Recently diagnosed. Glucose drop from 345 to 91?!

4catmom

4catmom

New Member
Hi everyone! This is a bit long, so please bear with me. :) So my beloved kitty Juliet has recently been diagnosed with diabetes. It’s been a month, but I’m just now discovering this group. Her glucose level was in the 500s at the vet. She’s on Prozinc. Vet said to increase units by one every few days until she’s within the normal range. Juliet is 10, and very set in her ways. She absolutely REFUSES to eat wet food of any kind. She’s always been that way since I adopted her 9 years ago. I’ve been trying low carb, high protein dry foods. Her numbers usually are within 340-215 pre shot. (I test midday when I can, but my work schedule doesn’t always allow for this.) We’re now up to 5 units, and we’re still in that range. I’m worried about when it’s going to stabilize. 6 units seems a bit high to me, I’m worried about upping her dose to that. She’s peeing less, drinking less water, she’s gained weight and her coat is soft and clean again. Definitely an improvement in those areas. Last night at bedtime her glucose was 345. Gave 5 units. This morning her insulin is 91! Do I give any insulin at all? I don’t want her to drop too low. This is frustrating and my vet isn’t ever available to answer questions. I’d appreciate any and all advice!
 
Either don't give her insulin this AM or drop her way down to only 1 u for this AM. She might be on too high a dose but with no data to look at we can't be sure. You're correct that 6 u is a high dose and we recommend dose increases of only fractions of a unit (0.25 u - eyeballed) to avoid skipping past a good dose or accidentally overdosing.

Here's some info I put together for new members. It includes the testing routine we recommend, how to set up your "signature" so we have info at a glance, etc. Read it over a few times and ask a ton of questions! :)
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It would help us if you set up your signature (light grey text under a post). Here's how:
  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

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Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes (do what you can on work days)
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
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Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
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Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
 
I'm far from an expert shooter, but my kitty is an expert bouncer. :) If he drops too low, he's a puker, which seems to be fairly rare so I thought I'd share in case you see it. If I find kitty puke that's the color of food & digested/very liquidy (often with a tiny bit of a furball), it means he's gone too low and his body has freaked out. I spent a lot of time early on worrying about furballs or pancreatitis before the vet helped me realize that it's a low BG reaction... and I need to adjust the shots/food accordingly.

It's VERY overwhelming to being with -- I've been at this over 3mos now and I still have a largely unregulated kitty and daily moments of self doubt... but he DOES feel better (no ocd drinking/eating, better coat, playing with his bonded 'sister') ... so despite his numbers being bouncy and annoying, I'm on the right track -- and clearly you are too if she's already feeling better.

When I found this forum, I wasn't shooting under 300 more often than not, per vet advice (there's more to it than just that advice, but that's where we were landing) -- but that clearly wasn't working, so I started following the protocols that @Kris & Teasel shared and I started learning, he started getting better, and I'm gaining more confidence weekly. I chucked all of what I'd done and started low in early August, and increased by 0.25u ... it's working for us, albeit not quite as quickly as "I" would like. Romeo is also a slow settler... so many cats settle into numbers within a few cycles of the same unit... Romeo takes longer, and I seem to be letting him settle almost up to a week when I increase a dose. The bottomline is, the more testing you can do, the more information you have, and the more we (or really the others who also help ME, lol) can help you. Hang in there!!

p.s. My Romeo has a Juliet too... of course! :D
 
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