? Need Help - high glucose 494

[Frannie G]

Hi,

First time poster and I don't have a spreadsheet setup yet because getting glucose readings has been really difficult.

Lara is 8 years old is on 0.5 U of glargine 2x a day. Insulin was started at the beginning of September. She's a small cat (8 lbs) and got down to 6.7 lbs. She still hasn't gained weight much back. She is on Fancy Feast classic / flaked and loves purebites treats.

Last attempt for a glucose curve was on 10/31.
AMPS = 175
0.5 U
no success getting a sample until +6 = 293

Last week she was eating well and no ketones in her urine.

I was out of town this weekend and official pet sitters fed / gave her her shots. She ate fine Fri and Sat. This morning (EST) she was sluggish and not interested in food. They did NOT give her a shot (as directed). They also found signs of vomit.

When I got home (one hour ago) she was still super tired and sluggish (and skinny). Easy to get a glucose reading this time = 494. I also found signs of clear/green vomit when I got home.

Should I give her 0.5U to get the glucose levels down? She's drinking a little water right now, but it's taking a bit of effort. I will also try some food. It's been 24 hours with no food / no insulin.

Plan is to take her in to the vet tomorrow first thing.

Thanks,

Frannie (and Lara)
glargine, 0.5 U
Relion classic meter

 

[Basic's Mom]

Hi,

First time poster and I don't have a spreadsheet setup yet because getting glucose readings has been really difficult.

Lara is 8 years old is on 0.5 U of glargine 2x a day. Insulin was started at the beginning of September. She's a small cat (8 lbs) and got down to 6.7 lbs. She still hasn't gained weight much back. She is on Fancy Feast classic / flaked and loves purebites treats.

Last attempt for a glucose curve was on 10/31.
AMPS = 175
0.5 U
no success getting a sample until +6 = 293

Last week she was eating well and no ketones in her urine.

I was out of town this weekend and official pet sitters fed / gave her her shots. She ate fine Fri and Sat. This morning (EST) she was sluggish and not interested in food. They did NOT give her a shot (as directed). They also found signs of vomit.

When I got home (one hour ago) she was still super tired and sluggish (and skinny). Easy to get a glucose reading this time = 494. I also found signs of clear/green vomit when I got home.

Should I give her 0.5U to get the glucose levels down? She's drinking a little water right now, but it's taking a bit of effort. I will also try some food. It's been 24 hours with no food / no insulin.

Plan is to take her in to the vet tomorrow first thing.

Thanks,

Frannie (and Lara)
glargine, 0.5 U
Relion classic meter

I'm no expert yet, but it is miserable waiting for a response.

I would definitely give the scheduled insulin. Check her BG first always. If you are struggling to get a BG, a warm paper towel will help with getting more blood. The more you do this, the ear will create more capillaries. It will get easier. Check with your vet to see if you can have a freestyle libre installed until your cat's bg has stabilized. You won't have to poke Lara while the libre is on. I can include some links if you'd like. My post today has libre info that may be useful to you.

Do you have any antinausea meds for Lara? She will need them if she isn't eating much food. My cat did not respond to cerenia at all and I didnt realise it for a week or so. I had to get him ondansetron and he is still on it. I suggest everyone just start their cat on ondansetron instead of cerenia. Do not let the vet tell you that your cat isn't puking so they don't need it. They definitely do, if they are nauseous. And when they are sick and aren't feeling well, it isn't a great time to test out meds. Go for what we know works.

If you have them, try to get a ketones test tonight, either with a strip or meter. Strips are really inexpensive, but I had to get a meter because I wasn't always catching him. Those are $1 a strip (meter). I read that you are taking Lara to the vet, but if ketones are present, insulin, food, and water are what will help Lara at home, until you get there.

My cat got diagnosed right after I got back from being out of town. He wasn't eating his normal amount of calories and became extremely ill (hepatic lipidosis) on top of ketones and feline diabetes. This was the beginning of September.

 

[Basic's Mom]

Hi,

First time poster and I don't have a spreadsheet setup yet because getting glucose readings has been really difficult.

Lara is 8 years old is on 0.5 U of glargine 2x a day. Insulin was started at the beginning of September. She's a small cat (8 lbs) and got down to 6.7 lbs. She still hasn't gained weight much back. She is on Fancy Feast classic / flaked and loves purebites treats.

Last attempt for a glucose curve was on 10/31.
AMPS = 175
0.5 U
no success getting a sample until +6 = 293

Last week she was eating well and no ketones in her urine.

I was out of town this weekend and official pet sitters fed / gave her her shots. She ate fine Fri and Sat. This morning (EST) she was sluggish and not interested in food. They did NOT give her a shot (as directed). They also found signs of vomit.

