Need advise - numbers have been 600-750- meter high!

[Willow]

Hello

We just went through hell saving our cat Willow. Newly diagnosed with diabetes, Went through hell with her becoming DKA, keytones, dropping to 19mg and almost losing her, kidney and liver failure, turned yellow, see my other post for that whole story.

We had to hand feed and water her for two weeks, she finally started eating on her own. She will not eat the wet MD she will only eat the dry MD. She will eat any other wet food.
She does not eat a lot of food at once, she eats a little all day and this is causing us problems with getting her numbers under control. She is being given glargine twice a day 8am 8pm. Three weeks ago we started out at 1/2 unit when she was high enough to need it, from there we have had to increase the amount to the point we are now at two units due to her numbers being so high.
Her morning number yesterday did not even read it just said high.
After her shot she comes down 100mg and hour no problem until around the 400 range, she seems to,get stuck there.
I can tell during the day that she is high because she is drinking a lot of water and peeing a lot. I tried pulling her food during the day and she gets really hungry to the point where I put her food back she scarfs down a lot of food then barfs it up.
Her numbers yesterday were 8am high, +4.5 550mg, +9 479mg and she was really hungry becuse I had pulled her food for most of the day.
My wife had only given her 1.75 insulin shot in the morning
At 7:56pm she was 483mg I gave her 1.75 insulin.
This morning she was 609mg going back to the 2 units, I need to get her back into the 200-300 range.

In the begging of this whole mess we were advised to feed her two meals a day per the vet and this caused her to crash to low numbers. With her eating all day I have not had to stress over her crashing while we are not home.

My question is, could her high numbers be causing her to want to eat more food?
When we had her numbers below 200mg she ate very little food and water. With her numbers high she drinks and eats a lot all the time. She seems hungry all the time. I know the drinking water is due to her high numbers. After our ordeal with saving her and the vets bad advises I really don't trust their advises.

Thank you in advance for any and all advises and help

James

 

[Larry and Kitties]

Why did you go from 2 units to 1 3/4 units?
You are getting a relatively good drop in BG after the shot. The BGs you are measuring tends to indicate that the dose should be increased. Because of previous DKA I would be more aggressive in increase dose in order to get the BGs down

 

[Critter Mom]

could her high numbers be causing her to want to eat more food?

Yes, they certainly could. At higher numbers Willow's body won't be using nutrients as effectively because there's not enough insulin to enable the blood glucose to pass into the cells to provide energy for normal metabolism.

Can you let us know which insulin and which meter you are using, please?


Mogs
.

 

[Willow]

Why did you go from 2 units to 1 3/4 units?
You are getting a relatively good drop in BG after the shot. The BGs you are measuring tends to indicate that the dose should be increased. Because of previous DKA I would be more aggressive in increase dose in order to get the BGs down

The reason is my wife is scared to death of the cat dropping too fast on her watch! She is afraid of her not being there if the cat drops too fast. And since I was not home until later that night she was not going to be libel.

the dry food has caused the spike in bg. We just got advised other kinds of wet food we can give her and will slowly try and get her over to the wet and less dry.
Her DKA and other problems were caused by the vets. The longer we had her there the worst she got.

 

[Willow]

Yes, they certainly could. At higher numbers Willow's body won't be using nutrients as effectively because there's not enough insulin to enable the blood glucose to pass into the cells to provide energy for normal metabolism.

Can you let us know which insulin and which meter you are using, please?


Mogs
.

Glargine and alpha Trak 2

 

[Critter Mom]

Just checked your other thread, James. Can you please confirm here that Willow is being treated with Lantus and that you're using an Alphatrak 2 to measure her BG levels.

In answer to your question about ketone strips you can buy them at a pharmacy or anywhere that sells testing supplies for diabetics. Given Willow's history of DKA you might also want to consider getting a blood beta-ketone meter. The test strips aren't cheap but the peace of mind from being able to test easily and quickly for ketones is beyond worth it. (I got one to monitor my Saoirse after her recent operation and it was worth its weight in gold.)


Mogs
.

 

[Critter Mom]

Cross-post! Thanks for the confirmation.

I need to pop off to test and feed Saoirse but I'll post again later. Before I go I'd just like to say that I'm very sorry to hear about all that Willow has been through and also that I am glad that she has such loving humans who fought so very hard to save her - and succeeded!


Mogs
.

 

[Willow]

Cross-post! Thanks for the confirmation.

I need to pop off to test and feed Saoirse but I'll post again later. Before I go I'd just like to say that I'm very sorry to hear about all that Willow has been through and also that I am glad that she has such loving humans who fought so very hard to save her - and succeeded!


Mogs
.

Thank you!
Everyone said I had gone nuts! That we should put her down, four different vets advised to put her down. Good thing I don't listen very well.

 

[Willow]

Just checked your other thread, James. Can you please confirm here that Willow is being treated with Lantus and that you're using an Alphatrak 2 to measure her BG levels.

