Kitty Michael's amps 384 pmps 39

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Paula

Paula

Member Since 2014
Hi all,
I am concerned. for 2 days Michael's bgs have been high in the Morning between 300 & 400 I gave 2 u of insulin.
In the evening they have been low ranging from 86-39 I didn't give the pmps shot.
I recently have changed his food from hi-carb wet to lo-carb wet. I transitioned this over a few days.
Why would his bg be so high in the morning and so low at night? his SS is on my signature. Please look at it.
Thanks again in advance.
Paula & kitty Michael
 
If you got a PMPS of 39, do not shoot! You might want to re-test to make sure it's that low too.

It sounds like you're on too high of a dose and need to lower it

Since you went to low carb food, he's not needing as much insulin.

Looking over your spreadsheet now....will be back
 
What's happening is Michael is "bouncing".....His dose is too high, so it takes his numbers too low, then his liver kicks in and releases a lot of stored sugar and hormones to get him back up quickly.

Bouncing is normal, and is part of the survival mechanism from when our cats lived in the wild and times were tough. They couldn't find prey so their blood sugar would drop. To keep their blood sugar high enough to keep them alive, their liver released the sugars and hormones that would keep them alive to hunt another time.

It's very important that now that you're feeding a low carb food that you reduce Michael's dose. We generally start them low and slowly work our way up (in .25 unit increments) so we can really see how each dose is doing.

How much does Michael weigh? Is he underweight? There's a formula for the starting dose with Lantus that's based on weight.

It's very important to find a dose you can safely give every 12 hours, so if I were you, since you've done the diet change, I'd start over at the lowest dose recommended (based on weight) and go from there.

Please go ahead and feed Michael ...if you have some higher carb food, I'd go ahead and give him a teaspoon.....since he has insulin on board we don't want him dropping any lower!
 
Hi chris,
Thanks for replying. Is beechnut baby food chicken & chicken broth hi-carb? What are some hi-carb foods? I don't want to give him the y/d due the fact that would mess up his system. Michael weighs 14.8 LBs.
 
No...babyfood with just meat products isn't high carb.

Have you got any "Gravy" cat foods? Like Fancy Feast "Gravy Lovers?"...pretty much any food with gravy is going to be higher carb than pate's. You could also add a drop or two of Karo syrup to his regular food. Regular maple syrup will work too

It's important for you to keep testing for now until we're sure he's above 50

Let me do some figures and I'll get back with what the starting dose should have been
 
OK...at 14.8lbs, the starting dose for Lantus would be 1.5 units twice/day, but since he's dropping so far on 2 units, I'd suggest starting over at 1 unit and getting as many tests in as you can.

It's important to always get a Pre-shot test in (as you can see!) and then at least one other test somewhere mid-cycle. Getting a test between +5 and +7 during the AM cycle will help nail down his nadir (the point in the cycle where he's the lowest), but it's important to not ONLY get the same test every cycle....some days maybe a +6, others a +4 or +5 or a +7 or +8

At night, you'll want to at least get a test "before bed"...Most cats go lower at night so getting that "before bed" test is important to know if you should set an alarm to wake you later in the cycle.

Most of us really like getting a +2 because it's kind of our "crystal ball" test. If the +2 is lower than the Pre-shot, it's a good indication that you NEED to get tests later in the cycle because they might be dropping quickly.
If it's about the same as the Pre-shot, you can expect a more "normal" Lantus cycle, where they gradually go down until mid-cycle and then start to climb again as the insulin wears off.
If it's higher than the Pre-shot, you might be starting a bounce where the numbers rise due to the liver releasing those stored sugars and hormones and it's probably safe to not do so many tests.

