? Sudden bg over 600

[Aito]

So this morning we took Sica's bg and it was over 600. I don't know exactly how much over because my glucometer stops reading at 600 and only shows the symbol HI. She has been pretty lethargic all day yesterday and still is today, even after the insulin shot. I didn't manage to get an in-between shots measurement today, I'll try to do it soon but I can tell by her behaviour that she's not feeling much better.
Any advice? It scared me so much to see her bg go that high. Even the vets seemed concerned. What should I do and how bad is this? Does this happen sometimes?
Short update on her stomach problems: she has stopped vomiting but sometimes her stomach gurgles.

 

[Bron and Sheba (GA)]

If you can get some tests in during the cycle, that will give us valuable information. Just getting the preshot BG, while it is great you are getting it, is not enough and it is the inbetween tests that tell us how the insulin is working..
Is Sica eating and drinking well?
Are you testing for ketones in the urine? If not I would strongly advise you to buy a bottle of Ketostix from Walmart or a pharmacy and test the urine. Follow the instructions on the bottle. Anymore than a trace needs vet attention. Please let us know any results. You can record the results from the Ketostix test in the remarks column of the SS.
Continue with the 3 units unless Sica drops under 90.
Can you tell us what food you are feeding at the moment.? If it is higher carb, that will increase the BG.
If you are concerned about Sica, you might be best to take her to the vet.

 

[Sienne and Gabby (GA)]

I am going to say this yet again. Lantus dosing is not based on the pre-shot numbers. It's based on the lowest number in the cycle. You are not gathering information that will allow you to make decisions about the dose. You're also making it impossible for anyone here to provide you with any guidance about dose. You also need to be testing for ketones.

Please do not assume because the pre-shot numbers are high that the nadir is also high. My cat could start a cycle with numbers in the 400s and drop into the 40s at nadir. By the next pre-shot, numbers would be back in the 400s. If I wasn't getting the spot checks, I would have been increasing the dose when a dose reduction was indicated.

It is certainly possible that a "lethargic" cat could be a cat who's blood glucose is in hypoglycemic range. You are putting your cat at risk by only getting pre-shot tests.

 

[tiffmaxee]

I need to add you are not following SLGS the way you are increasing. Even TR would have you hold each dose for a minimum of 3 days and require tests for nadirs. Have you stopped feeding dry? If so for how long?

 

[Bron and Sheba (GA)]

@Aito
I can see you got 120 for AMPS today. That most likely indicates that Sica dropped lower than that last night. And we don’t know how low that was.
Did you give any insulin this morning?
If you are not getting tests in during the cycles, you have no idea how low Sica is going during any of the cycles.
You are risking Sica dropping low and having a hypo if you continue with the current dose and not get any mid cycle tests in. I can’t stress this enough.
For us to help you, we have to see some mid cycle tests.
Is there a reason why you are not getting the mid cycle tests?

 

[Dyana]

My kitty would sometimes have high numbers for AMPS and PMPS and dip very low in between. Those mid-cycle tests told me whether the insulin needed to be adjusted.