New diagnosis - high BG after injection - lantus

[Boris]

Sorry for not searching the message board for an answer, but we're concerned right now.

- diagnosed last Tuesday, reading of 450 at the vets.
- prescribed lantus insulin and a 2 unit twice a day shot.
- feeding Friskies Prime cuts, 1 can at 7am & 1 can at 7pm
- injecting insulin at 7.30am and 7.30pm
- recieved our glucose tester yesterday, an Alphatrack 2

So before feeding yesterday we measured 450

Today we measured 222 at 1.30pm and 454 at 6.30. Feed at 7, shot at 7.30 and a reading of 480 at 10.30.
This is scary, shouldn't the insulin be working now? 480 is a very high number. What should we do? We're hesitant to give Boris another shot - but the readings so high?

He's sleeping now, reacting when called (lifting his head), but not moving away when he's very annoyed at being tickled. This is unusual.

Advice would be really welcomed right now!

 

[Elizabeth and Bertie]

Re: New diagnosis - high BS after injection

Hello, and welcome to FDMB!

Well done, you, for getting to grips with the hometesting so quickly!

Numbers can remain high at first, and can also be a bit 'all over the place'. This happens quite a lot initially. Try not to worry, it's very early days, and as we often say (and remind ourselves!) round here: "Managing feline diabetes is a marathon and not a sprint." ;-)

That 222 you got six and a half hours after his morning shot (what, in FDMB-speak we'd call his 'AMPS + 6.5' (morning/AM pre-shot number plus 6.5 hours) shows that the insulin IS having an effect. The more BG numbers you can get during the insulin cycle (especially during the first half) the more data you'll have to enable you to see what's going on.

If the numbers are erratic then you may find that feeding small meals throughout the day - rather than 2 main meals - helps to balance things out a bit.

You're using Lantus, which is a great insulin for cats. And I'd strongly suggest that you edit your subject line to include 'Lantus' so as to attract the attention of other Lantus users. You could also post a message in the Lantus TR forum which may get Lantus users that the general forum doesn't get. :smile:

Welcome aboard!

 

[squeem3]

Re: New diagnosis - high BS after injection

Sorry for not searching the message board for an answer, but we're concerned right now.

- diagnosed last Tuesday, reading of 450 at the vets.
- prescribed lantus insulin and a 2 unit twice a day shot.

Welcome

2 units twice a day of any insulin is a bit high. We recommened starting at 0.5 units or 1 unit twice a day. Insulin can pack a punch so it's best to start at the lowest dose possible and slowly increase as needed than to start too high and risk a hypo. Once you inject insulin, you can't take it back out.

- feeding Friskies Prime cuts, 1 can at 7am & 1 can at 7pm

Not a good choice to feed to a diabetic :shock: Those are well over the 10% carb limit diabetic cats should have. The Prime Fillets are 14 to 19% carbs, according to Dr. Lisa's most recent food chart: http://www.catinfo.org/docs/Food Chart Public 9-22-12.pdf Any food that is in gravy is going to be really high in carbs. High carbs keeps blood glucose levels too high. The only time you want to feed gravy canned food is if your cat is mildly hypoglycemic.

Friskies's Classic Pate line is all low carb for diabetic cats. You can check the food chart link above for the exact varieties. There are other brands of canned foods you can feed: Fancy Feast, Merrick, Wellness, etc. Just check the food chart. Anything under 10% carbs is good for diabetics.

Here are additional fodo charts and lists you can use:
Hobo's Guide to Nutritional Values: https://docs.google.com/spreadsheet/ccc?key=0AmkyagqUb3nudG9sRVhTVnFEWlhaU19ZUXkxTnlhYXc#gid=0
Binkys canned food charts: http://binkyspage.tripod.com/canfood.html (info several years out of date)
New food list from Catinfo.org (Sept. 2012): http://www.catinfo.org/docs/Food Chart Public 9-22-12.pdf
Pet Food Nutritional Values list: https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50
Dr. Lynne's Wet Food list: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=12846
Low carb gluten free Fancy Feast: http://www.felinediabetes.com/glutenfree.htm

Two meals a day isn't enough for your diabetic cat. Instead of giving an entire can for breakfast and dinner, you can free feed the canned food. Multiple small meals throughout the day helps keep blood glucose levels stable and is best for most diabetics. A programmable timed feeder works great for this :smile: There are ways to keep the canned food from spoiling, from adding extra water to freezing canned food into chunks and letting that defrost in the feeder.

- recieved our glucose tester yesterday, an Alphatrack 2

If you find the AlphaTrack supplies to be costly and hard to find (can't buy them at any pet store or pharmacy, only online or at the vet's), you can switch to a Human blood glucose meter instead. Most everyone here uses a Human meter. Some keep a pet meter on hand as back up (or the opposite of that).

Today we measured 222 at 1.30pm and 454 at 6.30. Feed at 7, shot at 7.30 and a reading of 480 at 10.30.
This is scary, shouldn't the insulin be working now? 480 is a very high number. What should we do? We're hesitant to give Boris another shot - but the readings so high?

