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Lincolns Mom

Lincolns Mom

Member Since 2016
reposting my introduction not sure where else to start....

After a dramatic weight lose Lincoln was diagnosed with diabetes on March 25, 2015. We were started on Lantus from the beginning which gave me hope he would go into remission. We started at 1u once a day then went to 1u twice a day. We continued to go up 0.5u each few weeks till we hit 3.5u 2x per day. He gets super scared at the vets (messes himself in his carrier if we dont rush him in and back out.). So we were only doing Fructosamine testing at the vet. He kept coming back as in the 350s. We held him at the 3.5u for a few months. But then the vet wasn't happy with the fructosamine numbers and we started the increases again. Again going up 0.5u every three weeks until we were all the way up to 6u 2x per day. No matter what the frutosamine number wasn't changing. I had been reading posts on here from the beginning and i felt it was time to take action cause nothing was helping him. I went out and got a home tester for BG. I did a bunch of research and changed him over to a soft food diet that is only 4 carbs or less per can. And then i talked to the vet about dropping his insulin back. The vet agreed to try dropping it back to 3u 2x a day from the 6u he had been at. I have been testing and recording numbers and charting everything since then.

From Sept 5 till Oct 12 we had him at 3u 2x per day. Majority of the time he was between 16-18mmol/L with the occasional dip in the 15-14s and the occasional 20 showing up. Maybe once a week we would see a 20 and with us being a multi cat family usual meant he got into the crunchies.

I wanted to move him more into that 5-15 range so talked to the vet about going up to 3.5u x2 per day. He agreed that we could try that. So on the 13th of Oct we changed dosage to 3.5u x2 per day. And ever since then nothing has been right.

He tested at 12.2 the one morning. I still gave him his dose. In the month leading up to this he had tested at 11.6 and i had given 3u and he had only dropped to 6.2 so i thought i would be safe still giving him his dose at 12.2. Instead i saw him drop all the way to 4.1 and hide under my bed which he only does when he is really sick. I gave him a teaspoon of the fancy feast florentine and his numbers came up a little. But they kept going up and up and he ended up at 25.2 before starting to come down again. In the whole month+ before this i never saw anything over 20! Ever since then this last week he has been hitting a bunch of 20+s . Remember before at 3u he only occasionally saw a 20 and never over. I phoned the vet on Thurs the 20th of Oct and he was in surgery so ended up talking to the vet tech. She felt he was just adjusting to new dose and to continue to hold him at 3.5u till at least monday (tomorrow). She thought we would see a change this weekend but really we haven't.

I have 2 vets that are very easy to talk to and listen to my concerns and suggestions. I just need to talk to others that know even more and can help explain whats going on with my boy. I just want him to feel better and have a shot at remission
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My gut tells me to drop back to 2.5u and hold it there to see if what happens was somogyi. And then possibly go back to 3u 2x a day. I don't want to just keep increasing cause the vet sees higher numbers. Can someone here share some insight please?
 
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you can look at the curves for the different days if that helps on the other sheet -- just have to specify range of dates up top by 3 letters for month and numbers then just X the curve days you wanna see -- thank you for looking :)
 
ok - well, the good news is that you are here, ready and willing to learn how to help Lincoln. You've mastered home-testing, you've got a great insulin, and you're obviously devoted to your kitty! We can help you - this place is the best source for helping a diabetic cat.

We use mg numbers as our common language and I'm having a really hard time making sense of your spreadsheet. It is different than what we use. There is a direct relationship between the dose changes and blood sugar changes, and I'm not seeing the dose on this spreadsheet.

Here is the link to the one we use. It will be easy to switch your numbers to it, and then the ss will automatically convert your mmol tests into mg. That will allow more people to help you as well. Also the colors are extremely important. We learn to "read" those colors to see what's going on.

From the "Basics: New to the Group?" yellow boxed sticky at the top of the main insulin support group page.

      • Please set up a Google Spreadsheet as soon as possible. Always keep spreadsheets up-to-date! Valuable time may be lost looking for information when a spreadsheet is not up to the minute.
      • If you have not been able to transition your kitty off of DRY food yet, please note it on your spreadsheet and in your signature. A dry food diet will often require higher doses of insulin to bring numbers down. Having this information plainly visible will help us help you.
I'm going to write more next with some explanations about what is likely going on with Lincoln, but will post this now so you have somewhere to start.
 
If you need help with your spreadsheet, there are people who are happy to set up one for you and then turn it over to you. Just say so if you need that.

There are a couple of situations where a cat might have high numbers that don't mean they need more insulin.

One is what we call "New Dose Wonkiness." For an unknown reason, when a dose is increased, a cat can respond with higher blood sugar numbers for a day or so.

