Regulation Woes

[tehM00k]

Hi FDMBers,

My cat Mookie was diagnosed with diabetes 3 months ago in October. She is a 5-year-old 10 lb short-haired calico. After her initial treatment, she was on 1 unit of Lantus twice daily, then my vet had me switch her to 1 unit once daily, but after 3 days on that schedule she was vomiting and getting sick again. I started giving her 0.5 units twice daily and that was working out pretty well for awhile. However, mid-December, she had a weird, backwards curve that was in the 300s and 400s all day, and ever since then I haven't been able to get her levels back on track. I increased her dosage to 0.75 units 2x/day, then I increased it to 1 unit 2x/day, but her glucose levels kept going up & down. I suspected that either A) The insulin vial was losing its potency (I had been using the same one for 3 months), or B) She might be experiencing chronic Somogyi rebound. I started using a new insulin vial and I've been giving her 1.5 units 2x for the past 3 days, but her glucose is still hovering in the 300s-500s.

My initial reaction was to increase her dosage, but if it is a case of Somogyi, then I am just making things worse. I consulted my veterinarian, but she didn't give me any clear answers. What should I do? (Please take a look at her insulin log - there is a link in my signature below).

Thanks,
Sarah

 

[Wendy&Tiggy(GA)]

Hello there!

Welcome to the board, sorry to hear you are having problems. It's great that you are testing and tracking (lovely graphs!) although we would find it easier if you used our format.see here for instructions.. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Anyway First thing I can see is you are feeding friskies prime filet turkey dinner with gravy? According to our chart it's too high in carbs at 14%. You really want foods under 10% such as friskies classic pâtés but there are other foods on the chart you can choose from.

Secondly it would be good if you can test more often. We recommend before every single shot and at least once during the day to try and see what her nadir or low point is. We base dose changes on that. Plus it allows to see more trends than individual occasional curves tell us.

I am going to ask to see if I can get more eyes on this but I think they are going to ask you to test more frequently so we can really see what's going on.

Wendy

 

[Marje and Gracie]

Hello and welcome to FDMB

You have alot of great info but I'm not sure I understand it. For example, on her insulin log, you show some days where you only shot in the PM (1/19-1/21).

We also don't increase the doses by quite so much (1u to 1.5u) without mid cycle tests because we don't dose on the preshot...we dose on nadirs with seem consideration given to the preshots.

Lantus likes consistency so shooting as close as you can to every 12 hours helps.

Somogyi rebound results from a chronic overdose where you see numbers coming down very low and then bouncing up. Somogyi has not been scientifically documented as occurring in cats.

Has she had any infection? How are her teeth?

If there is any way to get her data on the SS (link Wendy gave you), it would be great. The colors help us look at trends and waves of action that are hard to visualize with a table.