Huge change in glucose since January

[Vicpug]

Puss was well controlled back in January on 1U Lantus twice a day. Over the recent months, control is getting very diverse and weird. Two graphs are attached from Libreview - the Freestyle sensor app. One graph shows good control from back in January, and the uncontolled graph is from this week. This week I have put puss on 3U in morning and 2U in evening. Still very strange results. What is happening to puss? Is she getting another illness? She is eating well and drinking heaps more water.

 

[Hendrick Cuddleclaw]

curious, why are you giving different doses morning and evening? I'm no expert, but the gurus here pounded it into my head that Lantus like consistent dosing and the best results come from finding a dose where you can give the same dose both day and night. Also, your spreadsheet has no data since late June?

 

[Diane Tyler's Mom GA]

Kyle is right you need to be giving the same dose for both cycles and you need to update your SS so the members can see what's going on

 

[Larry and Kitties]

At what time are you giving the shots? YO have to provide that when you are displaying LibreView data since your spreadsheet does not incorporate the BGvalues.

 

[Vicpug]

Shots are 4am and 4pm. I can update SS etc. etc. but the main question still remains. What am I doing wrong that moves puss from being tightly controlled in January with 1U twice a day, to being totally out of control on 3U and 2U. Is it diet or does puss have some undiagnosed illness. Diet is all low carb wet with a little dry food to control stools. Puss is getting very difficult to glucose ear prick test. Very unhappy.

 

[tiffmaxee]

You definitely do not want two different doses. Lantus likes consistency. Plus a whole unit difference really will not work. How did you decide when to increase? You say in January he was tightly controlled. When did that change? Sorry but I can’t figure out from your graphs.

 

[Hendrick Cuddleclaw]

Shots are 4am and 4pm. I can update SS etc. etc. but the main question still remains. What am I doing wrong that moves puss from being tightly controlled in January with 1U twice a day, to being totally out of control on 3U and 2U. Is it diet or does puss have some undiagnosed illness. Diet is all low carb wet with a little dry food to control stools. Puss is getting very difficult to glucose ear prick test. Very unhappy.

I think you have one possible answer -- inconsistent dosing day/night could be a factor

In your sig, it says diet is "wet"

what are you feeding specifically, how much, and when? what is the percentage of calories from carbs in each meal?

Your signature also says you're following TR, but with the two different doses day and night that doesn't seem to be the case, did you stop following it at some point?

 

[Larry and Kitties]

You say you are using Lantus (glargine) pen. Those only doses in 1-unit increments. Unless some medical problem prevents you from using a regular insulin syringe I wouod use syringes since you can dose in ¼ and ½ increments. You can get syringes w/ ½ unit marking and eyeball ¼ unit increments. You can just insert the needle of the syringe in the end of the pen where the pen needle goes and draw out the required dose.

Is there anything to explain why some days like Tuesday you get a good drop in BG but most other days you do not?
Is Puss eating the same?
Are you injecting in the same place or rotating areas? Some areas absorb insulin better than others.
What Length pen needles are you using? It may be too short.

My Wiggles did great on Levemir (about ½ unit) for 2 years or so them I got inconsistent results like you are seeing. This has been going on for over 1 ½ years. I tried different insulins, different injection areas, needle lengths, had a dental done all with no real improvement. I blame Wiggles, and all I can do is keep trying.

 

[Vicpug]

Many thanks for your help and ideas. Puss really does not like the ear jab for glucose test. So I rely on the Freestyle sensor and the occasional ear jab for monitoring. Diet is wet low carbs with a few weight loss biscuits. Tiki Luau chicken and Hills science diet perfect weight. At the start of the year puss was on dry food but I have moved to more wet food. I have attached 5 graphs all with dates. Maybe puss is better controlled with dry food? I had a blood test done last week, with analysis showing increase in the activity of one of the liver enzymes. Maybe an ultrasound is needed.
So far - Puss is eating well, I have a new Lantus Pen, using 5mm needles at various angles. She drinks lots of water of course. I do an occassional glucose test around midday and she sits at about 20-22 consistently. So yes, maybe I should blame puss. When puss was first diagnosed 15 months ago, she was on 4U twice a day. Thanks all for your help and apologies for my tardiness.

 

[Larry and Kitties]

I do not really understand the LibreView graphs you post. Can you post the Dail

y Logs like this:

 

[Vicpug]

Here are the summary 14 day logs. I am working on the detailed logs which can go over many pages.

 

[Larry and Kitties]

Are you using the pen w/pen needles?
Have you changed needle length or place you inject?
How old have you been using the current pen? Do you keep it refrigerated except when you inject?
If using the pen needles do you priime the a new needle each time? Are there any bubbles in the pen?

 

[Vicpug]

Yes using the pen with 5mm needles.
I move between two injection points along the neck lower neck. Pen is new and stored in fridge. Yes I prime the new needle every time.

 

[Larry and Kitties]

Anything to explain the low points in the last graph? Like is the injection point the same for the lows and yo used different points for all the other shots?
Without the four low points it looks like the dose should be increased.
If more insulin is needed you would need to increase dose to 1 ¼ units to do that you need to get syringes with ½ unit markings. If you used the pen needles you could only increase to 2 units.

 

[Vicpug]

I have been questioning my injecting technique. I have been questioning everything. I find it very difficult to explain the one low drop during the 14 day sensor. For most of the 14 days glucose sits at around 20. There were a few days where I upped the dose to 2U twice a day with no difference. Why this sudden drop just for one evening? Does the cats scruff neck area where I inject become somehow damaged over time and become less permeable? Where else can I inject? Somewhere on the rump area? Or maybe a food allergy? I could post some photos of my injecting technique if it helps. Very frustrating. Puss is drinking a lot of water now.

 

[Larry and Kitties]

I inject on the sides a little away from the scruff. You can inject anywhere there is enough "meat" to inject into.Two of may cats get inconsistent BGs similar to what shows for your Puss. This has been going on for years for Wiggles after excellent before that. I have done everything like different insulins, dental, changing injection site, changing needle length but still getting inconsistent BGs. I just keep trying.

 

[Vicpug]

Vet proposed an Ultrasound - I am not sure what it could reveal that may explain the symptoms.