NEW MEMBER - Tips for Managing High BG HELP

[Carla Satchmo]

Hi

Jonty was diagnosed earlier this week. Tonight is night 5 of glargine insulin. Currently on 2IU twice daily - he is 7.5kg. Jonty has asthma and was treated in September last year with radiation for a Pituitary tumour.

My vet initially advised quite high doses to start him on - 3IU then 4IU then 3.5IU. I was seeing massive dips in his BG so dropped back to 2IU - tonight is his 4th cycle at 2IU. Last night his overnight numbers were good but during the day he dropped by the 3rd hour and remained in the bottom on normal range most of the day. But tonight, it's like he's not responding at all. We are approaching the 6th hour since his shot and he BG is climbing - currently 18.7. I know how to help him with a hypo episode but feel completely helpless with a hyper. I've encouraged him to drink water. Is there anything else I can other than just pray his numbers start to drop. His spreadsheet is saved in my signature.

 

[Diane Tyler's Mom GA]

Welcome Carla and Jonty
If you can fill out what we call our signature that will be helpful,it's at the end of everyone's post in gray

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine

Giving you the link to read about lantus/glargine , read all the yellow stickys

Lantus likes consistency, We don't base the dose by going on the pre shots ,we base them on how low the dose is taking them. We also adjust the dose by 0.25 units ,do you have the syringes with the half unit markings?
Do you live in the US?
I can tag a few members for you once you fill out your signature and attach it to your spreadsheet

 

[Larry and Kitties]

was treated in September last year with radiation for a Pituitary tumour.

Did Jonty have acromegaly? If yes before the radiation was Jonty on insulin? Most acromegaly cats need insulin and are then diagnosed with acromegaly via blood test for IGF-1 when the required insulin dose keeps increasing.
Some acromegaly cats after radiation treatment still require insulin but at a reduced dose and for some they no longer need insulin. There is a FB group for acromegaly cats, https://www.facebook.com/groups/acromegaly?sorting_setting=RECENT_ACTIVITY.
I ha e had two cats dx'd with acromegaly via the IGF-1 blood test. MurrrFee who I only treated with insulin was sent onward a couple of years ago. Snuffles is still here and i treated with oral cabergoline and insulin and is doing good. The cabergoline reduced insulin dose. MurrFee was up to 50 units twice daily before his end.

 

[Carla Satchmo]

Welcome Carla and Jonty
If you can fill out what we call our signature that will be helpful,it's at the end of everyone's post in gray

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine

OK thanks

Did Jonty have acromegaly? If yes before the radiation was Jonty on insulin? Most acromegaly cats need insulin and are then diagnosed with acromegaly via blood test for IGF-1 when the required insulin dose keeps increasing.
Some acromegaly cats after radiation treatment still require insulin but at a reduced dose and for some they no longer need insulin. There is a FB group for acromegaly cats, https://www.facebook.com/groups/acromegaly?sorting_setting=RECENT_ACTIVITY.
I ha e had two cats dx'd with acromegaly via the IGF-1 blood test. MurrrFee who I only treated with insulin was sent onward a couple of years ago. Snuffles is still here and i treated with oral cabergoline and insulin and is doing good. The cabergoline reduced insulin dose. MurrFee was up to 50 units twice daily before his end.

No I don't think it was acromegaly. I've never been told that's what is was anyway - I was simply told it was . He was not diabetic prior to the radiation - didn't have high sugars and didn't have a huge appetite. His only symptom was blindness as the tumour was pressing on his optic nerve.

 

[Carla Satchmo]

OK thanks

No I don't think it was acromegaly. I've never been told that's what is was anyway - I was simply told it was . He was not diabetic prior to the radiation - didn't have high sugars and didn't have a huge appetite. His only symptom was blindness as the tumour was pressing on his optic nerve.

Sorry - it was a Macroadenomas but nothing was mentioned about it being acromegaly.

 

[Diane Tyler's Mom GA]

Carla can you please go to your spreadsheet and put you are now following SLGS instead of TR

 

[Diane Tyler's Mom GA]

If you are following SLGS now
Starting Dose:

• 1u BID if kitty is not on a wet/canned low carb diet
• 0.5u BID if kitty has been switched to a wet/canned low carb diet
• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
• Generally, shots are to be given 12 hours apart.

Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

Can you go to your SS and change it soon to SLGS

 

[Diane Tyler's Mom GA]

Hi

Jonty was diagnosed earlier this week. Tonight is night 5 of glargine insulin. Currently on 2IU twice daily - he is 7.5kg. Jonty has asthma and was treated in September last year with radiation for a Pituitary tumour.

