NEW hard to regulate kitty Graycie needs help..

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JennE

JennE

Member Since 2016
Hi everyone! I realized that I posted this post in the introduction section accidentally! Sorry..hoping someone can still help me..Here is my post again:

I just found this group however have been really struggling with my 8 year old cat Graycie. She was diagnosed 2 years ago and has been really tough to regulate. I even see an internal medicine specialist and her glucose is still unpredictable. She has had several hospitalizations over the past 2 years including one for DKA (I almost lost her) and one for pancreatitis.
Currently she is on 1.25 units Lantus BID and VERY recently switched from merrick chicken pate to canned Purina DM (with some dry mixed) due to a suspected allergy (loss of fur on her abdomen). She also has Cerebellar Hypoplasia (since birth) which affects her mobility.
I test with the Alphtrak 2 twice daily (more when I am not working). Her numbers are typically high (300s) at test time. I have tried so many times to increase her dose (raising it .25). It usually goes okay for awhile, and I see lower numbers... , and then BOOM..out of nowhere, literally, I will get something like "40"! So naturally (after I'm late for work trying to raise it) think it's Symogi rebound and bring the dose back down again, only to hold her steady in the 300s once again. Its so so frustrating! I feel so terrible that I cannot do this! People think that I'm crazy because I'm always late for work and worrying about this cat...I just think I need some guidance!
 
Many vets treat Lantus like older insulins, not realizing that Lantus has overlap between the shots, which means dose adjustments may take several days to fully show effects.
To use it optimally, Lantus doses are adjusted by how low the glucose goes, not by the pre-shot level.
You wait 3-5 days to allow the Lantus dose effects to stabilize, then evaluate how low the glucose goes in the +5 to +7 hours post-shot when the nadir is likely to happen (lowest glucose).
 
I understand that.. Graycie is very unpredictable. Same dose..same food.. for days, and all of a sudden, we get a hypo. It is difficult to be gone for most of the day, during nadir time, hoping that she's not going too low. It's also hard to tell whether she's bounced or not. This has been thousands of dollars worth of headaches to specialists over these 2 years. They call her "their little puzzle"..they think it may be tough too because she is only an 8 pound cat (always has been).
 
Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning, pre-shot, test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening, pre-shot, test)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

The nadir is the lowest glucose between shots. There is a general period when it will happen which is specific to the insulin being used and testing then helps make sure your cat doesn't go too low.

It is merely a grid for storing the info; no math required.
 
You say you feed some dry mixed in. Most dry food is high carb and usually raises BG. Is it possible that some days your cat eats more dry food than others? Were you also feeding dry when you were feeding the Merrick? I'm thinking perhaps some days he doesn't get as many carbs and his levels drop. My cat was very carb sensitive and even a little bit of a relatively low carb dry food would increase his BG 80+ points.

CAUTION: should you decide to remove the dry food you need to be aware that BG levels can decrease dramatically. You need to be testing regularly and be prepared to adjust the dose as needed.
 
I do..I add a bit of dry purina DM (i have been for awhile now..same amount every time)..she always goes for that first and we had been having issues in the past with her not wanting to eat right away. I will be starting my spreadsheet today after work.. It may not be that helpful during the day as unfortunately I'm not home..but I'll try my best to get what I can.
Thanks everyone!
 
JennE said:
It is difficult to be gone for most of the day, during nadir time, hoping that she's not going too low.
Click to expand...
I feel for you, Jenn. :bighug:

I'm severely agoraphobic and stuck in the house all the time; not a great life but at least I'm here for Saoirse. Were it not for that I think I'd be out of my tiny mind with worry over her. As it is I fret about her anyway, especially if I need to increase her dose. :nailbiting:


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I'm glad you found us here at FDMB. Many people not familiar with what it's like having a diabetic cat can't understand the worry that goes with it. It really helps to be connected with other people in the same boat. I'd be lost without this place, and I'm glad I was able to help you a little. :bighug:

There is a specific insulin support group for Lantus and Levemir. There are members there with a great deal of experience of using Lantus. I think it might be an idea to start a thread on that board. They may be able to help you with refining Graycie's dosing.

I love the images of Graycie in your avatar! She has the loveliest little face. :cat:



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Awe thank you! I did start a post..I have some new hope now. Yes, you are right. Many of my friends and co-workers think I'm "crazy" because my schedule revolves around the cat's insulin! But, I have never missed a dose. :-) Your kitty is gorgeous BTW!
 
You've done better than I have with dosing consistency. I have a number of health problems, and my ability to sleep has been severely compromised for nearly a decade. Trouble is that I can pass out without warning the fatigue gets so severe. On nights when Saoirse's running a bit lower I sometimes skip doses because I can't guarantee remaining awake to see her through a low. I feel like a fink but I can live with that as long as I know she's safe. :(

Thank you for the compliment; I'll be sure to pass it on to Saoirse. :)


Mogs
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