New Member - High BG after new kitten

Hello all,

I have learned so much from reading this forum but I am now stumped.
A little about my little guy Powder...
He was diagnosed with gastro Lymphoma and put on Prednisolone.
After a few high BG readings at the vet office I was concerned. The vet wasn't. She said it was probably just stress. I pressed it and she did a fructosamine test. It was high.
He was quickly weaned off of Pred but that didn't do it. He developed diabetes.
He has been on insulin for 4 months.

My vet is very conservative and kept his insulin dosage low. I followed her advice for the first several weeks as I was overwhelmed. But I started to read. I decided to follow more of a tight regulation protocol. He was well regulated in a few weeks and just before we got our new kitten a month ago - I thought he might be going into remission. I reduced his Lantus insulin to 0.50 units at night and 1 unit in the AM. His pre-shot readings averaged around 150.

Enter kitten. Within 3 days I got a reading of almost 300. Yikes! I increased his insulin but couldn't keep him in the sweet spot. He would have low readings in the AM after a break from kitten (they don't sleep together) but his evening readings would be high after spending the day with kitten. This morning I decided to increase his insulin yet again and gave his 2 units rather than the 1.75 units I had increased it to. Tonight his reading was 360! I haven't had a reading like that since the beginning. He then might have a few days of low numbers.

I'm stumped. Is it stress from the new kitten? The new little guy is very active and pounces on Powder. Or is it a secondary infection from a Herpes flare due to stress?

Would love to know if anyone has experienced anything like this?
Do you think increasing the insulin CAUSED the high BG reading?
I'm not sure how I should be dosing him.

Thanks in advance for your insights.

 

Hi and welcome Lana and Powder to the forum.
Without seeing the BG data, it is hard to say what is going on.
Do you think you could set up a spreadsheet and your signature and enter at least two weeks data into the SS please. That will help us see what is happening.
HELP US HELP YOU has the links to the spreadsheet, signature and hypo kit. Make sure you have a hypo kit set up.

Stress can increase the BG Levels. So can too much insulin. So can bouncing if the BG has been dropping low, or too fast or lower than your kitty is used to, or it could be from a herpes flare. Looking at the SS will give us some answers.
Are you testing before every shot to see it is safe to give the dose?
Are you giving snacks during the cycles?
What type of meter are you using?
What food are you feeding?
Lantus likes consistency so you are better to stick with the same dose am and pm.
Bron

 

Hello and welcome.

I question the removal of prednisolone for the GI lymphoma. If your cat has GI lymphoma, he most likely will need the prednisolone for life and also Leukeran (chlorambucil) (my cat did.) How was the lymphoma diagnosed? Was a biopsy done or a FNA with PARR testing? Texas A&M GI Panel? Ultrasound? Some cats just have to be on pred and the insulin can be adjusted as needed. We have other cats here on the Board who are on pred daily. How are his symptoms? Appetite? Vomiting? Diarrhea?

Hopefully, you can get a spreadsheet set up and fill in as much data as you can from your meter (past tests stored in your meter's memory.) If you do get a spreadsheet set up, hopefully you can share your labwork on it as well.

 

Thank you for your insights Bron and Suzanne. And thank you for directions to the Help us Help you! I definitely will fill out the spreadsheet. It might take some days... busy getting ready to go and get kitten #2 tomorrow. He's our kitten #1's half brother. I'm hoping having 2 kittens will take some of the focus off of Powder as they will play with each other.

My degree is in food science so I fully understand the need for a low carb diet for Powder. He has been eating a raw food diet that I make myself for many years now. I add pumpkin and I did increase it in the last batch. He has some constipation so I wanted to increase fiber. I'm hoping this minimal increase did not increase carbs enough to warrant the changes I'm seeing in his BG. This is his only carb. I feed him 6 times a day (started this with his gut issues) so he only gets treats after I torture him. HA! After BG testing and insulin shots. And yes, I test before each shot to make sure it is safe. I will wait if his reading is too low. I do have a hypo kit ready.

I am using the AlphaTrak2 meter and test strips.

Good point about consistency Bron but I was not able to do that. Perhaps this is a tell in and of itself. If he needs 2 units a day and I do 1 and 1 - he is always too low in the AM to shoot. Is it because he's sleeping? Not eating? So I need to skew it and give 0.75 PM and 1.25 AM to get consistent readings.

