New member, 3/19/2024

Hi from Gravy and Vicki. I'm wondering if her dose needs to go up. Gravy was diagnosed at the end of December 2023, and started Lantus in January. Before the diagnosis she had a mix of dry food and either Friskies or Fancy Feast wet food. She is now on Friskies pate.
Her labs 2 months ago showed kidneys were good.She was hitting nadir about 120 after starting Lantis. Lately her numbers have gone up and she has begun urinating and drinking excessively again. Her nadir on Sunday was in 160s.
She currently gets 1 unit of Lantus if blood glucose is 250 or above, and .5 units if 150-250.
I posted last 2 weeks of info on spreadsheet (which I hoped I linked correctly).

 

Hi and welcome Gravy and Vicki.
Great you have set up the signature and spreadsheet. That helps us a lot.
Looking at the SS there are a couple of things I would suggest.
Are you able to get any tests in during the pm cycles? Even a test before you go to bed is helpful. Cats often drop lower at night and unless you are testing, we would not know. Before suggesting an increase, I would like to see what happens over the whole of the days, not just 12 hours.
The second thing I would suggest is changing the dose to 0.75u and giving that dose for both the cycles instead of a different dose each time. Lantus is a depot insulin and if you chop and change the dose, it messes with the depot and you could get wonky numbers.
I would do those two things first for a few days so we can see how Gravy goes on the 0.75 U then we will be in a better position to give dosing advice.
What is a DEPOT

How often are you feeding Gravy? Are you giving a good meal before the dose of insulin and then giving a couple of snacks during both the cycles?
Keep asking questions we are very happy to help.

 

Thank you so much for your reply. I can test her 2 hours after her shot tonight, so I'll do that. She is fed right after I test her twice a day. I then feed the dogs and give her the dose. During the day, she usually gets 2 freeze dried chicken treats twice a day, and usually both Gravy and the dogs get a piece of regular chicken at lunchtime when I put chicken on my salad. She loves her food - which is how she got her name

 

A snack is a couple of teaspoons of regular low carb food. I would suggest giving her a snack at say +3 and +5 if you can each cycle. it is good she likes her food. That makes it much easier to look after a diabetic cat.

 

She will love having a little more snack time. I gave her the .75 dose tonight and will check her in a couple of hours. Thank you!

 

Let me know how she goes

 

At 9 pm her bg was 255. I did give her dasuquin at dinner so I don't know if that affects things at night. Vet wasn't worried about the dasuquin but I'll have to watch and see if that changes anything. This weekend I'll try to get more night readings.

 

Bron provided some great suggestions!

Lantus is an insulin that likes consistency. It's helpful to be as consistent as possible with shot time. Dosing also needs to be consistent. By that I mean that barring numbers dropping into dose reduction range, Lantus works best if the AM and PM doses are the same. If you are giving different amounts of insulin at each shot time, the depot never stabilizes. The result can be wonky numbers.

 

If you do happen to wake up during the night…you might be able to get another BG. That would be very helpful

 

I slept good last night so no waking up, but numbers not too bad this morning and I gave her a .75 dose again. Afterwards, I realized I woke up so early (Wednesday is my extra early day) I could have checked her then at 4 am. Though I don't know if she would want me to before my first cup of coffee. Thank you all for your help!!

 

Yes that would have been helpful. Any checks you can do help fill in the puzzle.

 

Try and get a few tests during the cycles if you can. Any will help. Otherwise we are only seeing the preshot BG which only give us limited data and does not tell us at all how well the dose of insulin is helping Gravy.

 

I checked her this morning at pmps+10 and she was 176. I'll check her for amps in about 2 hours. Today might be a bit chaotic as my husband is retiring today, but I'll try to get a check or two in and again this evening. Thank you for all your help!

 

Checked her again at amps and 164. Her vet wants her to start on antibiotic for suspected uti. We tested her 3 weeks ago and negative but increased urinating and drinking makes her wonder. I have to pick up antibiotic today. We did bloodwork for her in December but I wonder if we should just repeat again.

 

Well done getting those extra tests in. Great data. Keep up the great work!

 

Thanks. I tried to get a number at am+7 and wasn't able.to but she seems to be doing well with the dose. A little bounce last night , or it was still dinner affecting things, but it was down to 245 this morning before her shot.

