Weird results on blood curve — still struggling

[Xtian]

Hey!

Last Sunday we did a curve on my cat, and he was rather high (see here http://www.felinediabetes.com/FDMB/...curve-and-everything-going-wrong-help.146488/)

I should mention all results are in mmol/L.

We did a curve yesterday.

He was 6.0 and we gave him 2 units of insulin (we know this was a mistake now)
+3 he was a very low 2.7 (48.6)
+7 he was still low at 3.3 (59.4)
+12 he was 4.7, so we didn't give him any insulin.
+16 he was higher at 12.8 and we didn't give him anything.

My partner gave him 2 units of insulin +26 hrs later without testing first.
+1 he was 24.9
+4 he was 24.1
+8 he's now higher at 24.3 (went lower than higher?)

I fully understand we must be much more diligent and careful in our testing and administering of insulin. All feedback is welcome, but if you're only going to reinforce I'm a terrible cat owner because I did it wrong, I know. Please spare the shame.

I'm at a complete loss now. Do we give him more, only 8 hours later? How do I get him back on a reasonable 12 hour schedule? I know he needs 300 calories/day aiming to reduce to 200, but how should I implement the schedule?

Sorry for the tone, I find myself here in crisis mode.

<3 to all

 

[Xtian]

Just spoke with a vet who recommended 1 unit (v/s his usual 2) at to measure again in 3 hours .

 

[Brashworks]

Xtian - glad you got dosing advice from your vet. I read through your other post and am glad you are getting pre-shot tests.

Please remember that Lantus is a depot insulin - not sure how long Datura has been on 2U but keep in mind the effects of a dose can last for days. I gather he went quite low (even taking into consideration a possible false reading). If he were my cat I would test at +2 to see how far he has fallen. If he is dropping fast, maybe see if you can give him a little food. If he is the same or higher, you can likely head for a night's sleep but a "before bed" test is always good if you can get it.

You are not a terrible cat owner. You're here and trying to help him - this is a great place to be.

Lantus does work best if it is administered pretty much 12 hours apart. If your shot time is all messed up, you can always skip one shot and go back to your regular time the next day (I wouldn't do this on a regular basis, but a one-time adjustment I think is okay). I think that is safe to do unless his blood sugar is very high and he is prone to ketones. But try to get on an every 12 hour schedule. Monitor his dose of 1u for a few cycles and don't make sudden changes - typically dose adjustments are made at .25 U at a time. I can understand the current reduction though - sounds from your post last night like 2.0 U is definitely too high. Time and good record-keeping will tell.

Would you be able to get your spreadsheet set up? It really helps rather than looking at the numbers on individual postings. I know all the information plus the testing is overwhelming enough but the spreadsheet really helps, both you to monitor is progress, and the folks here to help you.

Keep breathing - you are doing well! It's all very new and so much information to digest, but keep at it and soon it will become easier.

 

[Brashworks]

Here is a link on how to set up a spreadsheet.

If you need any help, just send me a private message and I'd be happy to help you out. Click on Genghis SS below and you can see what one looks like. I use mmol/L as well, but the World Spreadsheet will convert to US readings (most of the folks here are in the US and need to see them in that format).

I know it looks crazy to interpret but it is a wonderful tool and I guarantee it will help you with Datura's road to recovery.

To send a PM, click at the top right on Inbox and choose "Start a new conversation".

 

[Chris & China (GA)]

You shouldn't give more insulin before 12 hours from the last dose....but you can work your way back to your "chosen" schedule 15 minutes per cycle or 30 minutes per day

What you're seeing is probably a "bounce"....there are 3 reasons for bouncing. 1 is going too low..2 is dropping too quickly and 3 is going lower than your cat's body is used to being (or a mix of all 3)

When any of those things happen, the liver releases stored sugars and hormones to bring the cat's blood glucose back up quickly. It's kind of a leftover survival mechanism from when cats were wild creatures....if their blood glucose was too low, they couldn't hunt and could die so the liver did it's thing to bring it back up so kitty could hunt again.

Looks like when Datura's blood glucose went too low (under 50 on a human meter, 68 on a pet meter) he "bounced"....it can take up to 6 cycles (3 days) for a bounce to clear, so it's important not to react to a bounce by increasing the dose.

Same thing happens when they just drop from (for example) 400-250....their body has become accustomed to living in those higher numbers, so even though we WANT them to come down, the liver doesn't understand that and Mr. Liver kicks in

The more you can get them into those good numbers, the sooner Mr. L will re-learn that it's OK to be there and stop reacting so much.

I agree with your vet though...we generally start out at around 1U and gradually go up in .25 unit increments so we don't bypass what could be a "best dose" for each cat.

It will really help if you'll start using our spreadsheet program so we can help you with making dose decisions. The unfortunate truth is that most vets, while they might be great otherwise, just don't have the time to stay up to date on the latest treatments and protocols for every disease in every type of animal they see. The people here do nothing but deal with feline diabetes and the conditions that tend to come with it, so they have lots of real life experience to share with you