Should I be worried?

Smokie’s Mom

Smokie’s Mom

Member
Good morning everyone,

I’m concerned with today’s BG. This morning I tried to take it twice and the meter just said “high.” I did feed and give insulin as usual, and +1 is 578. Trying not to freak out but woild like to know how concerning this is. Thank you!
 
Well, high is definitely too....high. But it's not the kind of thing where you need to rush off to the vet or anything. I'm glad to see you gave a little increase this morning as the numbers in general are still too elevated. You've had some really interesting patterns. Are you feeding anything at all besides the FF and Friskies pates? Treats? Access to another cat or dog's food?
 
Djamila said:
Well, high is definitely too....high. But it's not the kind of thing where you need to rush off to the vet or anything. I'm glad to see you gave a little increase this morning as the numbers in general are still too elevated. You've had some really interesting patterns. Are you feeding anything at all besides the FF and Friskies pates? Treats? Access to another cat or dog's food?
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Glad to hear I don’t necessarily need to head to the vet. Yes, I agree the patterns are interesting, and they’re frustrating to me. Smokie (well, both cats) eats strictly Friskies pate, no treats, no dry food, no other pet food in the house.

My husband is home today and can retest him as needed.
 
Are you testing for ketones? Since smokie has a history of DKA, you want to make sure that you're testing regularly, especially when he's in higher numbers like this.
 
You might ask DH to add some extra water to the food. As much as Smokie will tolerate. Extra water helps to flush out ketones if it's just at trace levels.
 
I did put a call into the vet, but they said the vet left for the day and will call me back in the morning. The tech I spoke with didn’t seem to think it was a medical emergency, which is good. She did ask me to send her all of Smokie’s blood tests so I sent the spreadsheet to them. Now to be patient until tomorrow! I still have a little post-traumatic stress after everything we went through last month - vet visit after vet visit, ER trip, nearly losing him, spending thousands of dollars on clinic visits and meds... it took a toll on me. I am being treated for moderate to severe anxiety, and all of this is triggering my anxiety. Trying to stay calm...
 
Okay, deep breaths. I absolutely understand the anxiety with those numbers. I would definitely cry if I saw a HI reading on my meter.

If he's still high tomorrow, keep him at 2.5 for both cycles, and then you can go to 2.75 on Thursday if you need to. Steady careful increases win every time. If you increase too quickly it just sets of erratic bouncing and then it's hard to know what to do. Insulin doesn't have a direct, logical response - so more isn't always better. It's a hormone and operates on complex systems and it can take a few cycles to know what the dose is going to do.

When you're anxious it's okay to post here and vent and ask for someone to chime in on what to do. We aren't always as prompt in responding as we'd like, but someone will come along eventually. If you want to share what time zone you're in and when you give the shots, we can try to see if someone is around at that time.
 
Djamila said:
Okay, deep breaths. I absolutely understand the anxiety with those numbers. I would definitely cry if I saw a HI reading on my meter.

If he's still high tomorrow, keep him at 2.5 for both cycles, and then you can go to 2.75 on Thursday if you need to. Steady careful increases win every time. If you increase too quickly it just sets of erratic bouncing and then it's hard to know what to do. Insulin doesn't have a direct, logical response - so more isn't always better. It's a hormone and operates on complex systems and it can take a few cycles to know what the dose is going to do.

When you're anxious it's okay to post here and vent and ask for someone to chime in on what to do. We aren't always as prompt in responding as we'd like, but someone will come along eventually. If you want to share what time zone you're in and when you give the shots, we can try to see if someone is around at that time.
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Great advice from Djamila!
 
Djamila said:
Okay, deep breaths. I absolutely understand the anxiety with those numbers. I would definitely cry if I saw a HI reading on my meter.

If he's still high tomorrow, keep him at 2.5 for both cycles, and then you can go to 2.75 on Thursday if you need to. Steady careful increases win every time. If you increase too quickly it just sets of erratic bouncing and then it's hard to know what to do. Insulin doesn't have a direct, logical response - so more isn't always better. It's a hormone and operates on complex systems and it can take a few cycles to know what the dose is going to do.

When you're anxious it's okay to post here and vent and ask for someone to chime in on what to do. We aren't always as prompt in responding as we'd like, but someone will come along eventually. If you want to share what time zone you're in and when you give the shots, we can try to see if someone is around at that time.
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Thank you so much for your advice, it means a lot! I am in EDT.

I spoke with my vet a little while ago. She recommended that I stick to 2U and do not deviate. She said that I shouldn’t test at AMPS or PMPS, that there is no real value in those numbers. She said “of course it will be a high number if he’s due for insulin” and said that the only valuable information I would get by home testing is by doing a curve. She recommended doing a curve in a week, which I will, at home. She said the pre-shot numbers don’t matter as much as the fact that he should be within the 100-200 range “for most of the day.”

Basically she gave me the impression that she thinks I’m testing too much and that his dose should be 2U, no matter what. So, feeling a little confused. I can stick with 2U for a week but I don’t plan on discontinuing testing.
 
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I do think it could be good to hold his dose for another day or so and see what shows up in his numbers. It wasn't that long ago that you were needing to skip shots, so it's really hard to tell if he's getting too much or too little insulin at this point. My hunch is too little because he had a really nice curve yesterday. I mean, the numbers were much too high, but the shape of the curve was exactly right. Normally a bounce-inflated cycle will be flatter than that. But again, it's hard to tell for certain at this point.

And speaking of those skipped shots, that is why testing is important. I'd be curious what your vet would have to say about those cycles ;). We do know that may owners never test their cats, and many of them survive for awhile. But we also know what cats who arrive here sick and suffering from bad dosing feel better, act better, and are healthier when their owners manage the insulin more precisely. I'm glad you have already decided to continue on with testing.

As for the dose, given that Smokie has a history of DKA, I would not recommend arbitrarily dropping down to 2u. If you start getting numbers that warrant that decision, then yes, but until then, giving too-little insulin can be dangerous for DKA kitties.
 
It always amazes me when vets say we are testing too much. The information we get from preshot tests is extremely valuable! It not only tells you if it's safe to shoot, it also gives you information about exactly HOW the insulin is affecting the kitty! Say you shot without knowing the preshot number and then mid cycle you saw that the number was 130. Well that's a nice number right? But what if that drop was from a preshot of 160? That tells you the insulin isn't doing it's job. So that mid cycle number actually isn't really helpful at all unless you have a preshot number to see what happened! Same as if you got a mid cycle number that was 250...that's too high for mid cycle but if that was from a preshot number of 500, you know you got a decent drop there! Plus as you continue to get to a good dose for Smokie, the preshot numbers should drop. That will help tell you that the insulin is bringing him down to a better overall number, which is good! So in sum, I disagree 100% that there is no value in those numbers. They give so much more information to the puzzle and without them, you really can't come up with a good dose at all!

As for dropping the dose, yes I worry about the DKA too. With that history, too little insulin is more dangerous for Smokie since he's prone to ketones. Please be sure you're checking for those frequently!
 
Thank you both for replying - I agree completely! I thought the vet’s advice was really odd. His PMPS tonight was 259 which is quite low for him (for a PMPS). I gave him 2U (this was an hour ago, before reading your responses!). I will get a +2 and possibly a +4, and of course test in the AM to see where we’re at.
 
I'm actually glad to read that you lowered the dose a bit. That is unusually low, and since it's out of the ordinary, warrants a little caution. Especially since I'm not sure at this point if he' getting too much or too little, it's good to be careful with surprising numbers. I'll be curious to see what you get in a few hours!
 
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