When I got home (one hour ago) she was still super tired and sluggish (and skinny). Easy to get a glucose reading this time = 494. I also found signs of clear/green vomit when I got home.

Should I give her 0.5U to get the glucose levels down? She's drinking a little water right now, but it's taking a bit of effort. I will also try some food. It's been 24 hours with no food / no insulin.

Plan is to take her in to the vet tomorrow first thing.

Thanks,

Frannie (and Lara)
glargine, 0.5 U
Relion classic meter

You can update your signature with Lara's diagnosis date, type of dosing method, insulin, and any other pertinent information. Do you have a link on how to set up your spreadsheet? @Bandit's Mom usually helps with those. They are in India and I am not sure of the time difference.

 

[Basic's Mom]

Hi,

First time poster and I don't have a spreadsheet setup yet because getting glucose readings has been really difficult.

Lara is 8 years old is on 0.5 U of glargine 2x a day. Insulin was started at the beginning of September. She's a small cat (8 lbs) and got down to 6.7 lbs. She still hasn't gained weight much back. She is on Fancy Feast classic / flaked and loves purebites treats.

Last attempt for a glucose curve was on 10/31.
AMPS = 175
0.5 U
no success getting a sample until +6 = 293

Last week she was eating well and no ketones in her urine.

I was out of town this weekend and official pet sitters fed / gave her her shots. She ate fine Fri and Sat. This morning (EST) she was sluggish and not interested in food. They did NOT give her a shot (as directed). They also found signs of vomit.

When I got home (one hour ago) she was still super tired and sluggish (and skinny). Easy to get a glucose reading this time = 494. I also found signs of clear/green vomit when I got home.

Should I give her 0.5U to get the glucose levels down? She's drinking a little water right now, but it's taking a bit of effort. I will also try some food. It's been 24 hours with no food / no insulin.

Plan is to take her in to the vet tomorrow first thing.

Thanks,

Frannie (and Lara)
glargine, 0.5 U
Relion classic meter

I would also allow Lara to eat whatever they want right now, even if it is high carb. When my cat isn't feeling great, he is less likely to eat his 'good food' and right now it is more important to get calories in Lara for possible ketones and because of the weight loss that has already occurred.

I won't be offended if you don't take my advice either. I'm no expert on this subject.

 

[Wendy&Neko]

Definitely give the insulin.

Are you testing her for ketones as well? I'm worried when cats are in high numbers, sluggish and not eating. Not enough insulin can be part of the recipe for DKA. You can get ketostix or other urinary ketones tester at most human pharmacies.

As Sybil mentions, there is some basic information we like to see in the signature to help us help you. More information in this post.
New? How You Can Help Us Help You!

The high number you are seeing could be from a number of things, skipping insulin is one. My kitty regularly tested that high and higher until we got closer to a good insulin dose. If your kitty has been on the same dose for over a couple months, it's time to evaluate the dose and see if it needs changing. Most cats insulin needs change over time.

 

[Frannie G]

I've given her 0.5 U dose. She drank quite a bit of water, but is not interested in eating anything.

I've updated my signature. I had started a spreadsheet, but just don't have much glucose data.

I've been able to test her urine for ketones pretty easily. It's usually low, but it has gotten up to 15-40 a few time and takes a day or 2 to go down.

For testing her glucose: I switched to 26 gauge lancets, that helped and I use the lancet just as a holder. Rubbing the ear before and milking it to get a drop and put it on my fingernail works pretty well. 2 weeks ago she flicked her ear while I was getting a sample and it tore and I still didn't get enough blood, so I took a break for a while. She didn't like the warm rice sock thing, but I'll need to try some other ways to warm her ear up before taking a sample.

When the vet first started her at 1.0 U her glucose level dropped below 50, so we can't be too aggressive without more numbers. She's a really small cat.

Thanks,

 

[Wendy&Neko]

I only used the rice sock once. I used a pill bottle (or old film canister hanging around) filled with hot water. Much smaller and easier to manipulate.

Any data you have that you can share with us in a spreadsheet will help us help you.

Sometimes when cats first start insulin, they are very sensitive to it and drop low, but over time it becomes not enough. You are right, more data is needed. But I am concerned about the ketones numbers you are seeing. It should never be above trace. Anything above that means a visit to the vet.

Are you using U-100 syringes with half unit markings on them? We typically change doses by 0.25 units at a time. We eyeball that distance between the 1/2 unit marks.

Here are some tips to help get her to eat: Suggestions on How to Stimulate Kitty's Appetite