In answer to your question about ketone strips you can buy them at a pharmacy or anywhere that sells testing supplies for diabetics. Given Willow's history of DKA you might also want to consider getting a blood beta-ketone meter. The test strips aren't cheap but the peace of mind from being able to test easily and quickly for ketones is beyond worth it. (I got one to monitor my Saoirse after her recent operation and it was worth its weight in gold.)


Mogs
.

Yes and yes
Lantus

 

[Critter Mom]

Hi again, James.

It would be great if you could start up one of our spreadsheets and plug in the dosing and test results that you have for Willow. Here is the link with instructions on how to go about this:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Also, we have a very active insulin support group for cats on Lantus and Levemir and there are a number of highly experienced members there who will be able to give you a lot of help with getting Willow better regulated. Here's a link to the support group's board:

http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

There are a number of really informative forum 'stickies' at the top of the board for you to read through and learn more about Lantus and how it works.


Mogs
.

 

[Melanie and Smokey]

Everyone said I had gone nuts! That we should put her down, four different vets advised to put her down. Good thing I don't listen very well.

Very good thing you don't listen well! What a lucky girl.

You are right to not listen on that feeding only twice a day business too. Feeding multiple small meals a day eases the load on the pancreas. We definitely want to feed our diabetics more than twice a day. I have found with the ones that REALLY want to eat, it also eases their stress level. Usually they are so hungry they can't self regulate and will eat everything in front of them, so either an auto-feeder or manually feeding every 2-6 hours (depending on the cat) has worked well for us. Stopping food 2hrs before shot helps get a preshot number that isn't influenced by food so you know if it is safe to shoot.

Welcome to the board and good luck! I look forward to hearing of Willow's getting this business under control.

 

[Willow]

Hi again, James.

It would be great if you could start up one of our spreadsheets and plug in the dosing and test results that you have for Willow. Here is the link with instructions on how to go about this:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Also, we have a very active insulin support group for cats on Lantus and Levemir and there are a number of highly experienced members there who will be able to give you a lot of help with getting Willow better regulated. Here's a link to the support group's board:

http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

There are a number of really informative forum 'stickies' at the top of the board for you to read through and learn more about Lantus and how it works.


Mogs
.

I will work on this tomorrow,
Thank you so much

 

[Willow]

Very good thing you don't listen well! What a lucky girl.

You are right to not listen on that feeding only twice a day business too. Feeding multiple small meals a day eases the load on the pancreas. We definitely want to feed our diabetics more than twice a day. I have found with the ones that REALLY want to eat, it also eases their stress level. Usually they are so hungry they can't self regulate and will eat everything in front of them, so either an auto-feeder or manually feeding every 2-6 hours (depending on the cat) has worked well for us. Stopping food 2hrs before shot helps get a preshot number that isn't influenced by food so you know if it is safe to shoot.

Welcome to the board and good luck! I look forward to hearing of Willow's getting this business under control.

I will try to pull her food two hours before, she grazes all day. She has put on a lot of weight over the past two weeks. When we got her back from the vet she was skin and bones. She looked so sick and weak. Today she is looking plump!
When I pulls her food for a few hours she is so hungry when I feed her she scarfs down the food then goes and barfs it up.
The dry food is making it hard to get her numbers down. I'll work on the spread sheet tomorrow and see what others advises.

Thank you again

 

[Chris & China (GA)]

When I pulls her food for a few hours she is so hungry when I feed her she scarfs down the food then goes and barfs it up.

If it's wet food, try spreading it out thinly on a flat plate....it will force her to slow down when she's eating and help stop the "scarf and barf"

Removing the dry really can make a big difference in the numbers, so the sooner you can transition her off of it, the better....although we totally understand that there are some hard core kibble addicts out there that don't make it easy!

 

[Critter Mom]

I'm really glad to hear that Willow has managed to regain the weight she lost.


Mogs
.

 

[Willow]

If it's wet food, try spreading it out thinly on a flat plate....it will force her to slow down when she's eating and help stop the "scarf and barf"

Removing the dry really can make a big difference in the numbers, so the sooner you can transition her off of it, the better....although we totally understand that there are some hard core kibble addicts out there that don't make it easy!

Good morning,

I was looking over her numbers this morning because her pre shot is again high 659 bg.
I'll be putting them in a spread sheet so others can see and give me advises.
From a quick look at her numbers she went out of control when we transition her to only dry food.
Today I'm pulling her dry food and leaving her wet food instead to eat. Even with the wet food she just eats a little every hour. The only time she gobbles the whole thing down is when there was no food for a few hours, she will then be hungry in an hour. Pre dry food only I was getting her into the 200-300 +2 range, post dry food she is 450-600 range +2.
Interesting how the dry food is causing her numbers to stay high all day.
I hope the wet food will help bring her numbers back down to the 200-300 range.

