Need help interpreting Bodie's numbers

[Bodinator]

I have been testing Bodie twice a day for the past few days and I can't make any sense out of it. I've been reluctant to test any more than that because he's getting pretty feisty about the blood draw and bites me a bit (doesn't clamp down though, little lovey) and gets really stressed out if I take too long. (Which I do). He is also hungry all the time, super aggressive about any opportunity to get food, jumps up on the counter to lick anything that might be left there, tips over the trash can and I can't get the treats out before I give him the BG test because he goes too nuts. Please note on my SS that I gave him two evening fur shots Friday and Saturday. Ugh.

I emailed the link to the vet and she thinks it's one of three scenarios:
1. Somogyi effect At some point his BG might be too low, although he's never tested that low. So maybe not.
2. Bodie might need more insulin. We have increased it over the last few weeks to 3 units of Lantus. The vet is afraid he might become insulin resistant and is reluctant to increase it again. That's a scary one.
3. He has some undiagnosed condition. She is thinking pancreatitis, faulty cortisol levels or even cancer. She wants to do either an ultrasound or a GI panel for intestinal disease.

Thank you for your help.

 

[JanetNJ]

I have been testing Bodie twice a day for the past few days and I can't make any sense out of it. I've been reluctant to test any more than that because he's getting pretty feisty about the blood draw and bites me a bit (doesn't clamp down though, little lovey) and gets really stressed out if I take too long. (Which I do). He is also hungry all the time, super aggressive about any opportunity to get food, jumps up on the counter to lick anything that might be left there, tips over the trash can and I can't get the treats out before I give him the BG test because he goes too nuts. Please note on my SS that I gave him two evening fur shots Friday and Saturday. Ugh.

I emailed the link to the vet and she thinks it's one of three scenarios:
1. Somogyi effect At some point his BG might be too low, although he's never tested that low. So maybe not.
2. Bodie might need more insulin. We have increased it over the last few weeks to 3 units of Lantus. The vet is afraid he might become insulin resistant and is reluctant to increase it again. That's a scary one.r
3. He has some undiagnosed condition. She is thinking pancreatitis, faulty cortisol levels or even cancer. She wants to do either an ultrasound or a GI panel for intestinal disease.

Thank you for your help.

I can't see your spreadsheet... it must be set to private.

If he's that hungry he may need a bigger snack in between feedings. Unregulated diabetics can not utilize nutrients in food properly and so are literally starving even though they are eating. they need more food then a regulated or non diabetic cat. How many ounces are you feeding?

 

[Bodinator]

I changed the setting, I think you should be able to see his ss now, sorry.

He gets 3 oz in the morning and 3 oz in the evening. A bedtime snack of 1/4 can so add 3/4 oz. For the last few days I've been feeding him 1/2 can during the day, 1/4 can at a time, at least two hours apart because he's so hungry.

 

[JanetNJ]

I changed the setting, I think you should be able to see his ss now, sorry.

He gets 3 oz in the morning and 3 oz in the evening. A bedtime snack of 1/4 can so add 3/4 oz. For the last few days I've been feeding him 1/2 can during the day, 1/4 can at a time, at least two hours apart because he's so hungry.

Ok, so right now he's getting about 2 3/4 cans a day.... how much does your cat weigh? Is he underweight, overweight, or just right? Did he loose any weight before diagnosis?

so if he's hungry maybe you need to up it. Maybe do a can in the morning, 3/4 ths of a can in the afternoon, a can in the evening, and another 3/4ths can in the evening. that's 3 1/2 cans a day. she may need the extra food until her diabetes is well regulated. If she's still hungry after that do 4 cans a day.

 

[JanetNJ]

I'm not a lantus user or expert, so I'll let others speak to that, but I do want to say that I see that you went from 2 to 3 units with no stops in between. The protocol most here follow is raising the dose by no more than .25 so that the ideal dose isn't accidentally skipped.

 

[Tanya and Ducia]

With limited testing it's hard to be sure as to what's going on. IMHO the 3 unit dose is too large. And since it is not known what is going on in the PM cycle bouncing is the guess I am making to explain his red numbers.

I've been reluctant to test any more than that because he's getting pretty feisty about the blood draw and bites me a bit

Do you offer him treats/snacks after each testing session? It helps a lot.

 

[Bodinator]

With limited testing it's hard to be sure as to what's going on. IMHO the 3 unit dose is too large. And since it is not known what is going on in the PM cycle bouncing is the guess I am making to explain his red numbers.

Do you offer him treats/snacks after each testing session? It helps a lot.

Yes, he gets some dehydrated chicken treats. Because I have to hide them until after we do the test I am not sure if he associates the treats as a reward though.

 

[Bodinator]

Ok, so right now he's getting about 2 3/4 cans a day.... how much does your cat weigh? Is he underweight, overweight, or just right? Did he loose any weight before diagnosis?

so if he's hungry maybe you need to up it. Maybe do a can in the morning, 3/4 ths of a can in the afternoon, a can in the evening, and another 3/4ths can in the evening. that's 3 1/2 cans a day. she may need the extra food until her diabetes is well regulated. If she's still hungry after that do 4 cans a day.