 

How are things going?

 

Her numbers aren't too bad, though a little up this am at 277, though that could be the little piece of treat she scarfed from the dog. But she has pretty much stopped the excess drinking and peeing so I'm thrilled with that. I think that's probably a combo of steadier numbers and vet started her on antibiotic for suspected uti. She started with an eye infection, from seasonal allergies, but I've been cleaning it out a couple times a day and she's not winking at me anymore so it's getting better.
I'll try to get some more numbers tomorrow, especially to check on her nadir.
Overall very happy with her progress!

 

I didn't think I gave her a fur shot this morning, but her numbers were high so I might have. She was a little wiggly. Tonight she was fine with me testing her bg and ate well. But she decided to hiss and spit at me tonight when I gave her the shot. She was not happy and didn't want her treats. I don't know if she's feeling off from the antibiotics or what is going on. I'll have to keep a good eye on her for now.

 

I just gave her a spoonful of her pate friskies, and she perked up and then ate her low carb treat and dasuquin she didn't want before. I think she just is feeling kind of blah from the antibiotics. She has been doing great and not excess peeing and drinking but tonight she was doing both. I think that's definitely related to her glucose going high and not a uti. She tested negative but since she was drinking and peeing more the vet thought it might be. Taking a break from antibiotics tomorrow just to see how she does. Hopefully, she'll be a little happier tomorrow.

 

Try and get a few more tests in over the next day if you can as the dose may need to be increased to 1 u it. But I’d like to see some more inbetween BGs to check the BG is not dropping low.

 

Thank you. I'll try and fill in some of the blanks today and tomorrow. She's much happier this morning in spite of her high number so I think it was the antibiotics. And in spite of being on them, last night she drank and peed a lot, which she hadn't done in a few days, so it's definitely the bg not a uti. I was thinking it may have to go to 1 unit too, but we'll see.

 

Her numbers today are higher than I've seen them before. I think she's just not feeling quite herself though definitely better than last night. Last night was the first time I've wondered about her quality of life, and up quite a bit worrying about her. I even worried about her poor little ears. Feel better about that today, but we'll see how she does. She has vet appt Friday which was for her eye, but that's pretty well cleared up. I was going to cancel, but I might keep it.
No antibiotics today so we'll see how she does tomorrow. My poor baby girl.

 

Try and get some tests in overnight tonight. If the BG doesn’t drop, we might need to increase the dose to 1 unit.

 

Thank you for all your help. I'll try to get some tests in. I think she just hasn't been feeling too good due to the antibiotic. She had diarrhea last night, didn't want her chicken treats, etc. She's definitely feeling better today so hoping her numbers come down tonight/tomorrow and she gets a little more active again. I got her some different freeze dried treats so well see if she enjoys. Plus I might have had a fur shot yesterday so that might have affected numbers too.

 

Just tested her at pmps+3 and her bg has gone up to 340. Very strange for her. Ketones were negative again though, thank goodness.
ETA at pmps+5 bg is 340 still.

 

It is possible she is bouncing from a lower number you did not catch . Keep getting those extra tests for another day to se what happens.

 

It's possible. She was not herself yesterday though so maybe she was still clearing antibiotic. If she had been bouncy I would have suspected she caught a mouse and had a snack, but she just laid on her bed most of the day except when she saw food coming. Yellow this morning so I'm relieved. She's definitely happy this morning.
ETA I'm tempted to write last night's weird numbers off due to her just not feeling good. But I wonder if she is bouncing up at night and not during day. That would explain why I see excess peeing from middle of night and not during the day. I can get extra numbers today, but can't stay up late tonight. But Thursday night I think I need some extra numbers to see if that's happening.

 

Her numbers were better today, but not as good as they have been. She's definitely feeling better than yesterday but still not quite herself. I'm hoping tomorrow she feels all better and the numbers reflect that. Otherwise I'll bring her in for bloodwork.

 

Try and get a couple of tests in tonight, especially around +5 or 6 if you can to see how low she gets. If she doesn’t drop into green BGs, I would increase the dose to 1 unit tomorrow.

 

I missed the 6, but at +7 she was 289, so I'll increase to 1u in morning. Thank you for all your help.