Newly Diagnosed: Very strange BG curves, Advice Please

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Guinness's Mummy

Member Since 2014
Hi Everyone,

I'm brand new to the sugar baby arena, and Guinness and I could desperately use some advice. We are experiencing some very strange BG curves, and I can't determine whether the insulin level is too low, is he not responding to the insulin, or is something wrong with the actual meter. Below please find some information regarding his current therapy treatment. Guiness appears to be doing well on the 5 Ps, and has been less persistent in his "Mummy reminders" at meal times. He's eating, but no longer wolfing down his meager meal in one sitting.

Diagnosed: 7/31/14
Age:12.5, M - A handsome tuxie
Diet: Hills M/D 3/16 cup 2x a day
Current weight: 13 lbs (lost 1/4 pound since diagnosis!)
Insulin: Lantus, 2.5 units twice a day
Meter: Alpha Track 2

8/31 readings
8:39 453
10:34 523
12:13 445
14:43 458
16:20 532
18:14 447

This is his 2nd curve since diagnosis, and I've never had a BG reading below 420, however yesterday he had spikes in the middle of the day. I did use the control solution to test, and it appears to work normally. Has anyone seen something like this? He's not overly fond of getting his ear poked and sometimes requires mild restraining, but could could stress spike his values?
 
Welcome.
First I would stop the dry and feed low-carb commercial cat food. A prescription diet is not necessary or desired.
Hee is a list of those foods
viewtopic.php?f=28&t=117688
The curve you see is typical of too much insulin. How was 2 1/2 units determined?
Have you tried a lower dose?
I would definitely reduce the dose to 1 unit if yo change to the low-cab canned.
 
Thanks Larry, for your reply. By any chance do you have some reference materials? I'm not understanding how can it be too much insulin, if he's never had a normal BG reading? The insulin dose was increased to 2.5 units from 2.0 units by his vet based on his 1st curve which is below.

I'll chat to my vet about his food, but Guiness is a fickle kitty, and doesn't eat canned food.

6:30 Above 700 registered as only "hi" on his meter- pre-shot and breakfast
7:00 535 - post breakfast
7:15 - shot
8:51 476
11:02 420
13:52 453
14:52 536
17:07 679
19:02 543
 
If you change the diet to low carb canned, you may drop his insulin requirement by 1-2 units. Combine that with Larry's observation that you may be giving too much insulin, You might stop the insulin and test both blood glucose and urine ketones frequently while you remove all dry and high carb foods and let him stabilize for a day or so.
 
Note: Vet stress may raise the glucose level from 100 to 180 mg/dL.

Too much insulin can look like too little insulin because the body releases counter-regulatory hormones and stored glucose (glycogen) to keep the cat from dying due to hypoglycemia. You will see high, flat numbers in any curves you do. If the compensatory measures fail or are exhausted, you may have a tragedy.

The reason for urine ketone testing is in case this turns out to be an incorrect analysis. That is possible. There's really only one way to dermine if the analysis is correct and that is by testing it.
 
Hi there,

Welcome to FDMB, although I'm sorry you have to be here. My name is Shelly, and my cat's name is Jersey. Thanks to the wonderful people at this site, Jersey was able to go into remission after a few short months on Lantus. We definitely couldn't have done it without this place & these people.

I completely understand about finicky eaters. We were a Meow Mix household until Jersey's diagnosis. Our vet then put her on Hill's w/d dry at the time of diagnosis. Only later did I find out that it was higher in carbs than the Meow Mix she had been eating. ohmygod_smile Just like with human diabetics, feline diabetics need low-carb diets. There are a whole bunch of tips and tricks people have for transitioning cats to canned food. There are also a couple of lower-carb dry food options out there if, for whatever reason, you have to stick with dry food. Young Again zero-carb dry food is one of those options. I think it has about 5 to 6% carbs in it.

I'm not a dosing expert by any means, but I'll see if I can ask one of the more experienced users who helped Jersey and I if she can help you interpret Guinness's numbers.

Hang in there. Starting this dance is so difficult, but it really does get easier with time. If you can stick with us, I have no doubt we can help you and Guinness!
Shelly
 
Hi!!! Welcome to the FDMB. Shelly asked me to drop by and take a look at Guinness's numbers and provide you with some input.

First, please do not stop his insulin. Second, no one can tell with those few numbers if he is overdosed or not. However, it is highly advisable that you slowly transition him off the dry food and onto a low carb canned food. If you eventually want to try raw, that's fine but first we need to slowly move him to wet food. As we do that, we adjust the dose down.

Thanks for giving his weight but do you think he is underweight, at a normal weight, or overweight? The starting dose for lantus is 0.25u/kg of the kitty's ideal weight unless the kitty is underweight. If he's underweight, then it is 0.25u/kg of current weight. If we assume 13.25 lbs is an ideal weight for him, then 13.25/2.2 (there are 2.2 kg to the lb) x 0.25u would have his starting dose at about 1.5u. I'm not sure how your vet got to 2u. Also, we typically raise the dose in 0.25u or 0.5u if the numbers warrant.

