Roller Coaster readings...Any advice to regulate?

Calicos are Best (GA)

Calicos are Best (GA)

Member Since 2019
Hi everyone,

I have been struggling to stabilize my cat Lily's diabetes. She has a history of pancreatitis, bladder infection, and has gone into remission before for 9-10 months. Lily was just hospitalized January 17, 2019 and back in October 2018.

Looking for some advice to get Lily's numbers under control. Lily's readings have been crazy like a yo-yo and I am very worried. I am trying very hard NOT to have her go to the hospital again. Lily's normal food is Kitten Fancy Feast. For 1 week I tried to mix some different foods with the Fancy Feast. For 4 days I mixed 25% of Wellness with Fancy Feast and for 3 days I tried to mix 25% Weruva with Fancy Feast. The meter readings have been so bad I cut out trying new foods and am just feeding Lily Kitten Fancy Feast. (her regular diet as of January 29th).

Here are some examples of Lily's recent readings:

1/27/19:
527, gave 2 units of insulin,
12 hrs later it was 96, did not give her any insulin

1/28/19:
692, gave 1 & 1/2 units insulin,
12 hrs later it was 516, gave 2 units of insulin

1/29/19:
96, gave 1/2 unit of insulin,
12 hrs later it was 549, gave 2 units of insulin

1/30/19:
109, gave 1 unit,
12 hrs later it was 236, gave 1 unit of insulin

1/31/19:
604, gave 1 & 1/2 units of insulin,
12 hrs later it was 237, gave 1 & 1/2 units of insulin

**** Does anyone have any advice or insight? I have a couple spreadsheets with Lily's info in my signature. Lily is on Lantus insulin. ****

I have been out of town for about 3 weeks helping family. I don't know if the stress of being in a different house is affecting Lily's diabetes maybe?

Thank you to anyone who can help! Any advice would be greatly appreciated!!! :cat:
 
You did the right thing coming to this forum for help. I'll let the others weigh in on dosing but I can tell you the first issue that will be addressed is the need to keep the same dose AM and PM. Lantus works best when dosed consistently. Have a look at the yellow info stickies on this forum's main page.
 
Thank you for that advice! I didn't know it was bad if you give different doses. I was struggling on the 27th of January, when it was 527 in the morning. I gave 2 units of insulin and then it went to 96 at 12 hours later. So I didn't give insulin and it sky rocketed to 692 in the morning on the 28th of January.

Same thing happened on the 29th of January, only it was 96 in the morning. Didn't know what to do, 2 units was way too much to give at 96, so I did a 1/2 unit to help, but it was still bad 12 hours later at 549. I definitely need some help!
 
We determine how to change the dose of Lantus based on how low it takes the cat, and don't usually look a the high numbers, which tend to be the preshots. Getting tests somewhere in the middle of the cycle is key, including the night time when many cats go lower. Since you've had to skip a couple shots after giving 2.0 units, I'm going to say it's too high a dose at this point. Since you've have given 1.5 units for a couple cycles in a row, let's stick with that dose for now and see what happens when the depot stabilizes with some consistent dosing.
 
I like that plan. That sounds good to stick with 1.5 units. Would you guys continue to give 1.5 units in the morning, if the reading is 96 again? or even at 150? Should I give 1.5 units or would you guys skip that dose with a reading 200 or lower? I always give insulin while my cat is eating.
 
The answer depends on a couple of things. First is your ability to monitor after giving insulin. Second, people here pick one of two dosing methodologies, the Tight Regulation Protocol or the Start Low Go Slow Method. Each of those dosing methods has guidelines on shooting low. Regardless, on this forum, we suggest that if you get a number below 150, you do not feed, and post here for advice before shooting. If people choose SLGS for dosing and do not have much data, that number would change to 200, especially if they cannot monitor that cycle.

Those dosing methodologies both have what is called a reduction point. Meaning if Lily goes below that number, the dose would be reduced further. So you would hold the 1.5 unit dose for at least a few more days, unless she goes below the reduction point. Can you get another test in tonight before bed?
 
