Newly diagnosed kitty testing 502 mg/dl (27.9 mmol/L) on 4th day of insulin

Status
Not open for further replies.
Pandapapa

Pandapapa

Member Since 2024
Hi all, this has been a very helpful community as I learn how to take care of my cat Panda who was diagnosed with diabetes 5 days ago.

Disclaimer
First off, i love this community and I already set up the spreadsheet and plan on doing a blood glucose curve on Saturday but i have started testing him twice now with AlphaTrack 3 (which i confirmed with control solution that it is accurate). But right now I want some urgent information as i can't get hold of my vet (who generally seems pretty relaxed about waiting for a couple of weeks before I even did a test -- although he did suggest i do it at home since it's more accurate and cheaper)

Preliminary info about Panda's history
Panda was rescued from a hoader house of 180 cats and was in pretty bad shape when he was rescued with his bonded brother Jasper. I adopted them about a year ago and noticed puking and diarrhea problems right away. Originally, working with the rescue and the cat behaviourist there, it was thought to be a behaviour issue (as he did have a lot of behaviour issues) after about 6 months of lots of work, despite his behaviour improving a lot, he was still getting sick frequently, then after vet visits, it was thought to be a allergy issue and after trying many things, he started doing really well with raw food (high quality, mix of kangaroo, turkey, fix).

Although he was thought to be 9 years old, after the last visit with xrays and ultrasound, the vet thinks he's more like 11-12 years old

Panda's Diabetes Diagnosis (4 days ago)
But he was still always tired and drank a lot of water. So finally we got the diagnoses of diabetes with blood test where he tested 437mg/24.3mmol. From xrays and ultrasound they also suspect he has or have had pancreatitis (which i think means he could be a type 3c diabates. Great! I started injections on Sunday (about 4 days ago). We were prescribed 1 unit of Lantus.

Effects of Insulin Shots
I gave him his first shot (Lantus 1u) on Saturday evening and twice a day at 8am and 8pm since then.

After that first day I noticed immediately his water drinking and peeing went down a lot but he still begs for food a lot (but less than before)

Starting Glucose Testing for Panda
I got my AlphaTrack 3 yesterday and read it all, calibrated it and tested with solution.

First test: I tested him at 930pm last night (which is 1.5 hours after his second shot of the evening) and reading was 355mg/L.

Second test: Then i did second test half hour ago which was 9 hours after his morning insulin shot and 3 hours before his second. That test was 502mg/L!

I understand these are very high numbers. So i'm looking at the community to guide me on what I should do next. I know it will be hard to see the vet tomorrow. I also don't want to increase the insulin without talking to the Vet

Panda is a great kittie, i realize now his BG was probably always as high as 502mg/L because the way he's behaving right now is like before, just meowing for food and drinking a bit more water (but much less drinking and less begging) So i feel like it's not urgent however i know that just because he wasn't hurt from it before doesn't mean he won't be this time.
 
Here's a picture of Jasper and Panda. The diabetic kitty Panda is the white one on the right. I appreciate all the help and guidance!
 

Attachments

  • panda-jasper.png
    panda-jasper.png
    799.6 KB · Views: 101
Welcome to the best group you could have joined.
There are many experienced members here.
Your 2 kitties are adorable.
If you can tap on this blue link and give us some information about Panda.
It will also give you instructions how to set up our spreadsheet and how to use it, it's really simple. If you do need help setting it up just ask and we can have a member contact you and set it up for you.
Here is a link helping us to help you link. If you noticed, our members have some basic informatiohelp.
out their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help
I will also tag some experienced members for you
 
Pandapapa said:
Hi all, this has been a very helpful community as I learn how to take care of my cat Panda who was diagnosed with diabetes 5 days ago.

Disclaimer
First off, i love this community and I already set up the spreadsheet and plan on doing a blood glucose curve on Saturday but i have started testing him twice now with AlphaTrack 3 (which i confirmed with control solution that it is accurate). But right now I want some urgent information as i can't get hold of my vet (who generally seems pretty relaxed about waiting for a couple of weeks before I even did a test -- although he did suggest i do it at home since it's more accurate and cheaper)

Preliminary info about Panda's history
Panda was rescued from a hoader house of 180 cats and was in pretty bad shape when he was rescued with his bonded brother Jasper. I adopted them about a year ago and noticed puking and diarrhea problems right away. Originally, working with the rescue and the cat behaviourist there, it was thought to be a behaviour issue (as he did have a lot of behaviour issues) after about 6 months of lots of work, despite his behaviour improving a lot, he was still getting sick frequently, then after vet visits, it was thought to be a allergy issue and after trying many things, he started doing really well with raw food (high quality, mix of kangaroo, turkey, fix).

