SimonSmith & his Mom Sydney

[SimonSmith]

Simon is a grey domestic short hair cat who is 13.5 years old. He was diagnosed with pancreatitis in November 2015. In addition to the pancreatitis, he was also diagnosed as diabetic and has been on insulin ever since. He was first on PZI but that did not regulate his bg. He is now on Lantus but we still can't get the bg regulated. Always over 400. He was up to 6.5 units and testing was still showing high numbers. we dropped the insulin to 3.5 units on Sunday May 28th because the 6.5 was still showing high numbers an I figured that we had far exceeded the optimum dosage. He receives 2 shots per day, 12 hours apart. He eats canned food. We had him on low carb/high protein but had trouble with him vomitting due to pancreatitis. He is currently on Royal Canin Ultra Light canned food and Royal Canin Kitten Instinctive and Hills MD canned food, no dry food at all. He is not vomitting and solid feces. I am giving him super small doses of Viokase-V (1/16 teaspoon) for about 3 weeks now. We started him on 1/4 teaspoon and he immediately vomitted. So taking it slow with pancreatic enzymes and plant based enzymes. He eats several times a day. Breakfast, then shot, eats about 3 hours later, then dinner, shot, and eats again about 2-3 hours later.

I do intermittant bg testing but would like to run a glucose curve and maintain a spreadsheet. If someone could please help me with how to run a glucose curve and how to setup the spreadsheet.

Any thoughts on how to lower his BG? I also give him subcutaneous fluids every 7-10 days but when I tested him yesterday his bg was over 500. I'm really scared and want to help him. Please help with any thoughts.

 

[Jen1218]

Hi. I haven't been here long enough to give advice, but you came to the right place. Lots of knowledgeable folks on this board. Someone should be along shortly to answer your questions and help get you fully set up. Welcome.

 

[Mandy & Rex (GA)]

I am also "new" here. Have you read any of the Stickies about the glucose curves and TR and SLGS protocols? If you go to your profile, you can add information to your signature. That's where you will have a link to your spreadsheet. Someone should be along to give you instructions on how to get that set up.

 

[Tracey&Jones (GA)]

If someone could please help me with how to run a glucose curve and how to setup the spreadsheet.

Hi, I can't give dose advice but that seems a little high to me - even your reduced dose. I hope someone with more experience will be along shortly however their advice may be limited as the board uses the spreadsheet to understand the patterns and help guide you. It is the map needed to find that treasure of a "good dose".

A note - with Lantus - it is important to know how how low the dose is taking him not nesessarily how high the pre-shot numbers are! Which means you need some mid cycle tests. Simon can be in a continuous bounce situation and you would not know it without those mid cycle numbers. I know this from experience...not good.


Here is the link with information for setting up a spreadsheet. If you need help give a shout out in the technical forum. We have a few people that can help you set one up.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
And here is the link on how to understand the spreadsheet.
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
And here is how to set up your signature so everyone can see your information and spreadsheet. Just some additional information - is he on any other medications/supplements? You may want to put that in your signature as well.
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

For the food, what he is eating probably it isn't really low carb food. The pancreatitis may have caused the upset vs. the low carb/high protein food you tried. Have you tried the Fancy Feast Classic/Pate - Jones eats it and he had pancreatitis and IBD? Make your changes in food slowly. But I would start home testing on a regular basis before switching over to a low carb food. This change in food can have a dramatic impact on BG numbers and you don't want a hypo situation. Small meals are actually a better option for a diabetic cat (if they are happy eating that way) as it encourages the pancreas to work during the digestion process.

