question about feeding schedule

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Terra is ravenous this evening at shot time, but her sugar is 538. Should I hold off on feeding her until the Lantus has a chance to get into her bloodstream - say wait until +3 or +4? Is it detrimental for her to eat her fill now, while her BG is so high and before there's any insulin in her system?

She seems a bit unsteady on her feet this evening. That's a very high number and I was encouraged and hopeful by the lowering trend in the BG readings in the past 24-36 hours.
 
I would let her eat. She has had her shot right? That would be the only reason that I would hold off on Bean is if she has not had her shot yet. Otherwise, feed.
 
Thanks for the advice. I am feeding wet low carb food. I wasn't sure if feeding when sugar is high was going to harm her. Just tested at +6.5 and BG's at 369. High but at least it's lower than at PMps.
 
Are you testing for ketones. With BG levels like that you need to be testing regularly for ketones. You can get ketodiastix from your pharmacy to test her urine if your meter doesn't do it.

I am very concerned by your comment that kitty is unsteady - that, combined with the high BG levels if they've been that way for a while, could indicate DKA which is very serious indeed and requires immediate vet attention. I don't want to alarm you but please keep a close eye on her and take her to the vet immediately if she remains unsteady and seems lethargic. Often you can smell a fruityness on their breath too. I have included a couple of links for you below.



http://petdiabetes.wikia.com/wiki/Ketoacidosis
http://www.felinediabetes.com/ketones.htm
 
To answer your PM questions:

Yes it looks to me like Terra is bouncing and this is perfectly normal. When she gets into numbers lower than she is used to her liver has a little panic and starts releasing glucoden. As she goes on and her liver gets used to being in lower numbers and starts recognising them as normal again we hope that it stops reacting like this. Lantus can take 4-6 weeks to settle in and you should expect to see something like what you are seeing to start off with (not saying there won't be bounces after this time though).

I highly recommend you post you results daily in one of the lantus forums (tight regulation or relaxed - if you are trying for remission I recommend tight regulation which is where Vyktor and I post) so that experienced people can get to know you and Terra and keep an eye on what is going on and give you informed advice.

I am concerned with your dosing. Lantus likes consistency - the same dose at same time twice a day 12 hours apart. I see that you are moving backwards and forwards between 1.5 and 2 units, this is not the way to go. To get the best results increases and decreases are generally made in 0.25 increments and on the basis of nadirs based on a specific protocol.

In regard to getting some urine for ketone testing it is not necessary to catch her in the act if this doesn't work for you. I am lucky in that Vyktor goes pretty much like clockwork at around 5 - 5.30 am. I hear him scratching in the litter, race out of bed and shove a spoon under him to catch a sample (I leave the spoon on a desk near the litter tray so we are ready to go at anytime). If Terra is shy about her toileting you can try other methods. Some people put some plastic wrap over the litter others use clean aquarium gravel (which is not absorbent) in the tray. In the past (before I discovered Vyktor was amenable to the spoon method) I have cut up plastic shopping bags and put those in his tray instead of litter. As long as you can test the sample within an hour they are all good methods.

I can't emphasise enough how important the ketone tests are and I am worried about Terra based on what you mentioned about her being unsteady on her feet and also that she is losing weight. The first outward sign I had that Vyktor had DKA was unsteadiness on his feet, at this point it was already extremely serious. Vyktor was hospitalised for four days with the vets uncertain whether or not he would pull through for the first two days...
 
hi karen,

i want to second what serryn has told you. you won't have a good response as long as you are changing terra's dose around. you will continue to see wonky numbers and you won't be able to get terra regulated. i can't emphasize that enough - lantus likes consistency. it's just the way it works in cats. between dogs, cats & people with diabetes, cats are the hardest to regulate. you want to try to stay as close as possible to 12 hours apart on the shots (you've got about 15 minutes leeway without it affecting anything) and you want to hold the dose for at least 6 shots that are consecutive. of course if life happens and you can't do it in 12 hours, you just do what you need to do and regroup later.

if you post daily on one of the lantus forums - i know you've posted in both - but if you post, at least on the TR forum people watch out for newbies and will simply tell you when you need to change the dose. i'm sure that's true on the relaxed forum as well. we encourage newbies to edit the subject line of their first post of the day and ask for someone to give advice on the dose - then a person who feels comfortable reading terra's spreadsheet will look at it and give you suggestions to hold the dose or increase. when we increase it's almost always by .25units. a 50% increase is a lot and it causes even more bouncing - which you are seeing some of.

i saw you are contemplating starting over. i'd discourage you from doing that at this point. you've got some significantly high numbers, you're reporting some symptoms that are concerning and possibly from the BG being too high. i'd return to 1.5units tomorrow morning and then stay there for at least 6 consecutive shots.

it's an overwhelming thing to learn - i totally understand. don't feel badly about any of this - let's just help you get terra back on track! hang in there and the folks who are farther along the sugar dance than you are will help you learn.

regarding your question on food - at 7am i test punkin's BG, prep 1 can of fancy feast low-carb and get his insulin ready. when i put down the food bowl and his face starts sucking, i shoot the insulin in. 3 hours later i test his BG and give him 1/2 can. from that point until the next shot at 7pm, i give a very small snack when i test him. at 7pm i repeat the process from this morning.

i don't change any of that routine based upon numbers, except to test more often if it looks like he may be getting low. if a cat is sick and vomiting, then post and someone can help you discern if you should give the full dose or not.

just ask if you want to change the dose so we can give you the benefit of our expertise! :YMHUG:

it gets easier!!! truly. i would guess it will take a few days for terra to recover from all the changes, however. hang in there!!!
 
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