Although he was thought to be 9 years old, after the last visit with xrays and ultrasound, the vet thinks he's more like 11-12 years old

Panda's Diabetes Diagnosis (4 days ago)
But he was still always tired and drank a lot of water. So finally we got the diagnoses of diabetes with blood test where he tested 437mg/24.3mmol. From xrays and ultrasound they also suspect he has or have had pancreatitis (which i think means he could be a type 3c diabates. Great! I started injections on Sunday (about 4 days ago). We were prescribed 1 unit of Lantus.

Effects of Insulin Shots
I gave him his first shot (Lantus 1u) on Saturday evening and twice a day at 8am and 8pm since then.

After that first day I noticed immediately his water drinking and peeing went down a lot but he still begs for food a lot (but less than before)

Starting Glucose Testing for Panda
I got my AlphaTrack 3 yesterday and read it all, calibrated it and tested with solution.

First test: I tested him at 930pm last night (which is 1.5 hours after his second shot of the evening) and reading was 355mg/L.

Second test: Then i did second test half hour ago which was 9 hours after his morning insulin shot and 3 hours before his second. That test was 502mg/L!

I understand these are very high numbers. So i'm looking at the community to guide me on what I should do next. I know it will be hard to see the vet tomorrow. I also don't want to increase the insulin without talking to the Vet

Panda is a great kittie, i realize now his BG was probably always as high as 502mg/L because the way he's behaving right now is like before, just meowing for food and drinking a bit more water (but much less drinking and less begging) So i feel like it's not urgent however i know that just because he wasn't hurt from it before doesn't mean he won't be this time.
Click to expand...
@Wendy&Neko
@Suzanne & Darcy
@Marje and Gracie
@tiffmaxee
 
Diane Tyler's Mom said:
Welcome to the best group you could have joined.
There are many experienced members here.
Your 2 kitties are adorable.
If you can tap on this blue link and give us some information about Panda.
It will also give you instructions how to set up our spreadsheet and how to use it, it's really simple. If you do need help setting it up just ask and we can have a member contact you and set it up for you.
Here is a link helping us to help you link. If you noticed, our members have some basic informatiohelp.
out their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help
I will also tag some experienced members for you
Click to expand...

Thanks for the welcome and info Diane! Tyler's a cutie kittie as well. I set up the spreadsheet with the 2 tests I did and added it to my signature.
 
Pandapapa said:
Thanks for the welcome and info Diane! Tyler's a cutie kittie as well. I set up the spreadsheet with the 2 tests I did and added it to my signature.
Click to expand...
Your welcome Tony, that was fast setting up your signature
and spreadsheet :cat:
Are you testing Panda first thing in the AM to see what his BG is to see if it's safe enough to shoot ? If you aren't I suggest you do, you don't want to shoot blind not knowing what his BG is, same goes for the PM cycle

You might want to read all the yellow stickys here about Lantus
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

If you work I would try and get it at least one more test after the AMPS test @+2 (2 hours after giving insulin.) Or as soon as you get home from work.
Same goes for the PMPS cycle.
On the weekends if you can after testing AMPS try and get some more tests in say around @+2, @+4 and @+6, you want to try and find his nadir,
Learn how YOUR kitty is responding to insulin:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
Mix up the testings times also.
We don't adjust the does by the pre shots, we increase or decrease by the lowest point in the cycle.
Lantus takes àbout 5-7 days for the depot to fill
Feed small snacks during each cycle, feeding only twice a day is old school, feed like one or 2 teaspoons of his food , try and not feed after @+6
If you work you can purchase an automatic feeder and set it up to open at certain times.
They have them for wet food
I assume you don't live in the US , I know the Alpha Trak test strips are expensive, I used to use the Alpha Trak in the beginning, but the test strips killed me .
Most of us use human meters ,that's what our numbers are based on, but if you feel comfortable using the Alpha Trak that's fine. Just trying to save you some money
Make sure you gave your hypo kit set up with med and high carb food in case you ever need to bring his BG up.
I don't know where you live so I can't suggest any .
Well if you have any questions just ask, if I can't answer them I'll tag someone for you.
Thank you for rescuring Panda and Jasper .
I can't imagine those 180 cats that were there ,poor babies
Without me taking the advice from the members here I know Tyler wouldn't be in remission today, it's 3 years already ( knock in wood )
@Pandapapa
 
Last edited:
Diane Tyler's Mom said:
Your welcome Tony, that was fast setting up your signature and spreadsheet :cat:
Are you testing Panda first thing in the AM to see what his BG is to see if it's safe enough to shoot ? If you aren't I suggest you do, you don't want to shoot blind not knowing what his BG is, same goes for the PM cycle

You might want to read all the yellow stickys here about Lantus
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Click to expand...