Interesting methods! I did check Lily's blood tonight before I gave her insulin maybe at the 11th hour instead of exactly at the 12th hour. So at 8:58 AM this morning Lily's BG was 604, then tonight at the 11th hour at 7:48 PM it was 237...I don't know if that makes any significant difference using the Tight Regulation method?

I just did another meter test at 11:21 PM and it was 201. I am thinking by morning it will probably be a low reading. Perhaps I should have given 1 unit instead of 1.5 units like I did at 7:48 PM?

I will be leaving Lily at home tomorrow after giving insulin, but I won't leave right away. I should be able to feed her and give her insulin in the morning. At the 2 or 3 hour mark I should be able to check her blood again before leaving.
 
That's great if you can get a +2 or +3 before leaving. If it's down quite a bit from the preshot, then you could leave higher carb food out for her to snack on to keep her safe.

Calicos are Best said:
Perhaps I should have given 1 unit instead of 1.5 units like I did at 7:48 PM?
Click to expand...
We determine dose based on how low it takes the cat. So far her numbers haven't said she needs a dose reduction.
 
Well Lily's BG was 201 before I went to bed last night and it was 601 this morning. I checked it 3 hours later before I left the house and it was 434.

Tonight at 8pm it was 470 tonight. I gave her 1.5 units last night, this morning, and tonight. We shall see where her numbers show after having a soild pattern of 1.5 units. I think another factor is that she is one room all day. I'll have to let her move around more in my family's house. It has been hectic with the other animals in the house that upset Lily. They will have to take turns in the living room.
 
Keeping with the 1.5 units still. Lily's BG was crazy tonight at 665. Gave her 1.5 units of insulin tonight.

Gave her 1.5 units this morning. She was 203 before insulin this morning and 137 when I checked 3 and a half hours after her insulin. Was I supposed to give Lily 1 unit this morning instead of 1.5 units? I didn't want to mess up the dose and wasn't sure if I should change it yet so I did the same dose I have been doing. What do you guys think?
 
Glad you gave 1.5 units this morning. We determine dose based on nadirs, not the preshot values. Nice little blue in there today,sorry about the resulting bounce.
 
Yesterday & Today's Lily's #s:

2/3/19 8:19 AM - 514, gave 1.5 units
2/3/19 12:26 PM - 418

2/3/19 8:07 PM - 481, gave 1.5 units
2/4/19 12:04 AM - 408

2/4/19 8:13 AM - 607, gave 1.5 units
2/4/19 11:13 AM - 410

With these kinds of numbers, what do you guys think? Should I continue the same dosage? Increase it? OR Something else to keep in mind is the Insulin. The insulin I am using is Lantus. The bottle was first opened the 1st of September. Lily has been using the same bottle.

I don't see any floaties or cloudiness. I have read on here that those are usually things to look out for. I have another bottle of insulin, but I have been saving it to crack out at the right time. Now to decide if the insulin's potency is changing or is it Lily's Body?
 
She is bouncing from that lovely blue a few days ago. Bounces can take up to six cycles to resolve. Paws crossed that means she will come down tonight or tomorrow morning. One thing you can do is look at the dosing methods Sticky Note and decide if you would like to follow Tight Regulation or Start Low Go Slow for dosing. The one you chose determines what you would do next with the dose.

People here have gotten 5-6 months out of their Lantus vials. It was only seven days ago that she saw a green. When vials go off, it’s more gradual. The pens are a better deal because there is a smaller amount in each one, so you can usually use ito the last drop.
 
Thanks Wendy! You're so kind to be watching over and helping with my Lily! :cat: I think I will go with the Start Low, Go Slow approach. I'll give it some more time at 1.5 units and then pick a day to do a curve. I like this approach as this is what my vet had me doing. Only she said not to check the blood all the time, every day and only rely on the curves. However after being on here I am learning it is good to have the numbers all the time.
 
OK,with SLGS you would hold this dose for seven days, then do a curve. You are right that all the data counts. Could you put SLGS in your signature, so people know how to help you. And tomorrow,start a new post with a a link to this one. Our convention here is to start a new post per day so they don’t get too long.
 
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