I know you started at 1.5 units, but at that time it looks like you were feeding higher carb foods, and now that you've dropped the amount of carbs he's eating, I think it'd be safest for Michael to drop back to 1 unit and let us see how well he does on it and if it allows you to shoot both an AM dose and a PM dose
 
Chris,
Thanks sooo much for all this info. I tested Michael in the pm cycle @ +2 his bg read 53. It looks like he is going up.
(at least he is above 50.) I feed him more of his dinner, low-carb food. Does that help to bring up the bg? I don't understand. If the lo-carb food brings down the bg, then why is it so important to make sure he eats before you give a shot, and why did his bg go above 50?(I hope what I'm trying to say makes sense. I have a hard time trying to explain all this.)
I will try and test again before bedtime and will post on his SS.
If he is between 200 & 300 in the morning I will lower the insulin. If he is below 200 I won't give the shot.
Paula
 
OK..first, no matter what you feed, any food can bring the numbers up, so it doesn't matter if you fed low carb, medium carb or high carb earlier...he should go up (and he did...to 53) If you feed a medium or high carb food, the numbers will go up higher than if you feed low carb

The reason we tell you to go to a low carb food is so the insulin doesn't have to work so hard to get him into normal numbers. If you had continued to feed high carb food, he'd probably continue to need more and more insulin to combat it and get him into normal numbers. We don't want to keep feeding high carb food because it makes it even harder to get them controlled.

Continuing to feed high carb foods to a diabetic is like trying to put a fire out by pouring gasoline on it...You're adding fuel to the fire instead of suppressing it.

Cats have the unique ability to have their pancreas heal and start producing insulin again. The more time you can keep him in "normal numbers" (50-120) the more time his pancreas is healing. The idea is to lower the carbs so there's not so much to work against, and then get them "tightly regulated" (in normal numbers as much as possible) so their pancreas can heal....and gradually, as it heals, it can start producing insulin again and you can start reducing the shots until you don't need them anymore.

Not all cats will be able to go OTJ (Off the juice) but the best chance he has is to keep him in those healing numbers.

It's important that they eat because if they don't and you shoot insulin, it has nothing to "work against", and they can go too low. That's why we say to test/feed/shoot in that order so you can make sure he's eating normally before giving a shot.

In the morning, if he's above 200, I'd go ahead and give him 1 unit and then test as much as possible to fill in some of the blanks on your spreadsheet. Look at your spreadsheet like a puzzle....if the only pieces you have filled in are the edges, you can't really tell what the picture is!

If he's below 200, I'd stall, Don't feed, and re-test in 20 minutes...Use that time to post here and ask for help. Make sure your subject line says something like "STALLING, PLEASE HELP!" so it gets people's attention.

If nobody can get to you soon enough and the next test is higher than the first one, you can probably go ahead and shoot the 1 unit because he's going up as long as you can test later in the cycle. It's always going to be safer to skip if you can't test later in the cycle and you don't know how your cat responds to feeding and insulin.

Here's our Sticky on Shooting and Handling Low numbers. It can also help to guide you if nobody is online when you need them (but usually, there's someone around)

The first few times people shoot under 200, we like to have someone who's got some experience watching over you.

Dose that help answer your questions? If not, please feel free to ask more! That's what everyone is here for!
 
Chris, Thank you, thank you!
This is a lot of good information. It is going to take awhile for me to digest it.
I tested again @ +5 his BG was 164 I posted this on his SS.
Is there some kind of lo-carb food that he can nibble on during the night. If I leave his wet food out, he eats all of it right away and then he has nothing to nibble on during the night. He is used to nibbling during the night.
What about freeze dried treats?
Paula
 
You can freeze a small puck of canned food and he can nibble as it thaws.

Also, add 1-2 tablespoons of water to help fill him up.

Using a large plate and spreading the food very thinly may slow him down, too.
 
It looks like his liver has kicked in and released those stored sugars and hormones, so he's starting his "bounce"

He may be very high in the morning, and even if he is, I wouldn't give him the 2 unit dose again since it's taking him too low now. Just stick with the 1 unit for now (Unless he drops below 50 again) and lets see how long it takes him to clear the bounce and then re-evaluate his numbers.

