Pls Help.12days Back to insulin BG level still HIGH

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theng&miko

theng&miko

Member Since 2010
My cat MIKO 13years(male) old was diagnosis diabetic on July 2010 & OTJ 6 month. But honeymoon is over get back to insulin on this March 21,2011.
We also don't know why he have to back to insulin . Lab work came back showing normal only Low Platelet count : 46,000 * (low) & Urea : 116mg (high),Fructosamine test: 399**umol.

solarpen.jpg

We are using Human diabetic uses the SoloStar pen: http://www.lantus.com/images/hcp/charts/breakout.gif .Turn 1unit or turn 2unit and then push the button to inject.
My vet didn't teach me use the U-100 human insulin syringe. This Solapen is my vet recommended. I have no choice.

I have post before this few day topic on main : Pls help. 27.3mmol worry hyperglycemia. My vet said don't worry for high BG and is does matter only scare low hypo level.
The FDMB member said is REBOUND (Somogyi effect) i search for this name and learn more. My vet not much experience in diabetic . Vet said 2u for 2 week. But The Bg number is still in high level so me & my sister decide to inject 3u but my Vet didn't recommend. My vet said if have any effect u have to responsible. :shock: :sad: . When reach to this high number 491mg/27.3mmol we call Vet said don't worry for high BG is does matter only scare low hypo level. :shock: If high level to hyperglycemia my vet also don't know how to handle.

Pls view MIKO spreadsheet . Miko only eat EVO Turkey & Chicken Formula Canned Cat and Kitten Food before insulin at 11.30am & 11.30pm (3 spoonful cat food and add water). All time every 2 to 3 hour eat stem Chicken breast add water( small meal ).

Please HELP. Any help is greatly appreciated. THANKS THANKS THANKS SO MUCH.
 
Theng's post from main health yesterday

Hi Theng!

I read your post over in the Main Health forum and posted a link above to it. That way you won't have to repeat everything.

I'm new to this so can't offer any advice, except that I'm pretty sure you're going to want to find the U-100 needles to use with your Solostar pen. Lantus needs dose changes that are less than 1 unit and you can't do that with the pen.

But you are in the absolute right spot now and will get help for Miko here. Don't worry. Seems like most of the experts live in the eastern time zone of the US and canada, meaning for them, it's about 3am now. Probably will see some people up and responding in another 2 or 3 hours.

Glad you're here!
 
Theng, do you need help right now? What is Miko's BG right now? People are not on the board at this hour usually, I'm not an advisor but I can sit up with you if you are in need now.
 
Welcome, Theng!

you've signed on at a time when traffic is a little slow on the forum...I am not one of our wise folks, but rest assured you will get some very good input here.

The folks that live on the East Coast USA generally begin logging on quite early...truthfully it may be a couple of hours until then...which will be evening for you.

I can tell you that many of us use the Solostar Pen from lantus...we just use the U-100 syringes rather than attaching the Opticlix needle that comes with the pen for human use.

There is a vast amount of experience, support, knowledge and compassion among the people on the forum...and they are very willing to share!

I'm not knowledgeable or experienced enough to give you input...but i will try to draw the attention of the folks who can help you and Miko.

Good to see you here...there's something truly lovely about seeing people from around the world helping people help their beloved companions.

Celi & Binks
 
Hello mybuddybinks,Nicole & Baby & julie1220,
Thank you so much for reply. Now Miko still find. A bit lethargic coz bg level high, but still play a bit at night, eating fine (2hour meow for food), drink more & pee more about 10 times every 2 hour am to pm a day. I scare the high Bg level will damage organ.
Miko-1.jpg


Any help is greatly appreciated. THANKS THANKS THANKS SO MUCH.

Best Wishes,
Theng
 
hi there
I dont have much time left this morning to stay on (have to go to work)

from what I can tell on SS, it looks like it was a furshot? you missed right?

when you have time, read the information stickies, including the dosing protocol we follow here. At the top, you'll see them all with the star icon.
oh and breath ok? it's going to be ok.

Miko is very sweet by the way! Cute pictures!
Hang in there ok? One day at a time!
 
Very cute pictures, thank you for sharing! ;-)
How are you drawing the insulin? I see on your spreadsheet you have "push button but not press harder" ... I ask this because of the picture you shared of the Lantus pen too. Are you using u-100 syringes? Are you testing for ketones?
You are doing a great job.. how much longer until your next shot?

**Just reread your post, I see you are using the needles that come with the pen, I am not familiar with those & cannot offer any advice. Others will be waking up to help you too.

I still would like to know though (it will help others) how much longer until your next shot? (How many hours?) (Are you testing for ketones?)
 
