New member with BG level question

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jillians

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My 8 year old cat Sasha survived a nasty bout with pancreatitis (hospitalization, constant IV's, almost had to have a feeding tube... biggest pancreas the ultrasound tech had ever seen in a cat.). As a result of damage to his pancreas, he is now diabetic. He's been on Lantus, 3 units twice a day, since March of 2011. When the vet has checked his blood glucose, it's around 300. Vet seemed OK with this. I thought it might be a little high, but this is a cat who gets very worked up about being at the vet. Sasha has slowly developed what appears to be diabetic neuropathy in has back legs, confirmed by his vet. I decided I needed a more complete picture of his glucose levels and started to home test with a Freestyle Lite meter. Admittedly, I have not been able to do a pure glucose curve with him (pre-shot, meal, shot, multiple tests post shot). I also haven't been able to catch his glucose lower than 244. It's usually hovering around 300 (+2, +5, +8).

If he hadn't developed the neuropathy, I wouldn't be as concerned. I just feel like he's not well-controlled (or he is, but it's still too high. My BF says this doesn't make sense, but I think it does.) I looked breifly at the TR lantus protocol and I'm nowhere near being able to try it. I'm also not sure he will allow me to test him that often. So I guess my question to the group: Is an average of 300 too high? Is it unusual for a 14 pound cat to need more than 4 units of Lantus? (I went 3.5 for a few weeks and nothing really changed) Possible my Lantus is old ? I keep it in the fridge, but I've been using the whole bottle. If his numbers weren't so consistantly in the 300's, I would suspect a problem with the Lantus - but he's fairly stable.

Maybe given the severity of his illness, his pancreas is really not functioning at all & he just has a higher demand for insulin. Any input is greatly appreciated.
 
I don't use lantus so I can't answer your dose questions, but this reply will put your post back up to the top. You might add Lantus to the subject line to attract lantus eyes.

What is your kitty eating? We feed wet lo carb food between 8-10% carbs. When we switched Oliver from dry to wet, he went down 100 points overnight, so it can make a huge difference. A vet explains why here: http://www.catinfo.org If you are feeding dry, that would be a change to consider. BUT I would get advice about a dose lowering before I made a switch.
 
Watch out for the Freestyle Lite meter. There is a problem with it reading low at high BG levels so the readings you are getting from that will be lower than the actual BG. I believe the problem is related to something they changed in the strips about 12 months ago. When I discovered the problem I got a different meter and did some double testing the higher his BG was the bigger the variance between the meters. The biggest discrepancy I saw was when his new meter told us his BG was 455 while the Freestyle told me it was 280. Others on the board have been having the same problems and one of our human diabetics has now reported the problem to the FDA (after testing on herself and finding the same issue).

Not all cats have a BG increase when they go to the vet either, some cats BG actually decreases so Sahsa's numbers may be much higher than you think. At any rate I would think that irrespective of numbers any level that is causing Sasha nerve damage is way too high.

It would be really helpful it you could set up a profile and a spreadsheet for Sasha, it doesn't matter if it doesn't have as many entries as the TR people, every small piece of data you can put in can help build the picture and help others to help Sasha.

Here is the link to help you do a profile: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=59890
And here is the link to how to do a spreadsheet: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130

Also if the vet didn't suggest it already you might want to ask him about Vit B12 shots which can help with the neuropathy.

Hugs for Sasha

Serryn
 
Testing gets so much easier, especially when you do tricks to make it work. The most important one is feeding a low carb treat after every test--even difficult cats will tolerate testing if they know they're getting a treat afterwards. I used to burrito Bandit in blanket because he fought me tooth and nail--but I resolved that in order to get him into remission, we had to test at least 3 times a day, so we did regardless of how much of a jerk he was being. After a few weeks of treats (neosporin + pain relief ointment after each test was also a huge turning point for us), he not only tolerated the tests, he came running when he heard the meter beep on.