You can look into getting an Auto-feeder (this comes in 2 meal and 5 meal models) that you can program to open when you want, as well as trying the "foodcicles" BJ suggested

You can open a can of food, add some water and then put it into ice cube trays or muffin pans to freeze. Most cat's won't eat what they can't smell, and frozen food doesn't have much smell...then when it thaws, it smells like food again

The freeze dried treats are zero carb, so while you can leave some out, they're not going to help if he goes low again tonight....but as I said, it looks like he's beginning to bounce anyway, so should be OK for tonight.
 
I will try freezing. I tested this morning and his bg was 355. I gave i unit of insulin and posted to the SS. I wish his numbers would stay consistant.
When their low, I worry and when their high , I worry.
Thanks Chris and BJM for the suggestions & help. You're Great!
I will keep posting!
Paula
 
Nice to see you Paula.
Good luck with the new dose.

Keep posting, k?

You're doing great.
 
Looking good Paula!

If at all possible, get some tests in at random times today (most importantly "around" +5 to +7) so we can start to fill in some of the blanks.

It also looks like you're not quite understanding "bouncing"....Most of the time when our kitties are finally diagnosed as diabetic, they've already been in high blood glucose numbers for awhile, so their body's have gotten "used to" living in those higher numbers and consider them normal now.

When we start insulin, we're bringing the BG down into what are lower numbers than they're used to, so their liver thinks there's a problem and releases stored sugars and hormones to bring it back up where it's gotten accustomed to being...so they "bounce up"....they "bounce" off of low numbers, not high ones (so if you look on 7/18, you'll see Michael dropped to a 46 and then "bounced" up to 316 by the next morning. Then he cleared that bounce quickly and dropped to 72...and bounced again to 384....and then yesterday cleared that bounce and dropped to 39...and Mr. Liver kicked in again and bounced him up to the 355 you saw this morning.

All this is normal (although VERY frustrating at times!) It's a leftover survival mechanism from when kitties were wild and times were tough. If kitty didn't have food for awhile and his blood glucose dropped too low, Mr. Liver would do his thing to keep kitty alive long enough to hunt again and hopefully get food.

As they spend more and more time in lower numbers, Mr. L will re-learn what normal is, so it doesn't react so much when there's no reason to.

I know it's scary to see those higher numbers, but what's important to remember is that high numbers take time to do their damage...it's the low numbers that can kill quickly

For now, you're going to want to just continue with the 1 unit dose. Bounces can take up to 72 hours to clear (although it looks like he clears them quickly!) and let us advise you when (or if) you need to adjust the dose

Keep posting! We can help you get him under better control...and our first concern is to do it safely
 
Hi Chris,

I am sooo happy that you keep checking on Michael. It is so much help!
I just tested (@9:30am) and the bg is 266. He is going down. so the 1u I gave @ 5:15am is working.
I will post this on the SS.
Thanks again for staying with us. It means a lot. I feel better.
Paula
The ss is not working. It wouldn't let me type numbers or my notes. What do I do?
 
You need to stick with that lower dose to settle down those numbers. I was having the same problem until I dropped the dose down and stopped chasing the bounce. He settled in and now needs little if no insulin.
I'm going to try the Young Again dry zero carb kibble to find out how much it will make numbers go up vs 100% wet diet.

Better to give no/reduced dose than too much.
 
Hi Chris,
I Thought I was. It was working early this morning.
I signed in again. Now it's working. Look at the SS. The numbers are going down slowly. The 1u looks like its working.
Paula
 
Well he's still working off the depot dose of 2 units too

The first couple of cycles after a reduction can still be pretty crazy because of the way Lantus works. All that insulin you've been shooting into him has left him with a pretty good sized depot and it may take a day or two to drain the depot down so that you're REALLY seeing how well the new 1 unit dose will do.

Great job on getting some more tests in today!! Filling in some of those big blank spaces will really help!
 