A second cause is from "bouncing." I suspect this is what you're calling Somogyii. That has been disproven to exist in cats, but what does happen is that if a cat's body has become used to high numbers, when they get back into normal numbers, or even just something less than they have become used to, that can cause their body to perceive it as a hypo. The cat's body released hormones and stored sugars to send the cat's body back up high, where it thinks it belongs. That can last as long as 3 days before the hormones/sugars clear out and the cat's blood sugar goes back down again. That's very likely what happened when you caught the 25.2 after him being lower. Here is a link that explains more about New Dose Wonkiness and Bouncing.

Some cats are so stressed at the vet's that their blood sugar can increase by hundreds of points, literally. That's why hometesting is so critical - you can get the "real" story at home.

You mentioned crunchies for your other kitties - we've had people here document that their cat's blood sugar went up by hundreds of points after as few as 3 pieces of dry food. That can last a day or so.

A cat that is overdosed can have constant high numbers. Their body is trying to keep them alive in the face of too much insulin and the result is high numbers. At the same time, cats need varying amounts of insulin, so 3.5u might be just right for him.

Dose increases are based upon asking the question "how low can this dose make my cat's blood sugar go?" So we don't focus on the high numbers (because of the bouncing issue) and look for those low numbers. They are the most important numbers - both because of the need to prevent a hypo and because they tell us what to do with the dose.

A change in food can cause a dramatic change in the insulin needs. It was good you reduced his dose when you switched to canned. Is he eating all low carb canned now, except for the stolen crunchies?

The 4.1 (x 18 = 74) is actually a pretty great number. That shouldn't be low enough to cause symptoms, except that he's not used to being that low. Hypo concern is typically under 50, most likely quite a bit lower than that. Punkin had one episode in the 30's without symptoms or problems, but I took immediate action to bring his blood sugar back up over 50.

I'm throwing a ton of info at you, so ask questions and more questions. There are many people here who can help you.

So what to do next?
- getting your test results into our ss would be the first step, especially along with the doses for each day. It will also help to note when you changed food, if you can.
- can you set things up so Lincoln can't get to the crunchies anymore? Not even the pieces on the floor?

Then we can take a look at the situation and see what we can suggest about the dose. For now, I'd hold the dose and try to get us the rest of the information so we can see a clearer picture. We aren't vets, so we rely on numbers to help people.

And I want to say welcome. This truly is the best place you never wanted to be. Just keep asking questions and things will make more sense as you learn more. Glad to have you and Lincoln here.
 
Working on adding your spreadsheet into mine. Between me and a friend we are pretty good in spreadsheets so just give me a bit and i will have it so its in your format.

I agree -- i thought it was a bounce because his body hadn't been that low in so long. Even though its a regular area for non-diabetic cats his body was shocked to see it i think. So i completely agree that is what happened to him.

He is eating low carb canned food now. I try to feed the other kitties and then immediately put the crunchies away. Husband feeds and forgets but i continue to get after him to this is occurring less and less.

I will get the info in the tracker now and talk to you soon. And thank you for the welcome. I have been reading posts here for months now trying to help him and decided tonight i better just start asking for help. :)
 
Every cat is different - ECID - so it's much better to ask for personalized help for Lincoln. Some of what you read will apply to him, some won't.

I read for about 2 months before I joined. I was put off by the lingo "surfing, green lagoon," etc. But my sweet punkin needed the help and the people here literally saved his life. The vet had switched him from ProZinc to Lantus without telling me to change syringes. Then it turned out that Punkin had acromegaly (as do 1 in 4 diabetic cats) and my vet hadn't even heard of it. The folks here live this 24/7 and know it well.
 
Hi Welcome! You have come to the best place you can be to get help for Lincoln!
Glad you decided to come on in and join the village! It's a pretty awesome place with help by the boatloads for all things, diabetes being just one of them! Getting that spreadsheet up and running really enables the pros here to see things that who would know to look for! And soon it will feel just like home!
Again a Welcome and give Lincoln a scritch for me!:cat:
 
Ok spreadsheet updated and info in my signature -- thank you both for the welcome - will check in in the morning
 
Hi and Welcome, Lincoln and Lincoln's Mom (is that what you want us to call you, or may we know your name?)!

Julie has given you a ton of good info and asked pretty much all the questions, so I just wanted to offer you a link to our Lantus & Levemir Land Slang Dictionary, so we don't throw you for a loop with some of our unique terms and expressions.

My other tip is: ask questions! The only dumb question is the one you don't ask.

We are glad you and Lincoln are here.
 
Bump -- and thank you for the warm welcomes -- Lincoln is flattening out again today and looking better hopefully we continued to trend down on the 3.5u dose
 
@Lincolns Mom welcome from BC & formerly Red Deer :)

Just a note for next time, every day we start a new thread for everything that happens in that day and we link to yesterday's condo (the thread from yesterday). As you probably have seen when we make a post for the day we start with the date, kitty's name & amps (morning pre shot) or pmps (evening pre shot). This way everyone gets to know you & your kitty & it helps when your looking for some dosing advice.