Just want to welcome you to LL and our dose advisors will be able to offer you a lot of advice and like the others said when you have time read and read the stickies at the top of the lantus forum so much helpful information there I have been here over a year and I still refer to them often and love the pics of your cat :smile: :smile:
 
Hi Theng,
First, with your Lantus pen, you do NOT have to use the needles that attach to it... many people use those pens here for their cats, but instead of attaching those needle tips, they just insert the needle on the U-100 syringe and draw out the amount of insulin needed. It's important to make dose changes in much smaller amounts, less than whole units.
There are pictures for using the syringe to extract insulin from the Solarstar pens; hopefully someone can attach pictures for you on this thread.

Anyway, here are the links to the info on the protocol followed on this site when using Lantus:
Tight Regulation Protocol
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
Lantus & Levemir – Data Ready to Shoot Low Numbers
If you can read over the first one, you will see what I mean about smaller dose adjustments.

Your spreadsheet is amazing and provides a great deal of data... It looks like something happened around March 11th. I was wondering about some of the things that can cause a return to high BG - you went to the vet and bloodwork was done, what about checking urine for infections and also, what about the teeth? Maybe there is a bad tooth or some dental problem? I am wondering because the fructosamine number is quite good at 399

My cat MIKO 13years(male) old was diagnosis diabetic on July 2010 & OTJ 6 month. But honeymoon is over get back to insulin on this March 21,2011.
We also don't know why he have to back to insulin . Lab work came back showing normal only Low Platelet count : 46,000 * (low) & Urea : 116mg (high),Fructosamine test: 399**umol.
Click to expand...

I can't comment on the platelet and urea values but I am sure others will have that knowledge for you.

As already mentioned, testing for ketones is important with high BG numbers, so get yourself fresh box of ketostix or ketodiastix from the pharmacy and check Miko's urine at least once a day. If the strip records eve just a trace, please post on your thread here and someone will help you.

You will need to pick up some U-100 syringes, and be sure there are half unit markings on them. On the boxes of BD syringes I have, there is a label on the side.
You want the 31-gauge, 3/10 ml syringes with half unit markings.
 
Miko --

Are you able to purchase syringes in your country without a veterinarian's prescription? If so, please get the syringes people are recommending. If not, please ask your vet to give you the means to purchase these syringes. Many veterinarians are unaware that you can withdraw insulin from the pens with a syringe.

Please test Miko for ketones. With numbers in this range, ketones are a possibility. Ketones can be very dangerous.

With Lantus, jumping from dose to dose will cause numbers to jump around, as well. The initial dose of Lantus needed to be held for 5 - 7 days. Subsequent doses need to be kept stable for 3 days.

It also looks like you are not getting pre-shot tests (AMPS or PMPS). It is important to not skip these tests. It is the only way you will know whether it's safe to give a shot.
 
Hello,
Sorry for late reply, Thanks you so much for all member advice. I find at pharmacy only have BD ultra-fine only 30 gauge needle. Don’t have 31 gauge needle 1/2 unit markings. But my vet not agree us to use it. She still recommend us to use the Solapen with human syringe like above photo coz last time have remission before. We got no choice, today 11.40am we shot 3u at am and will shot 2u at pm. This morning Miko vomit but still eating and playing as usual. At 8.55am (malaysia time) pee and poo still ok and normal but at 9.05am Miko have problem when he go to pee. Miko pee about every 2 to 5 minutes around 18 times (small clump) and Miko meowing when pee. Call vet, Miko have to eat antibiotics & also need to test urine again. Hope not kidney and bladder stone......
 
when you took that urine test, did you wait about 15 seconds?
or was it longer? I believe it is about 15 seconds count for the colour if any, to show up, the longer you wait the darker it gets, I think

but anyway, if that test is right, and it showed up that colour right away, that is not good.

Miko have problem when he go to pee. Miko pee about every 2 to 5 minutes around 18 times (small clump) and Miko meowing when pee. Call vet, Miko have to eat antibiotics & also need to test urine again. Hope not kidney and bladder stone......
Click to expand...


if Miko is showing signs of distress while using the litter box, that could be very serious. Any chance the vet could check him out again?
 
I think you may be using strips that measure urine glucose levels -- not ketone levels. You need Ketostix, not Ketodiastix. The color coding is different. See this link.

If you are using Ketostix, there are two possible things happening. There may be blood in Miko's urine. That will cause the urine to be a red/brown color. If you have not taken Miko to the vet or this is a new development, please get Miko to the vet. The many visits to the litter box is not a good sign. Miko could be developing crystals and if he becomes blocked, this could be an emergency.

If this is a valid reading on a Ketostix, Miko is very sick. You need to get your cat to an emergency vet immediately. A red/brown reading on a Ketostix indicates a very high level of ketones and this cannot, under any circumstances, be managed at home. Miko will likely need to be hospitalized for treatment.

If these are Ketodiastix and you followed the instructions for urine glucose, it means that Miko's blood glucose levels are high. This reading should be consistent with the reading on your meter.
 
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