 

[jayla-n-Drevon]

Good morning,

I was looking over her numbers this morning because her pre shot is again high 659 bg.
I'll be putting them in a spread sheet so others can see and give me advises.
From a quick look at her numbers she went out of control when we transition her to only dry food.
Today I'm pulling her dry food and leaving her wet food instead to eat. Even with the wet food she just eats a little every hour. The only time she gobbles the whole thing down is when there was no food for a few hours, she will then be hungry in an hour. Pre dry food only I was getting her into the 200-300 +2 range, post dry food she is 450-600 range +2.
Interesting how the dry food is causing her numbers to stay high all day.
I hope the wet food will help bring her numbers back down to the 200-300 range.

The wet food will lower her numbers so it is a MUST to be checking her to be sure she does not go too low-
Dry food is very high in carbs (there are a few that are acceptable (young again is 1) Dry food stays in the system MUCH longer than wet so it will keep the numbers high.
Grazing is fine and sometimes even better for a diabetic so the pancreas doesn't have to work so hard to break down a huge meal-
your doing great and we are so happy you are here and asking questions!!

 

[Critter Mom]

Today I'm pulling her dry food and leaving her wet food instead to eat.

You would be better to gradually phase out the dry in a controlled fashion, James. It may be trite to say so but diabetes treatment is very much a marathon, not a sprint. Cutting out dry like that could potentially result in a drop of hundreds of points in BG level and you would be putting Willow at much greater risk of having a hypo episode - I can't stress this point strongly enough. You're working with a depot insulin: even if you were to reduce the dose starting at the next injection it would take several cycles for the current depot to drain down to a level where you would have some idea that Willow was getting a safe amount of insulin for the lower carb load.

Gradually adjusting the diet will allow you to adjust doses as you go along (post on the Lantus ISG board for input on dosing) in order to keep Willow safe. The gradual transition will also be kinder on her digestive system.


Mogs
.

 

[Chris & China (GA)]

It is possible to remove the dry quickly, but it's very important that if you do, you are home testing often!!

It's much safer to transition off the high carb dry food over a few days though. Just gradually reduce the amount of dry she's getting over the next few days until she's getting none.

Also, make sure you have a "hypo kit" set up with everything you need in case you need it. It should include several cans of high carb food (like Fancy Feast Gravy Lovers), Karo/honey/syrup, an extra container of test strips (in a hypo emergency, you do NOT want to run out of strips so a lot of us keep a spare package around at all times) and even a spare meter just in case your first one ends up broken somehow or with a dead battery. Also, printing out the "How to Treat Hypo's" document and keeping it with the "kit" is a good idea, just in case the message board is down or you lose computer access when you need it most.

 

[Critter Mom]

It is possible to remove the dry quickly ...

James, this is true but having had to transition my own cat from high to low carb 'cold turkey' out of sheer necessity (after an adverse reaction to a parasite treatment she refused the high carb dry our previous vet had prescribed for her and would only eat low carb wet) I would not recommend it. If I hadn't been home testing I would have lost her. It was a nightmarish 108 hours I would not wish on anyone.


Mogs
.

 

[Critter Mom]

PS - I am to this day beyond grateful to the FDMB members who came to our aid at that time.

 

[Willow]

You would be better to gradually phase out the dry in a controlled fashion, James. It may be trite to say so but diabetes treatment is very much a marathon, not a sprint. Cutting out dry like that could potentially result in a drop of hundreds of points in BG level and you would be putting Willow at much greater risk of having a hypo episode - I can't stress this point strongly enough. You're working with a depot insulin: even if you were to reduce the dose starting at the next injection it would take several cycles for the current depot to drain down to a level where you would have some idea that Willow was getting a safe amount of insulin for the lower carb load.

Gradually adjusting the diet will allow you to adjust doses as you go along (post on the Lantus ISG board for input on dosing) in order to keep Willow safe. The gradual transition will also be kinder on her digestive system.


Mogs
.

Hi

Here are her numbers for today
7:36AM 659BG 2 untis pulled dry food gave wet, then gave a little dry after she ate most of the wet
+4 529BG
So she only came down 130BG in 4 hours
I really need to get her into the 300 range
On a note her poop this morning was a lot for the size of cat she is!

 

[Willow]

James, this is true but having had to transition my own cat from high to low carb 'cold turkey' out of sheer necessity (after an adverse reaction to a parasite treatment she refused the high carb dry our previous vet had prescribed for her and would only eat low carb wet) I would not recommend it. If I hadn't been home testing I would have lost her. It was a nightmarish 108 hours I would not wish on anyone.


Mogs
.

Hi

How do I share my numbers?

 

[Willow]

https://docs.google.com/spreadsheets/d/1a0C8kkDcMG2yvjiE7R9ZbVRRXXKs4Zz6PDuTSqkmOBI/pubhtml

Here is my spreed sheet.
It really does not give the curves we did and Im missing some numbers my wife had done