? New and needing advice as BG is extremely high

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Jade_Leah

Jade_Leah

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My 12 year old cat was diagnosed with diabetes about a year ago. We had her on Bexacat for 9 months but it caused her to have chronic diarrhea and eventually stopped regulating her blood glucose. About a month and a half ago we made the switch the insulin and bumped up the dose by a unit weekly until we were at 6 units but she still wasn't regulated. Last week I asked for a dull blood panel (the last having been done in August when she suddenly was peeing on my bed and couch and ended up having a UTI) and when the results came back last Friday it showed quite elevated kidney values. I was horrified and she ended up in the emergency hospital for 3 days for testing an IV fluids amongst other things. They were able to bring her kidney levels down, but she then plateaued, which told us this would be a chronic kidney issue. Her pancreas also looked off (despite never having symptoms of pancreatitus). All of this led us to guess that those issues were causing her body to resist the insulin. While on the IV fluids her insulin worked for the first time ever, even to the point that she became hypoglycemic after one dose, so they took it down to 3 units from 6. Since coming home her blood glucose has been high again, which led me to asking her regular vet for a another blood panel and he also bumped her insulin back up to 4 units. I was petrified that her values had skyrocketed, leading to the insulin not working again, but while a bit more elevated since the last test, they are were not dire. I saw an internal medicine specialist who works for the hospital she was in on Monday. Her kidney values were actually a tiny bit better than what I'd seen the previous week. After the hospital stay I was sent home with 2x 2 ml daily aluminum hydroxide that she despises as well as some "take as needed" pain and nausea drugs. The specialist changed this to 2x 1ml daily and I got it componded into a chicken flavor. There has only been one day since she came home from the hospital that her BG has been decent and it is honestly getting worse as time goes on, even as we increase the dose of insulin. The specialist had me do an at home glucose curve and based on those results he had me up the dose to 4.5 units. It hasn't helped and as of this morning her BG was at 602. Her regular vet suggested another at home curve today, and which I am going to do, and an increase to 5 units, but the high number is terrifying me. She is still eating and drinking and being pretty normal for an older kitty with the issues she has. What is the protocol for BG this high? I had initially posted on Reddit asking for help in juggling diabetes and kidney disease and they suggested this forum. I'm sorry if this isn't a 911 situation, but the 600 reading are horrifying me.
 
Jade_Leah said:
My 12 year old cat was diagnosed with diabetes about a year ago. We had her on Bexacat for 9 months but it caused her to have chronic diarrhea and eventually stopped regulating her blood glucose. About a month and a half ago we made the switch the insulin and bumped up the dose by a unit weekly until we were at 6 units but she still wasn't regulated. Last week I asked for a dull blood panel (the last having been done in August when she suddenly was peeing on my bed and couch and ended up having a UTI) and when the results came back last Friday it showed quite elevated kidney values. I was horrified and she ended up in the emergency hospital for 3 days for testing an IV fluids amongst other things. They were able to bring her kidney levels down, but she then plateaued, which told us this would be a chronic kidney issue. Her pancreas also looked off (despite never having symptoms of pancreatitus). All of this led us to guess that those issues were causing her body to resist the insulin. While on the IV fluids her insulin worked for the first time ever, even to the point that she became hypoglycemic after one dose, so they took it down to 3 units from 6. Since coming home her blood glucose has been high again, which led me to asking her regular vet for a another blood panel and he also bumped her insulin back up to 4 units. I was petrified that her values had skyrocketed, leading to the insulin not working again, but while a bit more elevated since the last test, they are were not dire. I saw an internal medicine specialist who works for the hospital she was in on Monday. Her kidney values were actually a tiny bit better than what I'd seen the previous week. After the hospital stay I was sent home with 2x 2 ml daily aluminum hydroxide that she despises as well as some "take as needed" pain and nausea drugs. The specialist changed this to 2x 1ml daily and I got it componded into a chicken flavor. There has only been one day since she came home from the hospital that her BG has been decent and it is honestly getting worse as time goes on, even as we increase the dose of insulin. The specialist had me do an at home glucose curve and based on those results he had me up the dose to 4.5 units. It hasn't helped and as of this morning her BG was at 602. Her regular vet suggested another at home curve today, and which I am going to do, and an increase to 5 units, but the high number is terrifying me. She is still eating and drinking and being pretty normal for an older kitty with the issues she has. What is the protocol for BG this high? I had initially posted on Reddit asking for help in juggling diabetes and kidney disease and they suggested this forum. I'm sorry if this isn't a 911 situation, but the 600 reading are horrifying me.
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@Sienne and Gabby (GA)
 
Hello and welcome. Sorry to hear the Bexacat didn't work out for you and Lola. Prozinc is a good insulin for cats.