My vet initially advised quite high doses to start him on - 3IU then 4IU then 3.5IU. I was seeing massive dips in his BG so dropped back to 2IU - tonight is his 4th cycle at 2IU. Last night his overnight numbers were good but during the day he dropped by the 3rd hour and remained in the bottom on normal range most of the day. But tonight, it's like he's not responding at all. We are approaching the 6th hour since his shot and he BG is climbing - currently 18.7. I know how to help him with a hypo episode but feel completely helpless with a hyper. I've encouraged him to drink water. Is there anything else I can other than just pray his numbers start to drop. His spreadsheet is saved in my signature.

@tiffmaxee

@Sienne and Gabby (GA)

@Suzanne & Darcy

@Wendy&Neko

She is now following SLGS as stated in her signature, I have asked her to correct it on her spreadsheet

I assume she should decrease by 0.25 now ? Since her +3 was 70

 

[Carla Satchmo]

@tiffmaxee

@Sienne and Gabby (GA)

@Suzanne & Darcy

@Wendy&Neko

She is now following SLGS as stated in her signature, I have asked her to correct it on her spreadsheet

I assume she should decrease by 0.25 now ? Since her +3 was 70

Is he having a bounce tonight because he was too low today? I'm just seeing some worryingly high numbers tonight and I can't understand why. Or maybe my injection wasn't good and he doesn't have any insulin on board? It's just confusing me so much seeing his numbers fluctuating so drastically from daytime to night-time.

 

[Sienne and Gabby (GA)]

If I may offer an observation/comment...

Lantus tends to work better if the dosing is consistent. Doses are typically held a week if you're following SLGS (or 3 days when you were following TR). With shorter acting insulin, you can vary the AM and PM doses. With Lantus, if you make back to back changes like you did on 11/10 through 11/12, you are likely to get wonky numbers. Lantus needs to have sufficient time between dose changes for the depot to stabilize.

You AM cycle today was lovely. (I wouldn't call it "tanking.") I do think what you are seeing is a bounce. It looks like Jonty has gotten more used to numbers in the blue zone. He has to get used to seeing more greens!

 

[Carla Satchmo]

He just seems incredible unhappy in the low zones. He was inactive pretty much all morning and very forlorn. It breaks my heart to see him struggle to adjust. Then watch him struggle through the highs of last night - the poor little guy doesn't know whether he's coming or going. My whole motive right now is to keep him calm and content until the tumour starts catching up with him again. I just didn't expect the impact of trying to balance the insulin dosage would have on him.

 

[Sienne and Gabby (GA)]

If I may offer an observation/comment...

Lantus tends to work better if the dosing is consistent. Doses are typically held a week if you're following SLGS (or 3 days when you were following TR). With shorter acting insulin, you can vary the AM and PM doses. With Lantus, if you make back to back changes like you did on 11/10 through 11/12, you are likely to get wonky numbers. Lantus needs to have sufficient time between dose changes for the depot to stabilize.

You AM cycle today was lovely. (I wouldn't call it "tanking.") I do think what you are seeing is a bounce.

 

[Suzanne & Darcy]

He just seems incredible unhappy in the low zones. He was inactive pretty much all morning and very forlorn. It breaks my heart to see him struggle to adjust. Then watch him struggle through the highs of last night - the poor little guy doesn't know whether he's coming or going. My whole motive right now is to keep him calm and content until the tumour starts catching up with him again. I just didn't expect the impact of trying to balance the insulin dosage would have on him.

It is not uncommon for cats who are used to being in high numbers to react badly to being in normal BG numbers. Many cats will hide or just act “blah” whereas they act more “normal” or whatever is the new, diabetic normal, in high numbers. They need time to adjust.

 

[Suzanne & Darcy]

Oh and the cycle of 11/12 was beautiful. Today he has been bouncing a bit. He is bouncing because his body os not used to normal green - or blie - numbers.

 

[tiffmaxee]

The bounce is clearing already.

 

[Bron and Sheba (GA)]

That’s quite a drop at + 2 from AMPS
I would get a +3 and +4 to see if he is going to keep dropping. And I would give a snack now

 

[chuckstables]

It is not uncommon for cats who are used to being in high numbers to react badly to being in normal BG numbers. Many cats will hide or just act “blah” whereas they act more “normal” or whatever is the new, diabetic normal, in high numbers. They need time to adjust.

This. This is 100% accurate. For the first few weeks of being on Lantus he was... annoying. He wasn't very happy, and seemed to be confused by how he was feeling. He was so used to drinking water every 10 minutes, that he'd just walk up to the water bowl, sniff it, stare at it, then turn around and look at me like "what's going on here, why am I not thirsty". I did take him into the vet for i think 5 or so blood glucose tests (she actually did it for free, she was super nice about it), and his numbers were fine, if anything on the high side. After about 2 weeks he adjusted, and suddenly his behavior changed. He started having more energy, he started wanting to play for the first time in YEARS, and he's stopped the habit of walking to the water bowl every 10 minutes (keep in mind he was drinking almost a liter of water a day, and he weighed 9.5 lb's by the time I realized this wasn't normal).

His blood glucose when I first took him in was 540, makes sense that he'd have to adjust.