Insulin resistance to Lantus-bounce?

Status
Not open for further replies.
K

kmoses

Member Since 2011
Hi, I am returning to this board after a couple of years because my cat Krismas who went OTJ in 2011, is diabetic again and has gone from well regulated with glucose scores in 100-200 range in January to been steadily higher scores over the last 6 months, now has high flat curve in high 400's to low 500's despite taking 9 units Lantus a day in divided doses. AMPS tends to be highest value of the day and is increasing. Doses take the scores down about 100 points over 12 hours but by the next shot glucose is back up and overall overall pattern of elevation continues. Vets have done many tests and found no cause for this increase. Kitty has classic symptoms but still eats poops purrs and preens but is lethargic and coat is getting dry. Kitty eats no grain low carb wet food like Tiki Cat since dx the first time.

I am trying to figure out if this is a bounce, chronic Somogiy rebound, or true insulin resistance for some unknown reason. My vet urges more increases in Lantus up to 16 units a day. I am very concerned about ketosis, have been doing urine ketostix with no trace so far, but with these scores its only a matter of time.

I'm trying to get spreadsheet linked but dont understand the computerese and have asked for help with it. Last nite did partial hourly curve looking for dip at peak. 7:30 AMPS was 496, dose 4.5 units Lantus. I was out during the day so no tests then. PMPS at 7:30pm was 436, dose 4.5 units, +3=389, +4=393, +5=409, +6=412. This morning 7:30 AMPS 473, dose 4.5, +1=511.

Hopefully will get chart up soon and head over to the insulin groups. Thanks for your help and support, Kathy and Krismas
 
It is hard to say since yo did not provide the BG/dose history that got you to 9 units (assuming you mean 4 1/2 units twice daily).
Some cats just require a high dose. My MurrFee is pretty good on 15 units Levemir twice daily
 
I know I can't get that much data up here without SS and I can't link it
She was well controlled with glucose ranging from 100's to 200's on 2 units twice daily in Jan and Feb. Her glucose started climbing and I started adding half units slowly in March. The added Lantus never seemed to affect the glucose scores - they just keep rising. She never needed more than 4 units daily and now she's more than double that and still unregulated and vet cant find a cause. I would be fine if 9 or 15 units Lantus kept her regulated with good clinical signs but that's not the case here. I am suspecting somewhere in her curve her glucose is going through a drop that is too rapid or deep, and if that's the case more Lantus will just push higher scores till she develops keto acidosis. How else can I assess this situation? My regular curves which are tests every 4 hours from AMPS to PMPS haven't shown much - a drop of 100 points at peak is typical but when you start out with 500 that only brings it down to 400's still way over urinary threshold. I'm starting to test hourly around the peak looking for some telltale drop in glucose. I don't know what else to do. Thanks, Kathy
 
I would try a curve every two hours with the 4 Units twice daily dose and post the results.
Might be time to change to a different insulin.
 
Hi Kathy, are you still having trouble linking your spreadsheet into your profile? If you have it published already, you just go to the User Control Panel at the top of this page, and go to profile tab. In the edit signature tab, paste the code you created (control v or command v) and save it.
If you have questions, post a new topic in the TECH forum and ask away! Someone will help!


viewtopic.php?f=6&t=50130
 
Status
Not open for further replies.
Back
Top