Like it's been said before don't be scared to ask questions, everyone has been in a similar situation as you at one time.
 
What do you want to be called, Lincoln's Mom? Most of us use our first name, but it's up to you.

Fabulous job getting all of that info added to the spreadsheet!!! That helps immensely! I'm a little puzzled by the green numbers on 10/16. They're great, but my guess is that green cycle may have been from him not getting any crunchies that particular cycle. What do you think about that situation? The reason I'm asking is because if Lincoln can be prevented completely from getting into crunchies, it would be good to do that. However, we know how determined cats can be and if you think he is likely to snitch them regularly, then we should use the dosing guidelines for a kitty that gets dry food (the Start Low Go Slow) guidelines.

On the other hand, if you think you can prevent him from getting any dry food a majority of the time, then you would have the option of using the Tight Regulation Protocol guidelines. There are some advantages to using that - primarily that you can adjust the dose more frequently than with SLGS. You test more than enough to follow the Tight Reg guidelines, and being able to adjust the dose more often can help one get control of blood sugar more quickly.

This is a quick glance at some of the differences between those two dosing methods:

With the Tight Regulation Protocol, doses are held about 3 days, then re-evaluated and increased if needed.
With the Start Low Go Slow, doses are held for a week at a time.

With Tight Reg, you need to test multiple times a day (which you are already doing). The goal of Tight Reg is to get the cat into normal numbers (50-100 on a human meter) as quickly as is safely possible. Because one is pushing the cat's blood sugar into normal numbers, it means testing enough to keep the cat from becoming hypoglycemic.

With SLGS, one needs to get preshot tests and ideally, a spot check here and there, and once a week do a curve. Because Lantus dosing is based upon how LOW the dose gets the cat, you've got to get enough tests in to be confident about how low the cat is getting. Most people using SLGS don't test as much.

Tight Reg requires low carb canned food or raw food.
SLGS allows dry food - if a cat is being fed any dry food, they cannot follow Tight Reg.
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Regardless of which dosing method you end up using, I think you have plenty of evidence that Lincoln needs a dose increase. Overall his low points are in the yellow 200's. We increase in 0.25u increments - and it's amazing what even a small dose change can do in some cats. I'd suggest you go ahead and increase to 3.75u.

Also, I want to give you the link to the "Where Can I Find?" thread. It'll help you find information that will be helpful.
 
Thank you for the insight Julie -- And its Amber aka Lincolns mom. I am waiting on the vet to get in the 0.5 increment needles. All they get at the moment is full unit so i am pushing for the half marked needles to be brought in. As soon as i have them i will be increasing. I just want to be precise about how much i am giving him and not guessing which i am sure you totally understand.

There has been no crunchies out the last couple days. I am only putting them out, watching them eat, and putting away immediately. So the last few days he hasn't gone up at all and continues to drift down on the 3.5 units. Curious to see where he is going to end up. Not sure what happened on 10/16. He started out lower that morning and then just kept going down. I know the greens are good but i am worried about more of those rebounds cause his body isn't recognising the greens as normal for him. Really didn't like the numbers that came after.

Thank you all for the welcome. Been reading lots on the board and Lincoln is starting to get better i am hoping. Thank you all again :)
 
The "cure" for bouncing is to just keep putting their body back in green numbers. It does take time and some cats don't stop bouncing. Many do, though. As the cat goes along, if the nadirs are green the bouncing will lessen both in intensity (it might only bounce to 150 instead of 450) and in duration (the bounce might only last 4 hours instead of 3 days.) It's kind of miraculous to watch - the cat's body is really amazing in how it responds to everything. I've seen cats give up bouncing and it is very cool to observe. Not sure if you're a person who wants more and more info (I am) but I'll give you a spreadsheet to look at that demonstrates this process very nicely. Take a peek at Davidson's ss. You can skip this if you're not interested - I won't be offended.

Look at 2/1/14 and notice how he starts the day in yellow and then clears the bounce. Gets down to 70. He bounces back up to 360 and he bobbles around high for the next 2 days. See how he clears the bounce almost exactly 2 days after the 70 - and he gets to 98. That bounce lasted 2 days and got up to 360.

He begins another bounce almost immediately and that evening he gets to 309, but by the next morning he's clearing it and is back in green. That bounce lasted less than a full day.

Another bounce follows but he only gets to 250 at pm +1 that evening. And he's back in green by morning.

Then his bounces begin peaking out in blue numbers.

