My autumn's numbers are still high on 4 units twice insulin daily

[Autumnsmom]

So my IBD pancreatic diabetic [caused by pred] kitty Autumn still has high BG levels at 4 units twice daily of lantus [20.4 canadian- sorry I forgot the american numbers]. I have suggested to the vet and specialist that I reduce the pred [ Autumn has only had one minor attack of pancreatitis since January and a vet thought this was just a reaction to a topical medicine for cat acne] or change the steroid and that I want to change the diet [right now just the diabetic vet diet]. The specialist has implied that with Autumn having IBD pancreatitis and diabetes that she is basically a lost cause, and I get the feeling that the vet does not want to cross the specialist . So they won't do anything until Autumn has another ultrasound [ one done a year ago and one done in January]. A few weeks ago I was told that no bloodwork or ultrasounds or other tests were needed for six months, but now they are hinting more bloodwork- her last snap test showed that she was fine and the numbers suggested a very minor pancreatic attack in June, the ultrasound, xrays. Apart from the high BG levels she is happy alert playful loving beautiful coat, you would never be able to tell that she is sick. My greatest fear is that this is pancreatic cancer, and again neither vet will give me an opinion. I've read a lot on insulin resistant cats, and she shows no signs of problems, just the high numbers. I read about the fact it might actually be the insulin is a bad batch, or the site I'm using for the injections might be releasing some sort of anti insulin compound. I've mentioned cushings disease, the vet said this wasn't Autumn. I'm so frustrated with the answers I'm getting. I really don't want to go to the specialst again, but I'm out of options. Any ideas. I apologize for sounding like I don't like the vets, I like mine but I'm not really fussy about the specialist writing off Autumn. I haven't started the charts yet, I only test when she vomits and during a curve- the vet has me do numbers two hours, four hours six hours after lantus, and then 4 hours after lantus after the night dose. Again Autumn is happy, rarely throws up anymore [ I give her small meals and try not to give her wet right after she eats dry]. Any advice would be appreciated, I'm crossposting this on Cats with multiple conditions and the cats with pancreatitis

 

[Idjit's mom]

I'm sorry, I can't advise but I wanted to just say I'm sorry you are having these issues. I know the more experienced and knowledgeable members will have some input. Hoping for answers to your questions and for Autumn to be feeling better real soon.

 

[Elizabeth and Bertie]

I only test when she vomits and during a curve- the vet has me do numbers two hours, four hours six hours after lantus, and then 4 hours after lantus after the night dose.

Hi Autumnsmom,

I'm sorry you're having such problems. (((Hugs)))

Have I understood correctly that you are not testing Autumn's blood on a daily basis?
If you are not testing on a daily basis (before each shot, and at some point during the cycle) then it's possible that Autumn's blood glucose is dropping at times and you're not seeing that...

It's also a possibility that her blood glucose is dropping lower than her body is comfortable with and then 'bouncing' up high in response to that. (When the body senses the blood glucose dropping too low it can release stored glucose to raise the level, and also counter-regulatory hormones to try to keep the blood glucose high for a while (temporary insulin resistance)). When this happens, sometimes all the caregiver sees when doing occasional tests is high flat numbers. Too much insulin can look like too little insulin....
It may be that Autumn does need a high dose. Some cats do. But without more data I don't think it's possible to determine that for sure.

Eliz

 

[Autumnsmom]

So I am doing another BG curve, [every two hours after a m insulin, then 4 hours after evening insulin] and her dose is up to 4 units lantus twice daily. now her numbers are higher than ever- all above 20 canadian. What kind of testing should I be doing . She eats mostly dry purina vet diet diabetic, and some wet [ she will only eat a tbsp at a time, and I work full time]. I was not told to restrict food between testing. We see the vet on thursday, I know they will want to do an ultrasound, and I just read some scary stuff about pancreatic tumor [ Autumn has pancreatitis]. I would like to take her off the prednisone, and change the diet, but the vet and specialist are resisting this. So scared

 

[Elizabeth and Bertie]

her dose is up to 4 units lantus twice daily. now her numbers are higher than ever- all above 20 canadian.

Hi, if a cat's blood glucose increases as the dose is increased this might indicate that the dose is too high.

What kind of testing should I be doing

As a minimum, we'd recommend testing before every insulin shot. That is to ensure that the blood glucose is high enough to give the shot.
Then, other tests during the cycle are helpful. For example, a test a couple of hours after a shot can often give us clues about how the rest of the insulin cycle may go.
And it's helpful to know when your cat usually has the the lowest number of the cycle (blood glucose 'nadir'). Then you can check around that time to see how low the blood glucose is dropping at that point. Every day will be different to some degree, sometimes a little, sometimes a lot.

For information specific to using Lantus DO post on the Lantus forum where you are more likely to attract the attention of experienced Lantus users.
Here's the link to the Lantus forum:
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

Eliz

 

[Lisa and Witn (GA)]

Hi, if a cat's blood glucose increases as the dose is increased this might indicate that the dose is too high.

I agree. What was her starting dose and how quickly was her dose raised to 4 units? Did you increase it by whole or incremental units?

You are also feeding dry food which is usually higher in carbs. That could be also contributing the high numbers.