Wide Variations in BG

[Bowie]

Hello Everyone-

We are being consistent with food and insulting dosing over the last two weeks with Bowie and still seeing huge swings in levels. He’ll be in the upper 300s at night after a dinner, night time meal and 1.5 units. In the morning we feed him and then give another 1.5 unites and he starts to drop below 100 hours later. Has anybody else seen this? What might be causing these swings? Thanks.

 

[squeem3]

Your first thread: Bowie - newly diagnosed with Pancreatitis

It would be helpful if you can get your signature set up with all the basic info so you're not constantly asked the same questions over and over (name of insulin? food? ketones? etc). The signature info is here: Sticky - New? How You Can Help Us Help You!

Are you testing your cat's blood glucose levels daily especially before giving insulin? Having a spreadsheet with your cat's numbers will help members better help you. The instructions for the Google based spreadsheet is here: https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Which Lantus protocol are you following, Start Low Go Slow or Tight Regulation? Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

How low under 100 is your cat going and how many hours after insulin?

 

[Bowie]

We are doing go low and slow. I hope his spread sheet is attached here.

We dropped back to 1 unit and have seen the steady increase. Today is the beginning of trying again at 1.5


FDMB US 12/12 Insulin Spreadsheet Bowie - Alpha Track 3

 

[Bowie]

B

 

[Connie & Parker & Moonie]

Hi there -

I think you may get a quicker response if you use the drop down menu in the title and select "?" and put something like (Dosing Advice) in the title. That way, more experienced members know to prioritize your thread for a response.

I'm too new to give dosing advice, but if you're following SLGS, I'm surprised that you raised your dose by 0.5u. Dose changes are typically made in 0.25u increments unless the kitty is already on a very high dose or the caregiver is following TR and seeing nadirs >300 after at least 3 cycles.

Finally, what you're seeing is bouncing. It's unfortunately really common with diabetic cats.

Here is the explanation used in the stickie New to the Group :

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Hopefully this helps in the interim while you wait for a more experienced member to give dosing advice!

 

[Bowie]

Thank you Sara and Khloe. We were following TR (treatment recommendations) from the vet who specializes in diabetes and IM.

We are seeing a nice consistent BG in the low to mid 200’s the last two days and will see how he reacts over the next two to see if that drops a bit more.

It was hard to watch the drastic swings. Feels like we are finally on the right track.

Appreciate the insight and sharing of experience.