Skipping ahead to 2/25 - which is Davidson's last bounce. He peaks out at 111 and he only stays over 100 for a few hours. That's the end of his bouncing life. This is the path to a cat becoming tightly regulated and ideally, becoming diet-controlled. Doesn't happen for every cat, but it can for many.​

You are using u-100 syringes, right? Lantus is a human insulin and the syringes can be bought from any pharmacy, or online. Some US states require prescriptions for syringes, some don't. I don't know about Canada - do you need a prescription to buy them? @Wendy&Neko may have some suggestions on where you can buy them easily without having to go through the vet.

Yay on the crunchies situation - that's great!

One other option on the syringes is to use calipers. You adjust the dose using the calipers then ignore the markings. I never used them, but Marje did a good instructional post on them here. If you opt to go with calipers you could finish using the syringes you have now. Just depends on what you prefer.
 
LOVE the numbers - i am definitely a numbers person! Yes u-100 syringes. I will get on the vet again tomorrow about the needles. And its good to see how the bodies change and recover. A little less worried now about the next time he does it. When his numbers are too low or too high he acts so different -- scared, hides, hisses. :( But after i started home testing, changed food, and dropped back to 3 units he became much more cuddly, affection, and way less scared. He is the gentle giant of my group. Doesn't have to be cuddly just hate seeing him scared. You asked about the greens on 10/16 -- after reading the write up on the calipers... i am wondering if it was the syringes. I have the BD and Terumos and i have been using what ever i pulled out of the box. Clearly that write up confirmed how different they could be. Really might need to look into calipers.
 
You have Terumos that are u-100? Lucky you! They are fabulous syringes, but they stopped making the ones that had 0.5u markings - now I'm wondering if they are still available without them, but could be used with calipers. I loved those syringes and got others here hooked on them as well. When the word came out they were being discontinued, I phoned their headquarters in the US midwest and tried to make a case for continuing them. Maybe they are only made in Canada. In any case, I really liked them. They had a narrow barrel, which made dosing small increments so much easier than the syringes with a wider barrel. The plunger also moved smoothly.

Lincolns Mom said:
LOVE the numbers - i am definitely a numbers person!
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me too! I want to know all the why's and how's so I can understand what make things do what they do - and I always wanted to know what was behind people's advice to me when I was learning with punkin.

If you like numbers, here is the post I wrote a while back on shooting lower numbers - which means shooting the regular dose into normal range at preshot. I grabbed Davidson's ss from it. It's really counter-intuitive, but with Lantus and Levemir, the depot insulins, shooting lower numbers can often produce a much flatter cycle, even just a line rather than a curve. Like what you saw on Davidson's ss.

Having seen Davidson's ss, you can see why we encourage people to try to get their cats into normal range. High blood sugar is destructive on so many parts of the body, just like it is in people. Diabetes in cats and people is actually very similar. Most people have getting their cat's blood sugar under renal threshold as their first goal. What that number is is ambiguous - but somewhere 150-225ish. Some people test their cat's urine to see at what point the glucose will spill into the urine - many just try to get the numbers down. A non-diabetic cat will mostly have blood sugar that's less than 80.
 
I loved the Terumo syringes, too. When I heard they were being discontinued, I stockpiled them. My DH, who did most of the shooting, didn't like them because of how easily they moved, but that was what sold me on them - I have severe arthritis in my hands.

I agree with Julie that it's definitely time for an increase. Way too much pink on that SS. I hope you can get either the 1/2 unit syringes or the calipers (or both) soon.

Are you testing for ketones? Lincoln's numbers aren't super high, but it might not be a bad idea to check him anyway. You should be able to by ketone testing strips in any pharmacy. You just dip one in his urine, or hold one in the stream, and it changes color if ketones are present.
 
Got syringes with Half Markings!! Yaaaa! Had to go to human pharmacy but found out don't prescription for insulin or syringes. So tonight i will start him at 3.75u -- and we will go from there. A little bit of a rise this morning. I put some FortiFlora on his food last night. Does anyone here have that raise BG?
 
Hi Amber.

YAY on getting the new syringes. That will make it much easier on you to measure doses. You'd be amazed at the difference .25 makes.

Did you give him Forti Flora to encourage him to eat? How is that working out? I used to use it the same way, and for two of my cats it did the trick. For the other two not so much. I hear that the formula has changed slightly and some say it doesn't work as well as it used to.

Lincolns Mom said:
Does anyone here have that raise BG?
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That can happen for many reasons. It could be a bounce, although I don't see anything on your SS that would have made him bounce, he might have gotten into lower numbers overnight (not likely, but possible). It could be a food spike - when did he eat in comparison to the reading? Or, and this is our favorite reason, he could just be being a cat! :rolleyes:

Housekeeping note: We ask each member to start a new thread (condo) each day, rather than continuing to post on a previous one. It makes it easier for us to get the latest news without having to scroll through 20-30 posts. When you start your new condo, please link the previous one so we can go back if we need to see what was said before. Does that make sense? You can look at just about any condo on the Board to see how it's done.
 
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