Not sure what is happening..Need advice

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underdawg

underdawg

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Bo was diagnosed 9/23 with a BG level of 561. We went on 3 units of Lantus twice a day. Food was changed to Hill's m/d dry. Then when I read about dry food on this board, I changed to canned only with some 75% protein chicken treats. Later the insulin was increased to 4 units twice a day. Never could get many readings with the AccuCheck Aviva. Then he had a seizure last Monday night. I was able to use Karo and get him to eat before taking him to the emergency vet where his BG was then 74 upon arrival. The next day the regular vet changed dose to 4 units once a day to start on Wednesday. I did not feel comfortable to give 4 units but instead only gave 2 units Wed morning. Wed afternoon BG was 131 before eating. Thursday morning gave 2 units - BG was 349. Decided to feed 4 small meals. Actually midday and midnight "snack" is what is leftover from his portion for the breakfast or supper. Friday morning I could not get a BG reading so I did not give a shot. Friday afternoon his BG was 324 so I gave him 2 units. This was the last shot he has had because his BG levels are too low for me to give a shot: Saturday pm 119, Sunday pm 177, Monday pm 98, Tuesday pm 87, tonight 77. What does this mean? He has not had a shot since Friday night. He is scheduled for a curve This Friday to see what is happeing throughout the day. Can he hypo with no insulin in him? Tell me what this means. I was thinking it was maybe something positive..now I don't know what to think. Is he responsing to the diet change and loss of weight? Thanks for your help.
 
Bo cannot hypo without insulin on board, so no need to worry.

Just keep checking bg twice a day a few more days, but it seems like Bo is going on a honeymoon!

Congratulations!
 
Please continue to monitor his BGs. Although he can't hypo without exogenous (meaning from outside the body) insulin on board, these lower numbers you're seeing could be because of the symptomatic hypo and he may need insulin again in a few weeks. It is known that cats which have had hypos become more insulin sensitive. It may be a temporary reprieve or it may not be. Only time will tell.

When I was giving PZI insulin I caused Gandalf an asymptomatic hypo which resulted in his insulin needs greatly decreased for about a month, if you're wondering what the time frame might be. If he's still holding numbers below 150 in a month, he's probably in remission.

Was the vet made aware of your diet change before telling you to increase to 4U? And the advice to give 4U once a day to a cat which had had a symptomatic hypo greatly concerns me. It seems very old school - treat the hypo, not the diabetes, type approach. Meaning continue giving the same dose of insulin until they hypo again, then we'll consider lowering it.

There is a wonderful dosing protocol for Lantus called the Tilly protocol, which has helped many cats go in to remission and prevented what happened to Bo. You can find it here: http://www.tillydiabetes.net/en_6_protocol2.htm

Please print it out and give it to the vet. It may save another cat's life.
 
looks like he may have become diet controlled. don't let him eat dry again, tho, okay? don't relax your guard about that unless he stops eating and will only eat that.
some cats get a big hypo as a sign they are coming off insulin. let's be cautiously optimistic that this is what Bo is going through. on lantus we like to wait 2 weeks before officially saying they are "off the juice." so keep testing at least once a day for a little while just to be sure. really exciting news! :)
 
you said he's getting a curve - is this at the vet or at home? If the vet, you may want to cancel it, as you will just be wasting your money and the results won't be productive - due to all the outside factors including vet stress.

As you are home testing, you are much better off conducting your own curve in his own home environment.

just my 2 cents and hoping to save you lots of $$$$.
 
If one is home testing, 'curves' at the vet office don't tell you anything new. You pay money for nothing.

The curve numbers at the vet office are not even true numbers because of the stress on the cat! My Shadoe tests hi at the vet, but my Oliver goes very low at the vet. I get them home and retest in an hour .... and they are back to their normal, true numbers.

Fingers crossed for a nice diet controlled kitty! Toss the dry food out the window!
 
It means you were overdosing him but because you were hometesting you managed to catch his numbers going lower. He is likely going off of insulin, and at this stage you need to watch him closely and only give very small amounts of insulin if he goes over 200 (a very general guideline). And by small amounts, I'm talking 0.5 units, not 2....you do not have enough testing data to support anything more than that.

This is great news, please be happy!
 
Just a slight comment on the idea that bg numbers at the vet clinic...

NOT all cats exhibit elevated blood glucose levels due to stress. Some do, which is why we always caution people, but it has been documented that some cats exhibit no change whatsoever.

Jen
 
Thanks for all the info! The vet was aware of the diet change to m/d dry at the beginning and then I told him later that I changed to wet since i read about the differences in wet and dry on this board. Not sure exactly the sequence of that. I am sharing information that I get with the vet as I learn it. Hopefully, it will help someone else.

Bo and Andy are scheduled for tests tomorrow at the vet. Bo is getting a curve so that we can see what happens during the day with his numbers since it is hard to get more than one reading a day with him by ear. Also that will give me a chance to compare what the vet's readings are with my new meter. I call in or email new numbers to the vet when i think they are significant. Andy is getting blood tests and urine tests due to his UT problems and also to make sure he is not diabetic as well. ( i took a urine sample from my kitchen floor to the vet the other day when Andy was dripping and the vet was concerned about the test which indicated that the cat whose urine I carried in was diabetic. i hope it was just some spilled sugar that was in the dribble since Andy has enough to deal with having all the urinary problems.) Andy will feel better being there with Bo and Bo probably will feel better with company. I am not sure if Bo's numbers are affected while being at the vet. He is usually a very laid back looking kitty but he may be covering up his anxiety. I will pick them up as soon as I can.

Glad to hear about a time frame in which to check and the dosage suggestion if he gets over 200. I can handle that and will continue to be cautiously optimistic. :-D In hindsight, I really agree with the slow go approach. I am glad that you are all willing to help people who are new to this.

Don't worry about the dry food being served to them any more. I have seen the progress that was made with the switch to canned.

Thanks for all your suggestions and support! I will post new numbers after the vet visit tomorrow. Thanks again.
 
If you want to know how your cat reacts to vet visits, tests before leaving home with your meter, test at the vet office with your meter, then test again when you get back home.

Using the above method, I found that my Oliver goes very low, too low, and so I take food with me just in case he needs food to come up again.
 
That is a good idea to find out what happens to the Bg levell at the vet! I took some lunch with Bo last time but he did not eat. I went to visit at lunch time and got him to eat some of the protein chicken treats so I guess that was better than nothing. Since he and Andy will be together, maybe they will eat so I will take some lunch for both. I saw an insulated bag at WalMart that holds 6 cans that was pink for breast cancer awareness. Bo LOVES pink, especially hot pink, so I got that to use as his travel bag for visits to the vet. I hope he likes it.
 
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