need help interpreting glucose curve - kitty driving us nuts

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Pussina2001

Member Since 2012
Hello, everyone.
Thanks ahead for your help.

Pussina has been on Lantus for a week (2 units twice daily) before we did a curve at home using ReliOn. We got very confusing results, and the vet said she wants to do a curve at the clinic now, esp since we got really low numbers at some point, but Pussina was not exhibiting hypo signs. Have not measured ketones - not smth the doctor told me about, I guess I should get the strips. In fact, she is pretty energetic and is hungry about 6 hours after we've fed her. She is drinking, but not as much as she used to before insulin. But she is waking us up every night with mewing and clawing (we are delicious) - could this just be a problem of not feeding her enough? She is 7 pounds, 12 years old. Another note: she was missing for 3 months, then after she came back, she got diagnosed about month in. She had gained 1 pound since she came back and doctor said she would be ok at 8 pounds. She's pretty small-boned. Also: husband and I measured our glocose and we got nice, non-diabetic numbers, so I think the meter is working ok.

her original glucose at diagnosis was 566

I'd love people's input before we go retest her at the vet and any questions we should ask:

12/09/12:
2 am ----- 21 (def not comatose) 2-4 am going nuts, mewing etc.
6:10 am---98 (gave her 3 oz of Fancy Feast, 2 units of Lantus after she ate)
9:15 am---161
11:30 am--247
1:45 pm--335 (starting to ask for food)
3:45 pm --350
5:45 pm --360 (gave her 3 oz of Fancy Feast, 2 units of Lantus after she ate)
7:45 pm --380
9:45 pm--409
(3 am-5 am going nuts scratching, mewing etc)

12/10/12
5:20 am --315 (gave her 3 oz of Fancy Feast, 2 units of Lantus after she ate)
5:35 pm--86
9 pm -----114

12/11/12
5:35 pm ----37

Thank you thank you thank you.
 
Re: need help interpreting glucose curve - kitty driving us

Holy Toledo!!! You gave her 2u of Lantus after she hit 21!!!! The reason she was meowing like crazy is because she knew she needed to eat to stave off hypo. You are getting an inverse curve which normally signals too much insulin.

As a rule when just starting out you don't give insulin if they are below 200. Some of us do shoot lower numbers but that is because we have months and months of testing data and know how our cats will react to a particular dose. Even with that said a 21 at any point in the cycle would earn the cat a reduction in dose. Ideally you are looking for a dose that holds them within the range of 40-120 on a human meter. Anything below 40 is an automatic dose reduction.

if you haven't all ready please read the sticky notes over on the Lantus TR forum here http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
When in doubt please post here or over on the Lantus TR Group with your number and someone will help you decide if it is safe to shoot.


Mel, Maxwell, Autumn & The Fur Gang
 
Re: need help interpreting glucose curve - kitty driving us

She is dipping waaaaay too low! You're very lucky that she's not experiencing ER-visit hypos...yet! The general recommendation is to start kitties on 1u of insulin, so her already being on 2u is a sign that she's getting too much. That might be why you're seeing the nutty kitty behavior and the bouncing numbers. And since you're just starting out, it's suggested to NOT give a shot if she's under 200.

For a nice, pre-formatted spreadsheet to put your numbers in, check out this post here: How to Get a SS.
 
Re: need help interpreting glucose curve - kitty driving us

Also, while she's getting regulated, she's going to be ravenous. I would suggest feeding her a bit more than 2 cans of FF a day and spreading it throughout the day into smaller meals, which seems to work better for diabetic cats. Also, make sure you add more water to it, which helps stretch meals farther, fills up the cat's belly, and keeps them nicely hydrated, all things a diabetic kitty needs.
 
Re: need help interpreting glucose curve - kitty driving us

Yep, doctor said start with 2 units twice per day because her initial glucose reading (at diagnosis) was so high...so I did.

But, when I told the doctor that she's being ravenous, she said "maybe we should increase the dose to 3 units..." seems like that would kill her.

