High numbers for Louie~ worried!!

[Louieorangetabby]

I'm kind of in a holding pattern with Louie~ I've been so worried about his high numbers~ He was on a higher dose of Lantus for so long, and his numbers did not come down, so now reducing his insulin (I was getting worried that his system could not take it) it looked better for a while, but the numbers are back up again! After all this time, I still have no clue how to help Louie~ from time to time he sneaks some of the grain free kibble from our other 4 kitties, but I try my best to keep it away from him.......he is looking chunky these days~ quite hungry. Keytones testing negative~ what to do??
any suggestions?
thanks!
Tracy & Louie

 

[BJM]

Here's an experiment for you. Go to your spreadsheet. In the lower right corner, click on the magnifier's down arrow and set the zoom to 50%. Now slowly scroll up and down and notice the colors.

You might see a pattern that corresponds to the glucose levels and insulin doses.

If the Lantus doesn't seem to be lasting long enough, you discuss Levemir with your vet. It has the same restrictions Lantus does - exact dosing schedule, and dose adjusted by nadir values.

Also - does Louie have any complicating conditions - dental issues, IBD, pancreatitis, renal disease, etc? Those can wreak havoc with glucose levels. If he's not had his teeth checked & cleaned in over a year, sometimes that can make a big difference. If he has issues with constipation and/or diarrhea, this will affect his appetite and absorption, generating wonky glucose levels when those things happen.

 

[Blue]

I'm kind of in a holding pattern with Louie~ I've been so worried about his high numbers~ He was on a higher dose of Lantus for so long, and his numbers did not come down, so now reducing his insulin (I was getting worried that his system could not take it) it looked better for a while, but the numbers are back up again! After all this time, I still have no clue how to help Louie~ from time to time he sneaks some of the grain free kibble from our other 4 kitties, but I try my best to keep it away from him.......he is looking chunky these days~ quite hungry. Keytones testing negative~ what to do??
any suggestions?
thanks!
Tracy & Louie

OK on first look at the ss, you have only half the picture.... there are no numbers after pmps, and at the least, a before bed test would be helpful because many cats go lower at night.

Now, since you are testing, and you are seeing that the dose of 1.5u is NOT getting you better numbers, why not increase to 2u and see if you can get better numbers?

You will need to be sure the dry food is gone first .... the dry food could be the cause of the high numbers.
If you can't get rid of the dry, then you can expect higher numbers, but may as well as raise the dose to cover for the dry food diet.

How much wet food are you feeding him? You need to feed him more until he's more regulated and at some lower numbers. Some cats eat more when they are at higher numbers and/or lower numbers.

I am not quite sure why you are holding the 1.5u dose so long. You dropped from 2.5u down to 1.5u and all I see are higher mid cycle numbers... no change in the ps numbers.

It would be a good idea if you can do a full curve on one day; you need to see how the insulin is working, so pick a cycle when you can test every 2 hrs.

You may find that Lantus is giving you too big of a dip and you may want to consider switching to Levemir as it does give a much more shallow curve.

 

[BJM]

It seems as though the evening preshot is generally 1 color higher than the morning preshot.

Are you being diligent about the shot times? Feeding times?
(Can't tell from the spreadsheet, generally, no notes about these)

To me, this suggests the following possiblities

1) duration isn't quite long enough,
and/or
2) something stressful is ocurring during the day
and/or
3) he goes lower at night
and/or
4) his feeding schedule is affecting his numbers.

 

[Louieorangetabby]

Here's an experiment for you. Go to your spreadsheet. In the lower right corner, click on the magnifier's down arrow and set the zoom to 50%. Now slowly scroll up and down and notice the colors.

You might see a pattern that corresponds to the glucose levels and insulin doses.

If the Lantus doesn't seem to be lasting long enough, you discuss Levemir with your vet. It has the same restrictions Lantus does - exact dosing schedule, and dose adjusted by nadir values.

Also - does Louie have any complicating conditions - dental issues, IBD, pancreatitis, renal disease, etc? Those can wreak havoc with glucose levels. If he's not had his teeth checked & cleaned in over a year, sometimes that can make a big difference. If he has issues with constipation and/or diarrhea, this will affect his appetite and absorption, generating wonky glucose levels when those things happen.

Thank you for all the suggestions~! I know I have not been consistent with posting, but I really appreciate the help from this forum~
I might need to tighten his feeding schedule~ also, the shot times get a bit shifted around from 8am to 9/9:15 according to my work schedule.
Also~ Louie has never had his teeth checked~ so this is a big issue to look into~
I'm also changing out his food according to what I can afford~ I go between FF classic, tuna, evo, and low carb 9 lives and friskies canned. This might have to do with finding the right diet for Louie. Every now and then he gets into the kibbles....but I try to keep it away from him. Maybe I need to redouble my efforts with that.
I'll take a bedtime reading and find a day to do the curve testing. Yes~ Maybe even a switch to the different insulin. I reduced his dose from 2.5 to 1.5 because he did not seem to be making any progress and I worried about the amount of insulin he was getting with no result. I was advised to reduce and see what happened with his numbers. There may be any number of issues here~ but this evening I increased his dose to 2 units to see what happens.
thanks! Tracy & Louie