The Lantus board has lots of info on how Lantus works for cats: http://felinediabetes.com/FDMB/viewforum.php?f=9

You need to have patience :smile: Insulin doesn't work magically right away to lower blood glucose levels to a normal range.

It takes several day for Lantus to "build up a shed", as members here call it. It looks like the insulin and dose is working a little so far. The numbers don't really mean too much right now but keep test, especially right before giving the insulin shot and any other tests you can get in between. You may want to track your cat's numbers on a spreadsheet. Many people here use an online spreadsheet which they share with other members here to get help and advice. Here are the instructions: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130

And no, do not ever give more than 2 injections per day :shock: You don't want to OD your cat, especially not with a long lasting insulin like Lantus. Here is what generally happens with a Lantus injection:

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

 

[BJM]

Re: New diagnosis - high BS after injection

Welcome!

For some secondary monitoring tools, especially ketone monitoring, please see my signature link.

You've gotten great input so far, so I won't repeat it.

Learning to manage your diabetic cat safely is a process, not an event, so deep breathing to reduce your stress and lots of patience is strongly recommended. :smile: There is a bit of a learning curve too - dietary information, monitoring, dosing and more. You may find it overwhelming if you try to read it all at once, so break it into chunks, study a bit, take a break, and come back to it. You'll likely lear it faster that way.

 

[Boris]

Re: New diagnosis - high BS after injection

Thank you all for your advice. We're still getting used to home testing and its hard to take blood every two hours. But the readings we have taken today and the readings from last night fit with typical lantus curve. We're also seeing levels come down somewhat which is a in line with the advice we're hearing. We will pay attention and reduce dose if levels get too low.

We've invested in some 0 carb food now. Both creatures are over weight so we'll be controlling quantity and quality of their food properly now. Certainly no more Iams indoor cat dry food :-(

 

[squeem3]

You don't need to test every two hours :smile: That's only if you want to do a curve, which can be done whenever you have a full day available. The most important thing to do is always test before giving the insulin injection. Never give insulin if the level is under 200 beause you don't want to risk a hypo. With Lantus, ideally you should get one or two tests in sometime after the insulin shot. This can be done after the morning injection or after the evening injection, whichever time works for you. You don't necessarily need to get the extra one or two tests in every single day.

Catinfo.org has tips on how to help overweight cats lose weight. 20 to 25 calories per pound of ideal body weight is ideal for most cats. Weight loss should always be done slowly to avoid fatty liver disease.

 

[Julia & Bandit (GA)]

We've invested in some 0 carb food now. Both creatures are over weight so we'll be controlling quantity and quality of their food properly now.

Is this a dry food or a canned food? I ask because there are a couple dry food brands out there (like Epigen) that advertise themselves as 0 carb, when in fact this is a misrepresentation. We calculate carbs here in terms of % per 100 calories, where the "0 carb" dry food brands are rounding down their dry weight carb values, and when you actually figure out their carbs in % per 100 calories, they are well over the 10% and not good for diabetics.

We use the general recommendation to stay under 10% carbs with canned foods because they are generally low glycemic, but with dry foods it's more complicated. Even the lower carb dry foods that are below 10% carbs can still keep BG high. This is because not all carbs are created equal--dry food must use some kind of starch to bind the food together, and these starches have a high glycemic index because of the way the they are process during manufacturing. Bandit can eat a low glycemic canned food at 8% carbs with no effect on BG but a handful of the high glycemic EVO dry at 8% carbs will raise his BG 100 points or more.

It's really best to avoid dry food, period. It complicates regulation, and is also dehydrating for the cat.

Here's a fantastic resource that explains getting your cats on a safe weight loss plan: http://catinfo.org/?link=felineobesity. A few foods I highly recommend for weight loss (and diabetes!) are Merrick's Cowboy Cookout, Merrick's Surf and Turf, and Merricks Grammy's Pot Pie. (Here's a link to the store finder.) They are very high in protein, low in fat, and low in carbs, which makes healthy weight loss SO much easier. I struggled with Bandit's weight for years--the Iams and Purina dry food I was feeding him made him morbidly obese, and after the diabetes diagnosis I went through many different low carb foods, trying to find one that settled well with him. I struggled with him not being able to lose his last stubborn pound or two of weight, which was causing his blood sugar levels to remain higher than they should have been off insulin. It wasn't until I switched to the Merricks that those last couple pounds not only easily melted away, his formerly flabby physique transformed to solid muscle. And this was just by switching the food--I fed him the same amount of Merrricks as I did the other canned foods.

Those are just a suggestion, though. Any low carb canned food is going to help with weight loss. I would just avoid those that are higher in calories (and fat), like EVO.

 

[KPassa]

Welcome!

You've already gotten some fabulous advice here and it's great to see you're already blood testing! I think that's perhaps the hardest concept for most people to come to terms with, but it's worth it for your kitty's health!

Those are just a suggestion, though. Any low carb canned food is going to help with weight loss. I would just avoid those that are higher in calories (and fat), like EVO.

So true! I was using EVO primarily because I have a growing diabetic kitten that needs those extra calories, but I noticed that on the days I fed him EVO, he'd also be running at a higher BG level, so I've stopped feeding him that and am now seeing better numbers again.