Very high BG numbers

[KarrieK]

My boy Simon was diagnosed about 2 weeks ago and we've been home testing and giving insulin every 12 hours (2 units). His BG has been bouncing around, but usually pretty high averaging around 400. Our vet wants to give it another week or so before making a change in type of insulin (he's on Vetsulin now) or dosage. Tonight he was just over 700! He's acting pretty normal; eating good, activity good, etc but that last reading has me alarmed. Has anyone else's kitty tested that high while they were trying to stabilize? What could be the cause of this??

 

[Bron and Sheba (GA)]

Hi Katie and Simon
Yes I have seen very high numbers like that before. They are high but could be being caused by bouncing.
However without a spreadsheet it is very hard to see what is happening.
Simon could be dropping low during the cycle and bouncing up high at preshot.
What I would suggest you do is set up a SS and put in all the BG numbers you have been getting.
Are you testing before every preshot?
And are you testing during the cycle to see how low the insulin is taking Simon.
Here is the link to the SS
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Also if you could set up your signature and tell us about Simon including what type of meter you are using please
Here is the link
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

 

[Bron and Sheba (GA)]

I also meant to mention that 2 units of Vetsulin is a larger than normal dose to start a cat on. The usual dose is 1 unit and increased as needed by 1/4 unit increments.
The 2 units could be dropping Simon too low and too fast and then he is bouncing up to 700.
I would be inclined to reduce the dose to 1 unit twice a day, as long as ketones were not mentioned at the original diagnosis.
Because he is unregulated and in high numbers I would buy a bottle of Ketostix from Walmart or a pharmacy and test his urine daily for ketones at the moment.
Any ketones above a trace needs vet attention.
Please let us know how you get on.

 

[KarrieK]

Thank you so much for your reply! I have not been able to test during the day as I work all day. I do test before every shot (he gets insulin at 7am and 7pm which works with my work schedule). It's always been high at that time. On my day off I tested a couple of times during the day and it was low but never lower than 200. I can see where it would be interesting and helpful to do a curve so on my next day off (Christmas day) will try that. Tomorrow plan on picking up the Ketostix.

Also I do need to set up the signature, so I appreciate the reminder. My other kitty is in end stages of cancer, so I'm trying to take care of her as well. I know other members have multiple ailing kitties, so I'm not alone in being spread pretty thin right now. I just want to do all I can to try and help both of them. Sure appreciate your time and input!

 

[Bron and Sheba (GA)]

I am so sorry your other kitty is so unwell. We all love our kitties so much don’t we?

do you leave food out for Simon to eat during the day while you are at work? And during the night?

Also if you can get a +2 test in during the evening and a before bed test, that would be great. If either of them is the same or lower than the Preshot then it will probably be an active cycle and you may need to test later on the cycle to keep Simon safe.

Bouncing can occur when the BG drops too fast, too low or lower than Simon is used to. So even if it is only dropping to 200, he can still bounce back up to high numbers because of a fast drop or the fact he is not used to numbers in the 200s any more and his body thinks the high numbers are now the normal numbers.
Once we see his SS we will know more.

He could well do better on one of the longer acting insulins such as Lantus, levemir or Prozinc.
Vetsulin is really an insulin for dogs.
Sending vines to your other kitty.

 

[Sienne and Gabby (GA)]

Welcome to FDMB!!

I didn't see what you are feeding Simon. We urge people to feed their cats a low carbohydrate, canned food diet. We define low carb (LC) as below 10% carb. However, most people are generally feeding their cats about 5%, give or take. Lisa Pierson, DVM has an excellent website on feline nutrition. She also has a chart that includes the % of carbs in most of the canned foods available in the US.

If you are feeding dry food or a variety that's high in carbs (HC), please transition to low carb very slowly. If you reduce the carbs, it can have a dramatic effect on Simon's insulin needs.

 

[KarrieK]

Hello, and thank you for your reply. Sorry I didn't respond sooner but I've been working more hours the past few days. In response to your question; Simon gets mostly a home cooked diet (turkey, rabbit and pork loin). I started making my kitties food after his sister developed IBD over 4 years ago. At that time, I went into research mode which included Lisa Pierson's site. Consequently, neither of my kids have had any dry food since. We do supplement with some Fancy Feast Classics. Since diet has been mostly protein for several years so I am surprised he developed diabetes. Someone else mentioned a genetic component to it, which must be the case with him.

Since both of my cats are "grazers" I feed them 4 - 5 times a day, and leave their plates out for about an hour or so after as both of them will eat, leave, come back, etc. They eat small amounts at a time which has been better as years ago one or both of them would often "scarf and barf".

Right now I'm concerned about his numbers remaining so high, but I realize this process could take time so I need to be patient. In addition, I am wondering if he would be better off on a different insulin. Our vet wanted to wait a week or 2 before making that change, and since we have plenty of it (and, as you know - it's expensive) we thought we'd use what we have and keep monitoring him closely. I did pick up some Keto sticks and checked his urine, and (thank God) it was "normal".

Again, I truly appreciate everyone taking the time to give me feedback. I am a little overwhelmed as I try to learn everything I can about feline diabetes and apply it to our situation with Simon. He's such a cool little guy and is very much loved by everyone in his "family". Thanks again!

 

[Sienne and Gabby (GA)]

No worries. It sounds like you're ahead of the game with regard to diet!!

Feeling overwhelmed is very normal at this stage of the game. It truly gets easier. The next step is to get your spreadsheet set up. That's a way to keep track of your kitty's progress.

With regard to insulin, the two types of insulin that are recommended by the American Animal Hospital Association are Lantus and Prozinc. Vetsulin has a relatively short duration which is why you are seeing such high numbers at pre-test times.