. In other words, her system overreacts to the lower numbers by dumping a stored form of glucose along with counterregulatory hormones into her system that cause the numbers to spike upward.

Just an FYI, with Basaglar, trying to "shoot numbers down" doesn't really work well. It's something that can be done with shorter acting insulin but not with a depot insulin like glargine. The depot works something like an ocean liner vs a rowboat -- you don't get an immediate response. When you change a dose, it takes approximately 3 days/6 cycles for the depot to stabilize. In addition, dosing is based on the lowest number in the cycle, not the pre-shot number. At least since 8/5, you've been seeing numbers/nadirs in the 100s. With SLGS, you would be holding the dose. Try to remember that with SLGS, you want to hold a dose for a week. There's a chance that the number of times you've made dose adjustments based on the pre-shot numbers are going to result in wonky numbers.

I would see what happens with Destiny's numbers today. Please get some spot checks throughout the AM and PM cycles. Given the larger than usual dose increase, there's no way to predict what will happen with her numbers and you don't want to be surprised. If her numbers stay high, check with your vet. There could be an infection beneath the scab. If she's walking comfortably and her foot isn't hot, it may be fine but infection can cause a rise in BG.
 
Should I still keep trying to get her to drink enough water so she will pee so I can check for ketones right away this morning, or should I not worry so much about that at this point and just check the next time goes? (She is walking fine, while her toe has been sore the past few days, she isn't favoring it at all.)
 
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It has been an hour, so I just tested her BG and it is 407. It is coming down, so I am panicking a little less now. I will keep testing her every hour for a while.
 
Unless Desi has a history of ketones or DKA, I wouldn't worry. Many cats can have high numbers without ketones developing. If you think her foot is infected, the risk for ketones is higher but it's not a given that ketones will develop. You know your cat. You're also there to observe her. If she's lethargic, not eating, acting like she's not herself, then I'd start to be concerned.
 
Two hours and she dropped to 342. Since that seems like a big drop to me, I gave her some Temptations treats to eat.
 
Yes it's a large drop but she started from a high place. For future reference, unless your cat is in really low numbers, do not reach for the Temptations. First, Desi is not in danger of low numbers. A teaspoon of low carb food would potentially help to flatten the drop a bit. Second, using any kind of dry food or treat takes a while to be metabolized and enter the blood stream. It's not particularly good to bump numbers up quickly.
 
Ok. Thanks for letting me know. Since this is my first really high number, I panicked and over-reacted, giving her the 1 unit instead of her normal .5U. Then I worried that I over dosed her and she would drop too low instead, so I over-compensated again. Thanks for your very calming advice and I will know to not panic if it happens again. I really appreciate your help.
 
When you're still new to this, panicking is absolutely normal. (Just don't let Desi know!!) There's lots of collective wisdom here. Even if your kitty drops into low numbers, it would be unlikely that an experienced member would panic -- we try to guide you through a situation calmly so you can process the information. High numbers are less of a cause for concern unless your cat is prone to developing ketones or there are ketones present regardless of the numbers. You're doing fine!!

(I would point out that the above being the case, if an experienced member tells you it's time to go to the vet or the ER, scoop up your cat and go. Personally, there are some things I don't mess with and if my gut is screaming for someone to go to the vet, I listen to my gut.)
 
Should I still give her the .5U evening shot or skip it since I gave her a double dose this morning?
 
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