High BG for weeks - No clinical symptoms

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Nicole and Napoleon

Nicole and Napoleon

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http://www.felinediabetes.com/FDMB/viewtopic.php?f=3&t=15897

Napoleon's BG has been high for weeks, going down to 200s at the lowest. His AMPS was 590! Just started with Lantus. My question is how can he have no clinical signs - PU,PD, etc. - with these high numbers? I am definitely checking for ketones. Yesterday was his first day on Lantus and he was bursting with energy. Over the past 24 hours he has been alert, playing, grooming, running- he looks good! Knock wood. This is just confusing to me with such high numbers. Any ideas? Thoughts?
 
His numbers haven't been great but they haven't been completely awful, either. He has been getting insulin which may be holding the symptoms at bay. I don't really have a cogent explanation other than to point out that most of our kitties were probably diabetic for some time before they were diagnosed. I doubt that any of us was ignoring obvious symptoms.
 
There are many times when there are no symptoms, no signs, so you can't miss what you can't see. When I took Oliver in to the vet the first time to set up his file and get some full blood work done, imagine my surprise when the results showed p-titis! That's weird I thought; I did not see any signs like Shadoe had.
How often is it seen where someone tests and finds the result is a very low number, and they say that's weird, he's acting just fine!

So now you have switched horses in the stream. Different insulin, different horse, put aside the past for now. Now that you're using Lantus, you need to keep in mind how it works. Not only are you coming off high numbers, but you also reduced the dose (I don't know how the 2 types of insulin compare) and now need to fill the Lantus shed which will result in most of the insulin going to the shed and not much into the cat.

Follow the protocol and in time you will see changes in the numbers, but before then, you will be seeing great changes, improvements in Napoleon and the meter readings will come later.
Too often, people are so focused on that meter and getting those numbers down that they almost miss that the cat is looking and acting better. It won't happen overnite but then again, the cat did not become a diabetic overnite.

Watch Napoleon; see the little signs like the coat getting better, shinier, smoother, see those little habits come back that you had forgotten, like finding a lost toy or playing more or even just purring and sitting more content. That's the stuff you want.

For sure, watch the numbers and test for ketones, but when you get your purry pussycat back, you know something working.
 
cross post from health

Hi Nicole,

glad u cross posted, thank u for answering some questions over there in health

Im adding the link to the health thread so others here (who sometimes dont make it over to the health forum) can see what replies u received.
viewtopic.php?f=3&t=15897
 
I remember when Boris started on Lantus I could see almost right away that he was feeling better.
Love to hear about a playing kitty :-D
 
lots of us find that our cats feel better almost immediately on Lantus, even before the numbers come down. Just today, I noted that I only had to fill Jazzy's water bowls once today, instead of 2-3 times, and that there is a lot less urine in the litter box.

Now about the numbers: I'm a little concerned about ketones at these numbers. I think that probably your starting dose was too low - I probably would have started around 2 units or so and worked from there. There is a provision in the starting dose section of the protocol that says this:

Cats that have a tendency to get ketones and/or who are getting relatively high flat curves after the switch should have their dose raised earlier (after 24-48 hours). http://www.tillydiabetes.net/en_6_protocol2.htm

Napoleon is high and flat and he is ketone prone, so if I were you I would consider increasing soon. His numbers point to an increase of 0.5 units and you can do it whenever you are ready. Even if he is still building the shed, you have plenty of room to play with if he starts responding. It's up to you, though, you know your cat. I just increased Jazzy last night after only 4 cycles for exactly the same reason.
 
Thanks Lucy, I actually was thinking about the move to 2, but was not sure if I should or if it the wrong thing to do. The vet said 1.5 - 2u BID, so I am going to go ahead and give him 2 tomorrow morning.

Thanks for posting the link Ronnie :-)

Thanks Sandy and Gayle - it was so very nice to see him a little like his old self again!
 
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