I'm looking forward to seeing a spreadsheet. Details how to do so in this post:
New? How You Can Help Us Help You! Let us know if you need help setting up a spreadsheet as we have people who can help.

On this message board, we don't increase doses by as large an amounts as your has been suggesting. I can't say without seeing the data, but it's possible you've bypassed a good dose. If a cat sees blood sugar numbers lower than they are used to, or drop fast, it's very common for their bodies to do what we call bouncing, which results in higher number:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

It's also possible that Lola needs a higher insulin dose. Some cats will go lower when they have fluids.

High numbers are not a medical emergency, which is what we like to use the 911 for. My girl had two endocrine conditions that meant she needed a higher dose, and got up to 8.75 units. She did eventually get chronic kidney disease too, and a few other things as you can see from my signature.
 
Wendy&Neko said:
Hello and welcome. Sorry to hear the Bexacat didn't work out for you and Lola. Prozinc is a good insulin for cats.

I'm looking forward to seeing a spreadsheet. Details how to do so in this post:
New? How You Can Help Us Help You! Let us know if you need help setting up a spreadsheet as we have people who can help.

On this message board, we don't increase doses by as large an amounts as your has been suggesting. I can't say without seeing the data, but it's possible you've bypassed a good dose. If a cat sees blood sugar numbers lower than they are used to, or drop fast, it's very common for their bodies to do what we call bouncing, which results in higher number:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

It's also possible that Lola needs a higher insulin dose. Some cats will go lower when they have fluids.

High numbers are not a medical emergency, which is what we like to use the 911 for. My girl had two endocrine conditions that meant she needed a higher dose, and got up to 8.75 units. She did eventually get chronic kidney disease too, and a few other things as you can see from my signature.
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I apologize for using 911, but I wasn't actually sure if BG in the 600s was an emergency or not. I appreciate your response. I am going to fill out the spreadsheet to the best of my ability and will add a link to it.
 
My girl's early days the meter quite often said "Hi", meaning it was too high to read, or over 600 on a human meter. It is not a medical emergency. She did eventually become regulated. I also see you are using the AT3, which will read even higher that the human meter does.
 
Sienne and Gabby (GA) said:
You noted in your signature that Lola is eating "combo" food. What are you feeding her?
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Due to Lola's hospitalization and diagnosis of kidney disease/chronic pancreatitus, the specialist and my regular vet have basically told me to feed her whatever she will eat to make sure she does eat. In the hospital she was offered a bunch of different types of Hills wet and dry food including: wet w/d & k/d and dry w/d and k/d. She can be pretty picky about wet food so she only wanted the dry w/d at home. The specialist suggested we switch her to Hills k/d only (wet and dry) which I've been trying to transition her to, but I know this will be bad for her diabetes. I've scoured the internet and found helpful links on this site to Weruva BFF play pates which cater to both the diabetes and kidney disease. The specialist suggested sticking to Hills because they're better regulated by the FDA? I was skeptical and have also purchased the Weruva and have been offering it to her. She is just so obsessed with dry, crunchy food. I know the best thing is to get her on wet food entirely, but I fear she will not eat and will further damage her kidneys. I also mix her aluminum hydroxide in Churus to get her to take it with less of a struggle. If she refuses to eat anything else I will give her treats I have on hand so she can safe get her insulin and aluninum hydroxide. I know that I'm probably doing this all wrong, but I am willing to do anything to help get her well, so all advice is welcome!
 
Wendy&Neko said:
My girl's early days the meter quite often said "Hi", meaning it was too high to read, or over 600 on a human meter. It is not a medical emergency. She did eventually become regulated. I also see you are using the AT3, which will read even higher that the human meter does.
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Thank you for your response!
 
I honestly doubt that the Hill's foods are better regulated. You vet may be unaware that the pet food manufacturers lost a class action suit due to calling their food "prescription." There is nothing that would require a prescription that's included in pet food. Most companies have changed the labeling on their foods. Basically, they got their hands slapped because the sole purpose of calling a food prescription was to be able to charge more. As an example, the "prescription" dry diabetic foods are wildly high in carbohydrates.

I would agree with your vet. It's important that your kitty eats! Just one item, though. The phosphorus binder needs to be mixed in to the food that you're giving Lola. It neutralizes the phosphorus in the food. If you give it in something like a Churu, it may not be helping as much as you'd like. You have to be sure you're giving the Churu + binder right before you feed your cat. You could try mixing the Churu into Lola's food and see if that will encourage her to eat the "real" food + treat (vs treats alone!).

