? Sally; totally confused

[Ter and Sally]

I'm not seeing any action in Sally's numbers. Started dosing with calipers after finding some really horrible syringes in our new box of syringes. We had a low in the 50's then a few days of bounces and we haven't recovered since. We thought we were on the right track when we were able to confidently measure our doses. Now I doubt everything we're doing. We considered glucose toxicity, and thought that since we weren't even seeing blues anymore it would be wise to increase but did it cautiously. Her last labs at the end of July were normal, ultrasound normal, recent UA had some bacteria but the rest was normal. We did make a bunch of changes at the same time; different brand of syringes, measuring with calipers, dose change, antibiotics, new vial of lantus. The AB's were compounded and did have sweetener. This has all been in the last 2 weeks.
Are we missing something? Or is something else going on? We have been feeding her FF Tender Beef and Chicken mainly because the carbs are the lowest based on the new food chart. Should we not worry about the carbs and feed her the other low carb flavors; have we gotten our info wrong? She has been a little crazy sometimes for preshot tests, but is always napping or pretty settled during the day/night when we have tested her. My usual thing is to think she needs less insulin but I am fighting that because I am sure that must have what brought us to this point to begin with. No pu/pd. We add water to her food because she never drinks a lot.
Our meter's working fine, the strips are fine. What am I missing? Could it possible be as simple as NDW?
Is there something we should do by process of elimination to find out what might be happening?

 

[Wendy&Neko]

That's a lot of changes at once. It's always easier to see what is happening if you change just one thing at once. I know it's not always possible to do so. It's also easier to see what is happening if you note changes in the Remarks section of the spreadsheet. Changes such as staring and stopping ABs are worth noting. Ditto with new Lantus vials or pens. Then you can relate changes to what are happening with the numbers.

You don't need to feed the absolute lowest carbs, and in fact some cats do better on slightly higher carbs, but still under carbs of 10%. Food can also differ slightly from manufactures batch to batch regarding carbs so who knows if it's even the lowest carb in a oarticulR can. I fed food that was mostly in the 3-5% range. If Sally wants variety, give it to her.

OK, regarding dosing. Experience here, and the SLGS method, suggest 0.25 unit increases are better at this point. Just sneaking up the dose doesn't work as well. You also have some glucose toxicity likely going on. Another thing that will also clarify what is going on is to try to get a night or before bed test each night if possible. May have cats go lower at night, it's those lows that tell us how to change the dose.

For now you are seeing NDW. If after 7 days you don't start seeing most nadirs between 90 and 150, I would do the full 0.25 unit increase. Hopefully you won't have to.

 

[Ter and Sally]

I was hoping I was seeing NDW. Scared of what other possibilities there could be, although I think I am jumping the gun there because there is no reason to suspect anything else at this point. We made all those changes coincidentally, then thought about it in hindsight. I noticed my husband hasn't been putting the comments in the remarks section but in the little notes in the spreadsheet.
I'm disgusted with myself for being such a chicken about increases alll along.
The food issue is one we have been grappling with as well. She used to get variety but then when the new carb info came out we changed to just the one flavor. We have been thinking about just going back to what we used to do thinking that the carbs may be beneficial; I don't think they are necessarily bad unless they are super high.

 

[Sienne and Gabby (GA)]

I agree with everything Wendy noted.

With regard to a UTI, did your vet get urine via a needle and do a culture and sensitivity test? If not, there's a reasonable chance that the antibiotic may not be specific to the bacteria that caused the problem. A UTI can cause high numbers. You may want to get the urinalysis repeated if: (1) the original test wasn't a cystocentesis or (2) to make sure the UTI is gone. UTIs can be rather persistent. Sorry if you know all of this -- others who are reading may not be familiar.

 

[Ter and Sally]

Oh no Sienne I never mind; I appreciate all the help. And sometimes you need to be reminded. We didn't do a cysto this time. Sally doesn't travel well and the place I work (for a derm vet) and her vet are both 30-40 miles away, respectively. We have to time her travel so that it is well after/before her meal times, and we only have 1 car, so this time on short notice we weren't able to plan. I did do a repeat free catch and the bacteria was gone, and everything else was in normal range. I was hoping the infection was causing the change in numbers but now I guess not. In the past she has had both an anal gland infection and UTI and neither time affected her numbers, weird.

 

[Sonia & Leo]