Help with Ceasar's BS please

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MalsGiGi

MalsGiGi

Member Since 2016
I have updated Ceasar's SS with the latest readings. I have just gotten home and tested him with a result of 589, the highest it has ever been since I have been testing. I just fed him 4 ounces of tuna. His behavior is totally normal. His Novolin PM dose is due about 6:15. I will retest again before his shot. I have also ordered Lantus which should be here within a couple of days. I am hoping this is going to help regulate him much better.
 
I hope you and Caesar will have a better time with the regulation on Lantus. I've not used Novolin so don't have anything much to add other than to ask if you can get tests at +2 and +3 to see if he's starting to go low earlier in the cycle and then bouncing up to that nasty black. If you look at Woody's threads on Feline Health, he's on Novolin. You might be able to pick up some pointers.


Mogs
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Hi, sorry I've been away this morning. I did not check Ceasar's BS this morning because he fought me terribly bad lastnight where I didn't get enough blood so the meter gave an error. I did give him his Novolin this morning and his 5+ BS just now is 403. That is improved from lastnight, but not near as good as we need to be. I see all these people with concern for HYPO and we definitely haven't even gotten close. I'm hoping the Lantus will be here tomorrow or Saturday. My vet is not happy about me buying from an individual and does not want me to give it until he sees him and the insulin. I'm not concerned about either, I'm just concerned about knowing how much to give him?? I gave him some 9 Lives Pate which I have not fed before and am wondering if that had anything to do with the 589???
 
I notice you missed the evening dose on 2/3/2016 (per your spreadsheet).

MalsGiGi said:
I gave him some 9 Lives Pate which I have not fed before and am wondering if that had anything to do with the 589???
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9-Lives sent me their nutritional data in the last month or so as a PDF. I converted it to a spreadsheet to sort the data. Their pates run from 3.44% to 10.31% carbohydrates on a dry matter basis (these figures are their analysis, it is not my own calculation of carbs by difference), however, the 10.31% is the outlier, it is the one with "rice" mentioned in the name, all the others are 3.44-7.83%. Among the analyses they sent me, there are no "pates" with higher carb values.
 
MalsGiGi said:
I see all these people with concern for HYPO and we definitely haven't even gotten close.
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Without blood glucose tests in the early part of the cycle you cannot be certain of that. Novolin can drop BG very hard and fast in the early hours of a cycle.

For example, have a look at the spreadsheet for another cat on Novolin from a couple of days ago (tested with Alphatrak meter - reads higher than a human meter so 66 is a hypo number):

2 Feb 2016

AMPS - 451
AM+3 - 66
AM+9 - 393
AM+11 - 385

If that +3 BG reading hadn't been taken it could look like Woody's dose might not be high enough whereas in actuality it was too high.

I'm not in any way implying that Caesar's BG is doing something similar; there is no way of knowing without testing. You should do preshot tests for every dose of insulin (including the PM doses). Is there anything we can help you with to try to make testing easier?

I suggest that you get several +3 tests for day and night time cycles as soon as possible. If it's tricky for you to do the daytime +3 tests, get some 'before bed' tests at PM+3 for Caesar. More test data - particularly at the times in the cycle when your particular insulin is at its peak of effect (I've read this can be anywhere from +2 onwards) is the only way to get a better picture of how Caesar is responding to the Novolin. I'd also recommend running a full curve as soon as possible - with a focus on getting hourly tests between +2 and +6 and perhaps 2-hourly tests thereafter (assuming Caesar is in safe numbers). Be sure to record the food variety, carb content, feeding time(s) and amount(s) fed. The information you gather will give you some better picture of what's happening.

MalsGiGi said:
I gave him some 9 Lives Pate which I have not fed before and am wondering if that had anything to do with the 589???
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If the 9 Lives paté has higher carbs than Caesar's regular food it could drive BG up; if it has lower carbs than his regular food then that could have resulted in him going low and then bouncing back up to the 589. Without sufficient BG data it's impossible to tell.


Mogs
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Sorry, yes I did give him his shot lastnight and failed to record it. Im glad to hear the 9 Lives pate (meaty pate with chicken and tuna) is indeed low in carbs. It was just the only change I could think of. I know I need to find a day I can test frequently, however that is very difficult with my schedule. I will try to do that ASAP and post to his SS. Again, thanks for all the input. I haven't missed many pretests, but he was totally terrified lastnight so I didn't stick him again after not getting a sufficient sample.
 
MalsGiGi said:
... he was totally terrified lastnight so I didn't stick him again after not getting a sufficient sample.
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Oh, poor baby! :(

Try warming the ear a lot longer before poking. And maybe give Caesar some extra diabetic-friendly treats to reassure him and cheer him up? Also, check the gauge of the lancets you're using. The 26-28 gauge lancets are a bit coarser and can make it significantly easier to draw a sample (especially in the early days).