Thanks Chris & Los Gatos. I'm trying. I will try to test one more time this evening.
btw Los gatos what does fwiw mean?
Paula
 
For What It's Worth
As in, I'm really new to this (June 6 diagnosis) so near useless information but I'm forwarding my experiences.
They had me give him 3U and I've brought it down to .5U or 0U without the vet, just information garnered here. Otherwise I'd be chasing Fluff's numbers up and down the street with a needle in my hand.
 
You guys test a lot. How are your cat's ears?
My cat's ears are really getting scarred. I put Neosporin ans Vaseline on them. If I have to test for ever, what is going to happen to his poor little ears? He is such a good boy. It breaks my heart to put him through this. I know it's for his safety.
Thanks for all the kudos. I'm trying to do the best I can with his spread sheet even though i'm so confused.
Paula
 
After I test, I'll take a tissue and squeeze his ear to stop the bleeding just like they do when they draw your blood. Seems to work for me and I don't use Vas/Neo. I also don't test nearly as much as I used to as I have an idea of what he will do. Now it is just usually AM/PM pre-shot.
 
Paula, I have a pure white cat (as you can see in her picture) and although most of the time if you were looking closely, you could see a tiny little area on one ear where she's been tested, it's really not been much of a problem

Make sure you always use a NEW lancet every time. The metals they use are so sharp and so thin that they degrade quickly. (see picture below)

Always have a cotton ball, make-up remover pad or some Kleenex ready to use after you've got your sample and apply pressure to the ear for about 15 seconds. Apply a little Neosporin with pain relief ointment after each poke

Although you've probably seen the picture of the "sweet spot", you can actually poke anywhere along the edge of the ear, so vary it if it's getting really scarred.

needle-deterioration.jpg
 
Hi again Paula!

I had a moment to look at Michael's spreadsheet and had a few thoughts

First, if you get a test result that's really out of character for your cat, it's always a good idea to re-test. With the drop in dosage I wonder about that 65 you got this morning (although it could be totally right!!) Since the 2 unit dose had been taking him into hypo numbers and then he was "bouncing", it's totally possible that the 1 unit dose could be a good one for him! (maybe even less!)

While you're right that we have a "no shot" rule if under 200, that really doesn't mean you don't shoot. If you get a number under 200, we'd want you to "stall", DON'T FEED, and post for help. By shooting insulin when they're lower, you'll usually get a flatter cycle. I know it just sounds weird, but if you shoot at 350 and they drop to 200, shooting when they're at 200 doesn't mean they're going to drop to 50...it just doesn't work that way.

Most of us will shoot anything above 50, but only after we've got enough data on our cats to be able to do it safely. The first few times you get a result under 200 (and when you go to the TR forum that "no shot" number drops to 150) we like to make sure one of the more experienced members is watching over you, so if you stall, take that time to post and make sure your subject line says something like "STALLING, PLEASE HELP!" so it catches someone's eye

When you stall, you don't feed and retest in about 20 minutes....if the number is rising, you can pretty much safely shoot because you haven't fed them anything and the number is going up anyway (so the last shot is wearing off) IF nobody is available to help you, you can also go by the Sticky Shooting and handling low numbers

Are you still having problems with your spreadsheet?
 
Hi Chris,
Thanks for looking at Michael's SS. When I tested this morning the bg was 65. I tested again ( within 5 mins) and the bg was the same 65. Since he was under 200 I didn't give him a shot. I have a Doctors appt. so I won't be able to test until later this afternoon. besides i'm still not sure about the feeding and insulin. Of course, if he is 200 or above this evening, I will give him 1unit of insulin. I'm still confused, because his numbers aren't consistent. If his numbers ever become consistent, I will try shooting low.(with the help of you wonderful people.)
I use a cotton ball for his ears and also apply Neosporin or Vaseline.
Paula
 