Should I bring her to the vet tomorrow for the vet gluclose curve, or should I go ahead and lower insulin on my own (and feed her more) and see how she does. She's also getting worse and worse at ear pricks. Now we have to hold her down.
 
Re: need help interpreting glucose curve - kitty driving us

Go ahead and reduce the dose yourself you on't need your vets approval. She's probably cranky about the ear pricks because of feeling crappy because of too much insulin.
 
Re: need help interpreting glucose curve - kitty driving us

There is nothing a vet is going to do when running a curve that you can't do at home, plus a curve at a vet's is horribly inaccurate, because almost every cat is stressed at the vet's (strange smells, dogs barking, people that aren't mom etc) and stress raises BGs.

Personally if she was mine I would drop back to 1u or even .5u twice a day, hold that dose for 5-7 days while testing both blood sugar and for ketones...they did tell you to test for ketones right?

Another trick with ear testing is to make sure they always get treats before and after so they come to associate the test with something positive. Any low carb treat will work and it doesn't always have to be food either, my one guy isn't big on food treats but oh the brush! He would crawl over broken glass for a good brushing, so that is what we used with him.

Mel. Maxwell, Autumn & The Fur Gang
 
Re: need help interpreting glucose curve - kitty driving us

It seems highly irresponsible of your vet to just arbitrarily determine her insulin needs to be increased to 3u because of a hungry appetite?? She's an 8 pound cat! I would drop her to 1u (or even .5u), do the curve at home, and find a new vet. Your current one seems set on killing her.

ETA: cross-post with Mel. Looks like we both said similar things re: dosage. :-D
 
Re: need help interpreting glucose curve - kitty driving us

No, didn't tell me to test for ketones...

I think I'll follow your advice and drop her to .5 units twice a day and feed her more. And do another curve next weekend. If her pre-shot values are less than 120, should I still give her the shot? I can't do the curve during work week, so I don't know the "true nadir", which is what you're supposed to base the dose off according to tight regulation, correct?

Thank you!
 
Re: need help interpreting glucose curve - kitty driving us

If her preshot is below 120 then you will want to stall feeding her and her shot if you can for 30 minutes and retest to make sure she is rising...you never want to shoot a dropping number. When in doubt you can always post your number here and ask for dosing help. Just start a new thread with a title along the lines of Dosing help Lantus preshot and the number...that way those that use lantus can jump on and help you out.

I have some dosing experience with Lantus but my girl is on Levemir and my boy that was on Lantus wasn't on it long enough before going into remission to feel comfortable helpimg more than beyond the basics. But there is a huge Lantus user community here that are more than willing to help out. :-D

As for Ketones you want to get some ketostixs from any pharmacy that carries diabetic supplies they are the same ones that human diabetics use. Basically you want to try to catch her in the litter box peeing and hold it in the stream of pee, although if you can't get it that way let us know we have lots of tricks for catching pee...lol

Mel, Maxwell, Autumn & The Fur Gang
 
Re: need help interpreting glucose curve - kitty driving us

You can buy ketone test strips for fairly cheap at Walmart. They're super easy to use and you just have to stalk your cat to the litter box and slip one under her while she's doing her business.

If her pre-shot values (AMPS and PMPS) are less than 200 you generally don't want to shoot, not until you've collected more data on her. Here's some more information on low numbers.

You don't have to do a curve every day; you can spot test them whenever you have time and do a week-long "curve" of various values throughout the day and night that you might have grabbed over the week. Nadir occurs around +5 to +7 hours since the last shot, so it's ideal to get a nadir test at least once a 24-hour period to make sure she's not dipping too low.

Here are some links to the Tight Regulation Protocol and to the LL board.
 
Re: need help interpreting glucose curve - kitty driving us

I was cross-posting with MommaOfMuse again. :lol:

Wanted to give you one last link that I hope you won't ever need since you're decreasing her dose: Hypos can kill
 
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