He has been losing weight for a while but I think I had been disguising it by feeding him more. I thought that I should regulate his food and not make sudden changes with that either. Can you overdo the amount of food, or it just passes through without him getting any nutrition.

 

[Bodinator]

Ok, so right now he's getting about 2 3/4 cans a day.... how much does your cat weigh? Is he underweight, overweight, or just right? Did he loose any weight before diagnosis?

Ah, forgot to say, he's underweight now.

 

[JanetNJ]

He has been losing weight for a while but I think I had been disguising it by feeding him more. I thought that I should regulate his food and not make sudden changes with that either. Can you overdo the amount of food, or it just passes through without him getting any nutrition.

If he's underweight and hungry this is a no brainer. feed him more. Just no food two hours prior to preshot testing. otherwise if he's hungry, feed him. eventually his food needs will reduce as his numbers come down. really 3 cans a day is about what an average cat might eat. it's not excessive to go to 4 cans if he needs it. My cat Zimmy would eat 4-5 cans a day and he wasn't diabetic.... just a big guy (17 lbs when healthy).

 

[MrWorfMen's Mom]

I agree with Tanya. I think Bodie is bouncing and going low enough on some cycles to trigger his low BG defences. When a cat is diabetic, they get used to their BG being elevated and lower number become foreign to them which sets off their bodily defences and causes them to elevate their BG to even higher numbers. This often leads the vet to think more insulin is needed when in fact, it might mean less is needed.

I would NOT give a full dose shot of insulin to Bodie if his pre-shot number is under 200. You have given fairly hefty doses of insulin, (2 to 3 units) at lower pre-shot numbers and that is a recipe for bouncing. Bouncing makes it difficult to see what dose of insulin is ideal for Bodie. In the early days, it is better to make small dose changes of 0.25u at a time and ease the blood sugar down keeping bouncing to a minimum. If Bodie is below 200 at pre-shot, I suggest you post in the Lantus forum for some advice. Your choices when the BG is below 200 at pre-shot is to skip the dose or give a reduced dose but shooting a full dose on pre-shot numbers below 200 is not something we encourage folks new to the diagnosis to do without some guidance.

Right now, Bodie can't get the nutrients he needs from the food he consumes, so he needs more food. As Janet says, give him what he needs to keep him relatively happy. As he gets more regulated, his need for food will decrease.

I would also recommend that you take a test every evening cycle. If you can test before you turn in for the night, it will give you more data to see what Bodie is up to and fill in the big picture so that dose decisions can be made more easily. Many cats go lower at night so those night readings can be very helpful.

 

[Bodinator]

I agree with Tanya. I think Bodie is bouncing and going low enough on some cycles to trigger his low BG defences. When a cat is diabetic, they get used to their BG being elevated and lower number become foreign to them which sets off their bodily defences and causes them to elevate their BG to even higher numbers. This often leads the vet to think more insulin is needed when in fact, it might mean less is needed.

I would NOT give a full dose shot of insulin to Bodie if his pre-shot number is under 200. You have given fairly hefty doses of insulin, (2 to 3 units) at lower pre-shot numbers and that is a recipe for bouncing. Bouncing makes it difficult to see what dose of insulin is ideal for Bodie. In the early days, it is better to make small dose changes of 0.25u at a time and ease the blood sugar down keeping bouncing to a minimum. If Bodie is below 200 at pre-shot, I suggest you post in the Lantus forum for some advice. Your choices when the BG is below 200 at pre-shot is to skip the dose or give a reduced dose but shooting a full dose on pre-shot numbers below 200 is not something we encourage folks new to the diagnosis to do without some guidance.

Right now, Bodie can't get the nutrients he needs from the food he consumes, so he needs more food. As Janet says, give him what he needs to keep him relatively happy. As he gets more regulated, his need for food will decrease.

I would also recommend that you take a test every evening cycle. If you can test before you turn in for the night, it will give you more data to see what Bodie is up to and fill in the big picture so that dose decisions can be made more easily. Many cats go lower at night so those night readings can be very helpful.

Thank you, this is all great advice. Definitely do the bedtime test.

 

[Bodinator]

If he's underweight and hungry this is a no brainer. feed him more. Just no food two hours prior to preshot testing. otherwise if he's hungry, feed him. eventually his food needs will reduce as his numbers come down. really 3 cans a day is about what an average cat might eat. it's not excessive to go to 4 cans if he needs it. My cat Zimmy would eat 4-5 cans a day and he wasn't diabetic.... just a big guy (17 lbs when healthy).

Thank you. It's a bit overwhelming and what seems like a no-brainer wasn't obvious to me. I think I thought food was the anti-insulin but it's not that simple.
We're getting there.