Just in case, here is the link for hypos.
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Here is some information I found on the net once on a curve - a little edited.
This is simply a series of blood tests taken over the course of a normal day to determine whether the insulin dose you’re giving is correct for your cat’s feeding and exercise habits.
Take your first blood sugar reading in the morning, before injection time. Allow your cat to eat, sleep, play - just as they would on any normal day. The only thing that makes this day different from any other is that you’re taking blood sugar readings.
Make a note of the time of the first test and the amount of insulin given. (Easy to do with our spreadsheet).
Take blood glucose readings every two hours after the first one. So if your first reading and injection were at 7:00am, the next will be 9:00am, then 11:00am, you get the idea! (Or you can do every 3 hours)
You will hopefully notice that the blood sugar reading goes down to start with, then rises again as the insulin wears off.
If you are injecting twice a day, make a note of the time of the second injection and take a reading at this time too. Then, carry on taking readings every 2 hours until you have blood glucose numbers covering a full 24 hour period. (I have never done a full 24 hour curve but have done for the full day and at night up to when his BG started to rise). You may also want to take notes when he eats so you can see the impact of food on his BG's.

 

[SimonSmith]

Thank you all so much for your responses and support. I will take a look at getting the spreadsheet up and running and see if I can get a curve tracked. You all are awesome!!

 

[Anne & Zener GA]

Welcome to Lantus & Levemir Land, the greatest place you never wanted to be. Good for you to taking such great care of your handsome boy. I am tagging some with knowledge about high dose cats. Simon may need that much insulin, and maybe more. @Wendy&Neko @julie & punkin (ga)

Getting the spreadsheet going is critical, thank you for doing that.
Liz

 

[Red & Rover (GA)]

Welcome. If you have problems setting up the spreadsheet, just holler. There are a couple of spreadsheet gurus on board.

Off topic: does SimonSmith have a dancing bear?

 

[Wendy&Neko]

Hello and welcome.

Any thoughts on how to lower his BG?

Give him the amount of insulin he needs. This sounds trite but it's true. You will hear ECID a lot, or each cat is different. Cats need however much insulin they need. We have cats here on drops of insulin up to 50+ units per shot. Some cats have high dose conditions that mean they need more insulin. My Neko had two of them, acromegaly and IAA or insulin auto antibodies- think allergy to injected insulin. New research shows that one in four diabetic cats has acromegaly, a benign tumour on the pituitary that sends out excess growth hormone and causes the diabetes. They can need small doses of insulin or large. Needing doses in the 20's is not uncommon, though Neko maxed out at 8.75 units. We suggest that cats over 6 units get tested for the high dose conditions.

Getting that spreadsheet set up will help us help you help Simon.

 

[LizzieInTexas]

Yay! You made it.

Sydney had contacted me via PM and I was walking her through getting a public post.

If you have any issues getting the spreadsheet set up, please post up. We have great gurus that can help.

ETA - just saw you are in Houston. What area? I am up in Spring.

 

[saltycat]

Jack is one of those high-dose kitties. We started on PZI as well and switched over to Levemir around the 2 month mark when he was at about 6u of PZI. Jack was stuck in the 300-400's for awhile as well. It took some patience and time, but by methodically increasing his dose we eventually made that breakthrough and stopped seeing super high numbers. While he can still be a little unpredictable, I see much more good numbers then bad numbers these days.

Wendy is right on when she says they need as much as they need. The BG number is the important one, not how much insulin they are getting. It's great that you are already testing at home.

The spreadsheet is a great tool that helps you and other members see how Simon is doing. It also helps you see the patterns forming. I reference my own spreadsheet frequently since it is a bit tough to remember what I did a month ago. It can also be very rewarding to look at the spreadsheet and see the progress that has been made.

Hang in there, read up on some of the stickies and start getting that list of questions going. I know when I started I had a million questions and every one of them got answered by this great group. I owe my kitties good numbers to the community here.

 

[Susan G & Jimmy G]

You're getting great advice here. I just wanted to say hi to a fellow high dose kitty. We are nearing 6 on Lantus. I'm still new and will let the pros guide you...but I do want to say You are NOT alone. Keep asks questions and read the stickies and when you're done read them again. It's a lot of info to absorb. Hang in there! You've come to the best peer forum for our special kitties.