Alpha Trak readings are 30-40% higher than the human glucometers that most of us use. A 532 on an AT is about 394 on a human meter and a 420 is about 311. Plus, add in vet stress. It's always much better to do testing at home where he's not stressed. His numbers are not outlandish for a kitty on dry food. Take a look at Skooter's SS. Skooter's caregiver uses a human glucometer. Notice how his numbers were really high until she started to transition him from dry to wet on 7/4. She did the transition slowly while adjusting the dose down slowly.

I would recommend that you start a Spreadsheet for us and put as many numbers as you have on there. Please be sure and put in big bold letters at the top in the Remarks that you are using an Alpha Trak. Do you test every pre shot? I'd be sure I got a test before every single pre shot and then vary the tests. One cycle, do a +3 and +7, another do a +2 and before bed, etc.

Once you get the SS up (please send me a private message by clicking on the PM under my gracie's picture if you need help; it will take me about 1 min to do a SS for you to fill in numbers), then you might want to move over to the Lantus Tight Regulation Insulin Support Group where there are more of us to keep an eye out and to help you get his numbers under control and figure out if his dose is correct or not.

I would also get some ketostix from the pharmacy and check his urine ketones every day. Without fail.

I doubt the ear poking at home is raising his BG too much. Are you using Neosporin Ointment with pain relief after every poke? Are you poking the edge of the ear? Here are some Testing and Shooting Tips. Please let us know other questions you have.
 
Hi Everyone,

Thanks so much for the support. I did his BG test it was at 485. Just doing a simple post to see if I can get his digits up.

Cheers,
Lucinda
 
Hi Lucinda,

How are you and Guinness doing? You did a great job with the spreadsheet.

Please let us know how we can help - we love to answer questions! :-D
Shelly
 
Hi Shelley and Everyone,

Thanks so much for checking in. I have some good news to report.

Wet Food
-He's sort of eating it, but quite finicky. He's best with chicken, iffy with turkey and duck, and detests beef (it makes him vomit poor boy. Thanks Larry for the food list! (I was utterly confused trying to locate the different flavors)
Question/Advice
-Per his Vet he should eat 235 calories a day. Where do I find calories on cat food? Is their a magic list somewhere? I'm worried I might not be feeding him enough. He needs to loose weight but I don't want to starve him. He seems good, but I'd like to make sure his calorie needs are met.
-Also, is it OK that he swaps been different brands/flavors as long as his calorie needs are met? So far no digestive issues
-Any advice on treats? He's never eaten them EVER or human food, but perhaps his taste buds have changed? With all of the additional pokes he's getting, I would like to make more of a fuss of him than just a nice brush.

Glucose Levels (His numbers are not up to date)
-I had to travel for work, and my sitter won't do ear pokes, but I tested him last night and he was 69 pre-shot! I skipped his shot of fear of having a hypo kitty, and this morning he was at 225! It's a 200 point decrease from his normal at that time with skipping his insulin the night before. I'm planning to do a curve on Sunday.

Ketones
-I bought the test strips and we are 100% negative!

Happiness Factor
-Attacking feet, string, and biting. All of his favorite hobbies.

Thanks so much everyone for all of your support and advice.

Cheers,

Lucinda
 
Nice to see you and Guinness, Lucinda!

It's definitely okay to feed a variety of foods, and it may take a little while to figure out what he likes best. I fed Jersey several different flavors of Fancy Feast classic pates, and I found a place online where I could order single cans of food. I think I tried about 20 different brands; of course, she didn't like any of them. ohmygod_smile She also ate Wellness Core and Friskies special diet. We kept coming back to the same old Fancy Feast, though. It's what she liked the best.

I've seen that a lot of people use Pure Bites treats for their cats. Jersey, of course, didn't like 'em. She absolutely loves the Orijen treats, though.

That's great news on the negative ketones and on the play. It just makes your heart fill with joy to see the old play come back, doesn't it?

Glad you skipped when you saw that 69 pre-shot. It's quite a way to wake up in the morning, isn't it? Can you add the numbers to your spreadsheet when you get a chance? It just helps us see the trends (which sound like they're moving in the right direction) if the spreadsheet has the most recent numbers.

Thanks for giving us an update.
Shelly
 
Thanks Shelly and Critter Mom,

When I got Guinness I was required to name him after a beer, liquor, wine, or cordial. Being a tuxie, it worked. I think I need to go to tech support. His digits aren't updating automatically, but I finally got them posted.
I'll definitely try some of your treat recommendations. Hopefully it will make me feel less guilty poking him all of the time if he gets a reward.

I've been having trouble getting an avatar to be small enough, but till then, I thought you may like to meet my precious.
 
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