If you've not already seen this website, Tanya's website is the go to place for information on kidney issues. There's also a support group for caregivers with CKD cats, as well. It took a bit of tracking down to find the page on phosphorus binders so I provided the link. Some of the aluminum hydroxide products do not taste good. However, there are several that are odorless and tasteless. They are listed on the page I linked.
 
Oh my goodness, thank you for deep diving into all of that for me and providing links! I am trying to figure everything out and it's just A LOT to be struggling to control Lola's diabetes and now also having to deal with CKD and pancreatitus (which she has no symptoms of by the way). The diets for a diabetic kitty and a CKD seem so diametrically opposed, but there do seem to be some options? It's just getting this kid to eat wet food that'll be a struggle. I'm also wishing I had gotten an affordable human meter as the AlphaTrak 3 test strips are SO expensive! Especially if I am testing 3+ times a day. It looks like many people use ReliOn meters on this forum, so considering a switch. Anything for my newly designer label pricetag baby
 
We tend to encourage people to use a human meter. Most of the members here use Walmart's Relion meter. The strips are the least expensive around. (It's $0.17 for a Relion strip vs $1.00 for the AlphaTrack strips.) If your vet gives you a hard time, do a curve at home with the AlphaTrack for the vet and use the Relion strips the rest of the time. Many vets seem to conveniently forget that until relatively recently, most people were using human meters since it was very hard to find a pet specific meter, to say nothing of the cost. What is even more confusing is that many vets are suggesting that people use a continuous glucose monitor like the Freestyle Libre. The Libre has a sensor that's attached to the cat and you get readings from an app. Using the Libre means you don't have to poke your cat. However, the Libre is a human meter. The logic of telling someone to not use a human glucometer but to use a Libre is a bit mystifying!

Providing links is easy. I've been hanging around here for a long time. I have a huge amount of information bookmarked or know where to find it in the FDMB site.

I'm tagging one of our members who has a list of low carb/low phos foods. That will help to get you started. @Diane Tyler's Mom GA
 
Wendy&Neko said:
Someone from a user group associated with Tanya's website has put together a list of foods, for various conditions. Include a list for cats with CKD diabetes food list.

I'm going to remove the 911, as it looks like you've got answers to your questions.
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Thank you for removing the 911! I didn't know how to do it myself.

So this morning about 45 minutes before she is getting her first injection, Lola's BG is at 108. I'm afraid of giving her the 5 units she's been getting since Saturday evening as I don't want her to go hypo. I called her vet who said to still give her an injection but to do 3 units. I am just unsure if this is the right thing to do.
 
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What did you do? I can’t advise you, being new myself but I suggest you start a new thread titled with the date, Lola, amps 108 new and not sure about dose and a ? prefix. Post it in the prizinc forum for better attention
Good luck!
 
SmallestSparrow said:
What did you do? I can’t advise you, being new myself but I suggest you start a new thread titled with the date, Lola, amps 108 new and not sure about dose and a ? prefix. Post it in the prizinc forum for better attention
Good luck!
Click to expand...

I followed the vet's instructions but I didn't feel good about it. I'll be retesting her at the 2 hr mark to see how her BG looks. We see said vet today as I want a repeat blood panel after how high her numbers were this weekend and going to give her sub q fluids for good measure. Thank you so much for the suggestion about the prozinc forum!
 
Jade_Leah said:
I followed the vet's instructions but I didn't feel good about it. I'll be retesting her at the 2 hr mark to see how her BG looks. We see said vet today as I want a repeat blood panel after how high her numbers were this weekend and going to give her sub q fluids for good measure. Thank you so much for the suggestion about the prozinc forum!
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Well hopefully all will be ok. We’re shooting for what the BG will be not what it is, but it’s scary esp when we’re new at this. Hopefully someone on Pro zinc will see and come help you monitor. You might want to check earlier than +2. When people have shot low numbers I think they check earlier but I’m not sure.
 
Jade_Leah said:
We see said vet today as I want a repeat blood panel after how high her numbers were this weekend and going to give her sub q fluids for good measure.
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Sub Q fluids will make some cat's BG drop more than normal. You might want to have the vet test the BG first before the fluids.
 
Hi there. I am replying over on the ProZinc forum. Please reply to me over there. I have a 1 o’clock appointment today (I am on Eastern time) but will check on you and the spreadsheet in the next hour or so and then after I am finished.
 
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