If you could manage even a few evening PMPS and PM+3 tests it could be a real help to you in determining what's going on.


Mogs
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MalsGiGi said:
Hi, sorry I've been away this morning. I did not check Ceasar's BS this morning because he fought me terribly bad lastnight where I didn't get enough blood so the meter gave an error. I did give him his Novolin this morning and his 5+ BS just now is 403. That is improved from lastnight, but not near as good as we need to be. I see all these people with concern for HYPO and we definitely haven't even gotten close. I'm hoping the Lantus will be here tomorrow or Saturday. My vet is not happy about me buying from an individual and does not want me to give it until he sees him and the insulin. I'm not concerned about either, I'm just concerned about knowing how much to give him?? I gave him some 9 Lives Pate which I have not fed before and am wondering if that had anything to do with the 589???
Click to expand...

There's lots of experienced Lantus folks here that can help you out with the starting dose, when it arrives. Typically, a starting dose is .25u per kg of ideal weight...so if your cat is overweight or underweight, you'll want take that into consideration. However, when cat is switched to Lantus from a different insulin, you also take the previous dose into account. I would post in the Lantus forum and ask for advice on the starting dose when you're ready to switch.

I've attached a document for you to print out and give to your vet...it includes the dosing guidelines for Lantus, to help bring him on board with you. When you need to reorder the Lantus, your vet can write you a script and you can order it from an online Canadian pharmacy, where it's much cheaper than US pharmacies.
 

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Bandit fought me tooth and claw when we first started. I got a basket that was about his size, and a couple fleece blankets. Every test I'd put him in the basket, wrapped him up in the blankets like a burrito, and got the test. After each test, he got a diabetic safe treat. After a month or two of this, he hopped in the basket on his own, and I didn't need to wrap him in the blanket anymore because he stopped trying to scratch and bite me. After many years of tests, he knows the routine and doesn't need the basket or treats anymore.

It's very important that you are calm, relaxed, and have a no-nonsense attitude with the cat. Part of my problem in the beginning was that I was nervous, and I felt bad for Bandit, like I was hurting him. Once I realized the ear-pokes didn't hurt him at all, that he just didn't like me doing something new and strange to him, I got more confident testing him and took the attitude, "You're getting this test, cat, whether you like it or not because it's the only way to keep you safe and get your diabetes under control!". That's when he started to accept that these tests were happening no matter what, so he might as well enjoy the treats. :cat:
 
He has actually done very well most of the time with the exception of a few events. I put him in the same place and originally started with a towel, but haven't had to use it every time. I just retested him again and his BS was 342 at +8. I gave him a few small pieces of grilled chicken as a treat. Again, this is still better, and I guess I just need to be more patient, but I would sure like to see lower numbers.
 
Julia & Bandit said:
I've attached a document for you to print out and give to your vet...it includes the dosing guidelines for Lantus, to help bring him on board with you. When you need to reorder the Lantus, your vet can write you a script and you can order it from an online Canadian pharmacy, where it's much cheaper than US pharmacies.
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Thank you Julia! I feel I am going to need all the support I can get with my vet. He is strictly all about the pet meter, no human meters, dry diabetic cat food, and no canned wet food. I'm not sure how he will react to my getting the insulin from an individual, because his initial response was NO!!
 
The other concern I have is his lack of cleaning himself. His fur is getting dry and flaky and he has litter in his paws. He would have never been that way before. I would never put him in water to bathe him, but I am definitely going to have to find the best way to clean a cat. That is not something they usually like.
 
MalsGiGi said:
The other concern I have is his lack of cleaning himself. His fur is getting dry and flaky and he has litter in his paws. He would have never been that way before.
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The dander-ridden coat is a common symptom of unregulated diabetes. As his regulation improves he'll start grooming again.

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Thanks Critter Mom!!! I'm not sure how I would be doing this without you guys!!! Even more the reason I want to get him regulated ASAP!
 
I've been through it. Before diagnosis Saoirse's coat was a complete mess: greasy and riddled with dander. Shortly after she began insulin treatment she started shedding for Ireland. Her coat was in bits; so tatty, and so thin. :(

Saoirse got a weekly course of vitamin B12 and shortly after the first few doses her coat started to improve enormously. Might be worth chatting to your vet about whether similar might help Ceasar?
 
MalsGiGi said:
The other concern I have is his lack of cleaning himself. His fur is getting dry and flaky and he has litter in his paws. He would have never been that way before. I would never put him in water to bathe him, but I am definitely going to have to find the best way to clean a cat. That is not something they usually like.
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Yes, I completely agree with Critter mom---the dandruff and greasy, dry coat will get much better once his BG starts getting under control. When Bandit's BG is out of control, you can see it in his coat for sure. Once I get him well regulated it's bright and shiny with no dandruff, just like when he's in remission.
 
Sounds like you might want to get another vet. The ones who have no willingness to learn from someone who's got good advice on her side, are useless.
 
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