As for his lymphoma - he did not have a biopsy - just an ultrasound. My vet determined it was Lymphoma by the severity of it. She said regardless of a definitive diagnosis, it would be the same treatment so we did not do the biopsy.
He has been on chlorambucil for almost a year now.
He has not vomited since his first shot of pred - again a year ago. He's been 'normal'. He eats very well; he gained weight and maintains it; his poops are normal but I notice he strains at times.
He has had a total of 3 ultrasounds and the last one was almost normal. Still a bit of thickening in one area.
We were concerned about removing the pred but she said the chlorambucil should keep it at bay and we'll see if he needs budesonide. She was said even budesonide can affect BG so didn't want to start him on it if it wasn't necessary.
During his time on pred I changed his diet. As a kitten he had diarrhea on and off for the first 9 months of his life. Couldn't find any issues. This is when I learned of a raw diet. That did it for him. He ate predominantly raw since then but I also kept dry food and canned food in his diet.
I removed the canned food first when he was diagnosed with lymphoma and many months later, the dry food (he loves dry food).
I had tried differing diets when he first had gut issues and some of these changes worked to stop his vomiting for a period of time. So I figured I'd push the changes when he was still feeling good. Could it be that his inflammation was a result of diet and that's why his gut is now better without pred?? I guess time will tell.

Back to diabetes... last nights reading was 360 so I came here to sign up! I decided to increase his dose to 1.5 units (I usually give him approx. 1.15 at night). His reading this AM was 180. I didn't give him 2 units again like yesterday AM, I went back to 1.75. Perhaps I will try this more consistent dosing of 1.5 and 1.75 to see how that goes. I am also cleaning and disinfecting his eyes several times a day incase there is an issue (he's a pretty face persian).

Thank you for the welcome!

 

I am glad that he’s been on chlorambucil and is doing well on it. And you are keeping up with monitoring with ultrasounds! Fantastic!

hopefully the kittens will play together and leave Powder alone!

 

Hi Lana, Hi Powder! Welcome to the club, you are in the right place to get Powder help.
I'm pretty new here, not one of these unbelievably helpful and knowledgeable seasoned veterans -- but I have learned that Lantus likes consistency, as in the same exact dose both AM and PM. That is what helped Hendrick get to be so tightly regulated as he is now, in such a short time -- well that, and following TR, and listening to all the gurus here at the FDMB of course.

When I first joined, I was using the Alpha Trak II as well. I highly recommend getting a human meter instead, the folks here are more in tune with human meter numbers and the dosing methods are set up for them as well --- not to mention, the strips are way WAY cheaper. Super popular is the ReliOn Meter they have at walmart and other places, I think 100 strips is $17.88. There is really no reason to use an Alpha Trak, the so-called "pet calibration" is just a slightly higher number. I was resistant to change when the experts here ask me to do so but I did, and never looked back!

Let's have some pictures of Powder already

[edit] and the new kittens too plz!!


[edit#2] I'm really interested in your homemade cat food is there any chance you'd care to share the recipe you follow? Do you use a pre-mix for taurine, etc?

 

Yes. We love cat and kitten pics around here.

 

I'm excited! Cat people!!
Thanks for your feedback on the Lantus and AlphaTrak Kyle. I was thinking of switching after reading about it but like you I was leary. I just ordered more strips but I will start reading about human ones and keep the Alpha Trak for when I need precision.
I'm happy to share my recipe but I must admit, it's a bit time consuming.
I love nutrition so applied everything I know to this recipe.
I use heart for the taurine. Heart is high in taurine. Heart is considered a muscle not an organ so it's OK to use as much as you need.
I'll post it next week when I have more time.
Yes, photos! I'm hopeless with technology - don't even have a cell phone. But I'll figure it out and post pics of the boys. They're pretty cute.

 

I feed a raw home made diet to my cats as well so I would be interested in seeing what you do. I also feed a small amount of heart everyday.
Lantus dosing is based on the nadir or lowest point in the cycle, not the preshot BG.
With Lantus and consistency ….the same dose is best given for the am and the pm dose, not a different dose. Otherwise you are consistently messing with the depot which can lead to wonky numbers.

 

So helpful. Thanks.
Will get back to everyone with recipe!

 

and pics!

....don't forget the pics. Kitten tax!