I’m just getting panda used to injections. He’s very skittish cat in general. Testing these 2 was pretty hard. I live alone so I don’t face anyone that can hold him down. Although I will start testing tomorrow morning after he eats but before the shot (extremely hard to get a hold of him when he’s so hungry).

what I’m hoping to find out today is whether the 500 reading today is cause for emergency.
 
Hello and welcome. Wow, that was quick getting things set up. Thank you. That really helps us. A couple things on the spreadsheet, we need to see the units you shot each day in the U column AM and PM. So just put a 1.0 for last night and this morning and that will be up to date.

Don't worry about the 500 - we see lots of kitties in really high numbers to start. They are even worse (higher) when you use the Alphatrak. Most people here don't use the pet meters, because the cost of test strips is so high. When I started, everyone used human meters. Plus our dosing methods were written when everyone used human meters too. Since I started, the pet meter folks have done a lot of marketing to vets. My girl was know to have the meter say "Hi" at the start - that meant over 600. :rolleyes: As far as the difference between, 500 and 335, both fall into the "too high" category.

Lantus is a depot style insulin, and it takes a few days to a week to build that depot when you first start giving insulin. Meaning you can't really see the impact of an insulin dose initially.

There is one other factor that can cause temporarily higher numbers, and it's called bouncing. New cats do that a lot! Annoying to us, but normal for newly dosed cats, and even some not so new. Here is the definition.
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Are you using something like freeze dried meat treats to reward for testing? Once kitty associates treats with testing, it dose become much easier. Over time kitty will run to you when you get out the test kit. In case you haven't seen this post yet: Hometesting Links and Tips
 
Thanks for the great info Wendy! I'm relieved to hear about the high numbers and concept of bouncing! Also thanks for the corrections on the spreadsheets, I updated it (hopefully) as you suggested.

When I ordered the alphatrack3 (suggested by the vet tech)

In terms of treats, Panda is a very sensitive cat, changing his diet even a tiny bit from kangaroo/salmon/rabbit raw food sends him to diarrhea, although lookin back, undiagnosed diabetes or pancreatitis might've been the cause. That's why he's been on a very strict feeding diet with no treats. Although now knowing about diabetes, I will pick up some freeze dried meat treats to make the testing easy. I already feel so grateful and lucky that injections are so easy. It was only 4 months ago he let me pick him up and put him on my lap!

I do have a few questions, hoping you can help answer. I didn't know about 'depot style insulin' (maybe i read it but last 4 days have been information overload and my brain is all over the place with the abundance of information). Is that why my vet suggested that I didn't need to test until a few weeks later and only to let him know if his behaviour was getting worse? I understand importance of testing before shots, so let's say tomorrow, what kinda testing should I do, if any?

Since this is a depot style insulin, when should I do the full glucose curve testing. My vet had suggested I do that in 2 weeks. As I deal with this, and how difficult testing is going, i'm worried I might scare him and break the trust we built so arduously. I'm worried testing (unnecessary) might make insulin shots difficult, if not impossible.

Finally ,when i'm doing the testing, he's hating when i try to flip his ear. Can I use the lancer on the outside of his ear?
 
You can get rabbit treats, and there are lots of freeze dried salmon options too.

From the Sticky Notes on the top of the Lantus forum: What is the Insulin Depot? We have seen cats have strong reactions to insulin right away. The depot should be build 5-7 days after starting shots. I never understood the "wait two weeks before we test" idea - though I admit my vet did the same. Lantus generally has its nadir, or lowest numbers, in the middle of the cycle. If you can get spot checks between 4-7 hours after the shot, or before you go to bed, it can help fill in the picture. We determine how to change the dose by answering the question "how low is this dose taking my cat?".

I also tested on the outside of the ear. If you put a very tiny bit of vaseline on the fur where you are going to poke, it can help the blood pool up. With black ears, the blood otherwise does a deep dive and hides. Make sure you also do pretend ear pokes. Take him to a test spot, pet him, cuddle, rub the ears, then give a treat and let him go.
 
Wendy&Neko said:
You can get rabbit treats, and there are lots of freeze dried salmon options too.
Click to expand...

To clarify, that is freeze dried treats made with rabbit meat meant for cats not treats for bunnies :) Vital Essentials has good freeze dried treats. Northwest Naturals is another brand with novel proteins. Lots of other brands out there. Tip: most freeze dried treats are available for both dogs and cats. Buy the dog ones since the treats are bigger and you can just break the pieces up for a cat. More treats for not much more money than a little cat sized bag. Just double check to make sure the dog version doesn't contain additional ingredients. Soak the treats in water for a couple minutes for a softer texture if your cat prefers that.
 