Hi Chris,
Thanks for looking at Michael's SS. When I tested this morning the bg was 65. I tested again ( within 5 mins) and the bg was the same 65. Since he was under 200 I didn't give him a shot. I have a Doctors appt. so I won't be able to test until later this afternoon. besides i'm still not sure about the feeding and insulin. Of course, if he is 200 or above this evening, I will give him 1unit of insulin. I'm still confused, because his numbers aren't consistent. If his numbers ever become consistent, I will try shooting low.(with the help of you wonderful people.)
I use a cotton ball for his ears and also apply Neosporin or Vaseline.
Paula
 
My experience is with PZI and only ~50 days.
With my kitty the variation in shots of 1U or 2U would give me numbers like yours. It wasn't until I started all over and slowly worked it up that I was overdosing him and he only needed 0-1> rather than the 3U prescribed.

I can't advise if that applies to you as you are using Lantus. I'd imagine a 1-1.5 dose would be better than the swing between 1-2. It does take a few times to settle down the numbers from what I understand, it isn't instant.
When I just did my dry food kibble test, at the end he hit a 464 (don't know why, could have gotten into the "cookie jar".) but I brought him to half of that with a PZI 0.75 shot, rather than a 2+ dose that you would assume.
I think Michaels pancreas is working some but you get that glucose spillage.

Then again I haven't been doing this long
 
Los Gatos, Chris
Thanks for the reply and info.
I just tested M and his bg was 317. I gave him 1u of insulin. I guess he bounced again. I posted on M's ss.
Paula
 
Hey Paula....

I am a newbie myself :) But DEFINITELY looks like someone wants to play with a bouncy ball!! I am in the same boat with Skoots today....oh how he seems to love his bounces lol

Keep working with the advice you are given, even if it doesn't seem to be working, it can take a couple cycles for changes to catch up and be taken care of.

Will you be joining us in the TR group?!?!? Look forward to seeing you there!
 
Yes that's definitely a bouncy baby boy there!

It can take up to 6 cycles (sometimes more) before you really see how a dose is going to work, and when they bounce (which can take up to 72 hours to clear), about all you can do is hang in there and see what happens

We all totally understand how frustrating it is though!!

OK now Michael!! No bouncing in the house!!
cat1.gif
 
Chris,
Excellent!

High numbers for a couple of days I would think is better with a low dose and work you way up bit by bit. In a day or two you will see the results if you give a constant 1U. Unless of course you see a green.
 
I tested m and the bg is 294 so he is going down since I gave the 1 unit. If he is low in the morning(under 200) do I not give a shot? For the past couple of days he has only been getting 1 shot a day. Is this good? I will post on the SS.
Paula (still confused)
 
If he is low in the morning, stall 30 minutes without feeding and re-test.
The objective is a dose you can shoot safely twice a day within the amount of monitoring you are able to do.

If you'll be home to monitor:
- If rising and over 200 (*), you might try a lower dose of 0.75 units
- If rising and over 150, you might try a lower dose of 0.5 units

If you won't be home to monitor, maybe make that 0.5 and 0.25 units respectively.

Or skip if that makes you more comfortable.

And if you need to skip again, drop the next dose you give to 0.75 units.
 
If you get a number under 200, stall, don't feed, and post.

I'd start a new post and make sure the subject line says something very clear, like "STALLING, NEED HELP!" so hopefully someone will be online and can help you through it.

As long as you don't feed, you can retest in 20-30 minutes and if the number is rising, it's usually going to be OK to shoot. You can also leave food down for him. Most cats will go looking for food if their blood glucose drops.

Further up, I posted the link to "Shooting and handling low numbers" (it'll be in blue letters). You can also use that to guide you. (It's always a good idea to have that printed out somewhere just in case the message board isn't working)

What's important is that we find a dose you can give safely every 12 hours, so if there's absolutely no choice and the numbers are rising, BJM's ideas look like a good alternative...just leave some food down and test as soon as you can (assuming you can't test any other time during the cycle)

What's your schedule like? Can you get tests during the day at all? A neighbor or friend? Run home at lunch?
 
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