What food are you feeding? Low carb wet food (no dry) will help lower insulin need and blood glucose levels. Most cats on a low carb wet diet do not need much more than 1u of insulin. Also, if you're not home testing at least 3 times a day with Lantus (once before each shot and then a mid-cycle test in one of the cycles), you also run the risk of overdosing. Without the daily mid cycle checks, a cat getting too much insulin looks exactly like a cat getting too little insulin.

Methyl B-12 helps a lot with neuropathy. Here's some more information about treatment: http://laurieulrich.com/jasper/.
 
Serryn,

I didn't know that about the Freestyle Lite meter! That's what I've been using since my Stinky-kitty was diagnosed in Oct. There were a couple of times I thought maybe the meter was doing something wonky, but couldn't be sure, and decided to randomly test myself to check it. I know that my BG tends to be on the low end of normal, and it always gave pretty correct readings for me. I'd been considering getting a new meter before we get our "new" diabetic kitty next week, and this new information has pretty much guaranteed that I'll be getting one!
 
Most cats have higher BGs because of vet stress. Some, go lower because of the stress. I think my cat's BGs stay the same usually, for some reason.

I have heard that the Freestyle Lite meter shows much lower numbers than other meters, and you will think your cat is having lower BGs than he really is. I would choose a different brand.
 
Wanted to drop in and say welcome! You have found the best place to be....

I used (Bean is in remission) PZI and home tested (after gently encouragement from here). The meter that I used at the end of her insulin days was purchased from walmart: relion micro as the strips were very affordable. But I know I would not have been able to test Bean if treats were not in the picture. We picked a spot to sit and test. We gave treats and only that treat at pokey time. After a few weeks, she would see me grab the 'pokey basket', and before I could get the supplies on the table, she was wanting in the lap for treats... Warming the ear was very important for us, if I did not take enough time to completely warm the ear, there was no way I could get blood for the test. Also, I found out the hard way that the left ear is a much better bleeder than the right, no matter how warm the ear is. With these tricks learned, it made the testing time easier and quicker for us both. And of course, with mommabean getting in a routine and used to this, my sugar Bean was better with it as well.

I would think that 300 is not that bad of a number but if the meter is not reading right, could be the problem.

I wonder if someone is in your area that uses lantus that could let you borrow a dose to see if it is your insulin? And perhaps let you use a different meter? just a thought?? Bean was hovering over the bathroom sink for a couple of days. I tested and she was 49.. no reason to want to hover at the sink. So, I spoke with Louies mom as she lives close to me and she brought over her meter and Beans test was 70 after eating....knowing this, made me feel much much better...Still dont know why she is hovering at the sink, but I know her problem is not her #.

Bean did not have a situation with neuropathy, but many here have and I know of methob12?? tabs that lots give their babies for this and it has helped get them back into shape.

Beans bg was very much more controllable once she was being home tested at the right times, I got down the right routine: test,feed,shoot... curve testing. She also was put on a very low carb diet and raw foods. Her spreadsheet is below if you would like to take a peek.

Keep posting and let us know what is happening with Sasha. He will be very glad you found this forum. Happy paw hugs to you both!!!
 
Just wanted to check in and say thanks for the advice & encouragement. Since I switched him over to canned food, I've actually had readings at 100. I'm a little miffed that the vet didn't suggest that from the beginning. Maybe the neuropathy could've been avoided. I've been giving him methylcobalamin for a few weeks now. Hoping that with the glucose improvements, his back legs will start to improve.

Ear pokes are getting a little easier & today my boyfriend actually gave Sasha his shot while I was at work. He reports that it was much easier than he ever thought it would be. I thank you & Sasha thanks you!
 
I'm glad to see with the food switch your cat's numbers have come down. If you are not looking to follow the Tight Regulation Protocol for Lantus, I'd encourage you to aim to keep your cat's BG levels under renal threshold so his kidneys don't suffer from the effects of diabetes. While this varies with each cat, if you can aim to keep levels below 200, this would be good. You can get strips (Ketodiastix) that will test for glucose in the urine. The goal is to not have glucose spilling into the urine and that's how you would know that you are below renal threshold for your cat.
 
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