Thanks you for all your help and information @Wendy&Neko @Diane Tyler's Mom and @squeem3. It has been a lonely journey with Panda since adoption, as I love him so much and i always was seeing how much he suffered. Finding a diagnoses and cause have taken forever. So when I found out he got diabates, i felt really bad and overwhelmed that this was yet another issue on top of his existing issues. But now with some hindsight since the diagnoses, i think most of his issues might've been related to this and/or pancreatitis.

With your responses, help and kind words, I don't feel alone in this, and i really appreciate the time and care you put into responding. Very lucky to have found this community.

I was able to do testing this morning, he was about 391 AMPS. I've read about insulin depot, and went through the tips for testing. Very good information! I will get the freeze dried treats (thanks for suggestions squeem!) today and start getting him used to testing!

I'm so excited to see Panda live a happy healthy life especially considering he probably sent the first 9-10 years of his life in such a horrible situation. He's an adorable kitty!
 
Last edited:
Hi @Wendy&Neko i was able to start testing him regularly. It’s been about 10 days since starting. Looking at the numbers I think it’s time to increase his insulin dosage. I read the methods of increasing but numbers are all human testers.
He’s still pretty high even at his nadir. Can you advise me on whether it’s time to increase?
 
Because of that bounce effect, meaning they can have high numbers for six cycles due to bounce, it's hard for me to tell with the data you've got so far. We strongly recommend tests before every shot and if possible some spot checks elsewhere in the cycle. Is it possible to get a before bed test? Many cats go lower at night. I'd hate to see him going lower at night then bouncing during the day. That wouldn't be a good time to increase the dose. I'd recommend one more day of testing, plus a before bed test tonight, then evaluate the dose.
 
Thanks @Wendy&Neko !

i will try to do a test before bed. So far only way I can test him is while he’s eating. I divided his food into 5 meals so I feed him every 3 hours starting at 8am (just before his shot). I will give him a bit of food before bed tonight to test him.
 
Hi @Wendy&Neko ! I did a full testing today and also a +3 testing after PM shot.

wondering if I can increase it!

you know I really want to increase it because I see how much better panda is, and his behaviour and how happy he is getting. I feel like a bump will make him even better! But of course I won’t rush if not needed but his numbers still seem high to me.

thanks for help and insights!
 
Great job getting that curve done today. I think you can increase to his dose to 1.25 units tomorrow. If you have the syringes with half unit markings on them, we eyeball half way in between the markings. Some people find it easier to create reference syringe. Use an old one filled with coloured liquid (juice, tea, pop) and create what to you looks like 1.25 units. Or take a photo of what looks like 1.25 units to you. Just something you can look at next time you draw the same dose.
 
Hi @Wendy&Neko , thanks for the info, it was hard to guage 1.25 units but i found a system. I injected it for the last 2 days. His numbers seem a bit higher than before and also there isn't much of a curve. Like yesterday he pretty much was at same sugar level. I will just do spot testing today.

Also i'm testing every 3 hours, is that too much? Panda's ear is getting all mangled :( Can i just do AMPS and PMPS tests until it might be time to bump the dose (maybe in 2-3 days) or more testing.

Thanks again for the help. Panda is so happy, he's more relaxed, pees a lot less and he started grooming himself and generally having a much happier kitty and asking for helps!
 
The minimum number of tests you need is 4 -- both your AMPS and PMPS and at least one test during both the AM and PM cycles. I realize it seems unlikely to you that Panda may drop into lower numbers but cats can be unpredictable. We want to ensure that Panda is in safe numbers and the only way to do that is to test.
 
Thanks Sienna, I will continue testing minimum 4 times. Panda and I both got used to it. It’s just a painful exercise making “bleed” but I know it’s for his own good :)

is there any concern to him having a completely flat curve yesterday? I know lantus does that but I thought that would be happen way later.

also how many days should I wait before considering increase to 1.5u. I think it was 6 or 8 cycles?
 
Pandapapa said:
Panda's ear is getting all mangled :(
Click to expand...
If his ears look beat up poor baby a lot of members put pure coconut oil on them
I have read that many members use pure coconut oil, I have copied this from one of the members posts
just make sure the only ingredient is coconut oil (mine is solid at room temp and I would take an itty bitty dab and rub on his ears)
It seemed to help with the healing
You might be able to get it at a health food store or just Google pure coconut oil
 
Status
Not open for further replies.
Back
Top