Looking for any insight...

S

Sunast3

Member Since 2021
Hello there,

To preface, our 15 year old cat has been handling both diabetes and CKD. Our boy is very responsive to prescription food, insulin, etc. so we always try to do diligent research in this ongoing journey of making him his most comfortable and happy self. At one point, we were prioritizing diabetes as his kidneys were in a good spot (his kidney numbers have fluctuated quite a bit). Recently, his kidney values have progressed a bit, and through many conversations with our vet they suggested that for the mean time we prioritize kidneys. (Please know, we have done extensive research into cat food and are in process of switching from a prescription food to a food that balances both kidneys and diabetes; i.e. low carb/low phos/etc. He is currently on Royal Canin D as it is the lowest carb prescription option.)

Whew, now that we got that out of the way - My main question is... in the past week or so, Stoli has received back to back doses of insulin for two consecutive days. The AM number is then fine, but in the PM it drops to scary levels after receiving no insulin in the AM. Has anyone experienced this? We can't quite put our finger on it and want to understand how to proceed as well as continue to learn. For example, his numbers will be in the 300's while receiving insulin and then without receiving insulin the number drops significantly in the evening.

Open to hearing opinions and experience. Thank you!

Edit: Should also include, if numbers consistently swing from double digits to 500+, we may do an ultrasound to rule out any additional medical issues (pancreatitis, UTI, etc).
 
Hi there,

I responded but then realized you're not a newbie here! Here is your last post: https://www.felinediabetes.com/FDMB/threads/fluctuating-numbers-have-us-stumped.245697/#post-2772982

Are you still dosing intermittently? Your spreadsheet does not indicate the doses you gave today if you gave them in the AM and PM. Nadirs will move around with unregulated cats. This is why if you're on Lantus it's important to dose consistently. Sometimes the effects of Lantus lasts beyond 12 hours, sometimes 18 hours, so if you don't dose in the morning the cat might still drop low in the evening because there is a depot of insulin stored in the subcutaneous fat that still gets released and you might see its effects for three days after giving the shot. What it looks like is Stoli needs more insulin.
 
I see you are still dosing intermittently. As Sienne mentioned lantus does not work well that way. When you give some insulin it’s bringing the bg down and then he bounces back up. The insulin started to work when you were giving it twice a day and that is why you saw the green pmps. I would try giving .25 and see if that keeps your cat in a range you are comfortable with. It is possible that will be too much and you might need to lower the dose even more to 0.1. Here we suggest a minimum of two tests each cycle. The lowest point is how lantus is dosed. Did you ever get a chance to read the yellow stickies on how lantus works best? They are at the top of this forum.
 
It really needs to be fixed every 12 hours. Maybe .25 every 12 hours will work. Keep asking questions as you read the articles and we will be happy to answer. That being said he is too low to dose tonight. We would have you stall, not feed, and see if the bg would come up to a better number to shoot. You would need more tests if you did dose to keep your cat safe.
 
That’s a bounce from the pmps he is not used to as Sienne explained in your first post. You will have this up down scenario dosing like you are.
 
Hi and welcome! We love questions, so if there is something you aren't sure about just ask! There is a lot of information, we don't expect you to pick it all up in one day ;)
 
Sunast3 said:
Okay. Sorry, I'll do some more reading before positing again.
Click to expand...
Please feel free to post with any questions you have. The forum has so many sticky and info posts that even the most active and longterm users of the message board can discover new things they never knew before by re-reading. All of the things we discuss on the board not only helps you but others who might be experiencing a similar scenario and don't know what to do or what to make of it.
 
Stoli definitely needs a smaller dose of insulin. 0.5 units got him down to 31 on the AT, and that's way too low. Good luck with a reduced dose.

Out of curiousity, what food are you switching from and to? Several people have to balance kidneys vs diabetes so I like to know if there is another food out there we should consider. Also, when did you start the switch?

Just one other thing to mention, Lantus is great at keeping lower numbers flat and low. Over time and with experience and the ability to monitor, we lower the "no shoot" values.

And yet another reason to keep asking questions - your questions will not be unique. There will be others who profit from reading your questions and answers because they have similar questions. So keep them coming.
 
We usually tell new members to post and seek guidance with any preshot numbers below 200, then below 150. After a few months though we usually tell people to shoot any number above 90 if they follow the SLGS method or above 50 if they follow TR. The beauty of Lantus is that it works really well to keep low numbers steady and low. The drops you see happening from 250 to 80 don't happen as precipitously when you give insulin at 80. It may make you feel better to look at other people's spreadsheets. Ruby was tightly regulated and I could shoot any number above 50 with a good deal of confidence (ignore anything after she started prednisolone in June 2021). This was after she leveled out and no longer experienced the extremes that you are seeing with Stoli.
 
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