Why are BG numbers going UP after shot?

Hello -
I'm new to feline diabetes and would like some help deciphering what I'm seeing with Hoss' BG numbers this first week on insulin.

First, some background - he was diagnosed one week ago today. He was put on 2U Lantus 2x a day. We started insulin last Friday evening. I started testing the next day, on Saturday, but it took a few days to get better at it, buy a new meter that worked better for us and start getting into a routine. I've been getting more "regular" tests the last few days. During the workweek, M-F, due to my work & commute schedule, I will only be able to test Hoss pre-shot (5:30 AM), pre-shot (5:30 PM) and before bed, which will be about 3.5 hours after his PM shot. Today, I'm working from home, so I'm doing my first BG curve. I plan on doing a curve once every weekend. At least until he's regulated or in remission.

As you'll see from his spreadsheet, his numbers are staying very high. Hoss free-feeds, so I've never gotten a test where he's truly been fasted for 8 or 12 hours. But even just looking at trends, I'm confused by what I'm seeing today. Pre-shot at 5:30 this morning, he was at 287. I don't believe he had eaten much if anything for a couple of hours prior to that shot. But he ate a good meal after I tested and before I shot him. But 2 hours later he was at 370 and now at +4 he's at 451!! And I know he hasn't eaten for about the last 3 hours because he's been asleep. Shouldn't his numbers be going DOWN post-injection? I thought I read with Lantus they're usually at their lowest around 6 hours post-injection. If that's the case, you would think his numbers would have started to decline since he'll be +6 in about an hour and a half from now.

Can someone please take a look at his spreadsheet and let me know what you think is going on? I'm baffled.

Thanks!
ReaAnn

 

Testing does get easier, especially once the ears learn to bleed.

Jones free feeds as well, most times through observation I know that he doesn't usually eat 2 hours before PS but it is something to keep in mind that the PS # could be higher than normal.


I think a curve weekly is a great plan considering the work schedule. We do what we can and the fact you are getting a before bed test is great! Most cats will run lower at night.

In a normal curve you should see a +2 number be higher as the current dose hasn't started working yet and he ate! All the eating is creating some sugars. You should then see a decrease at +4 and again at +6. Sometimes you will see numbers start to go back up around +8/+9 and up again at PMPS. Now that is the normal perfect curve.

Now, factor in that Hoss is a cat. ECID - every cat is different. Some cats to a slow decline all the way to PS, some race down to +4 and start to climb again.

I would say for today's data...that he is bouncing. That is what it looks like to me. What was the mix of food today? I see you have some glyco dry in there.

 

The testing is going fine. I'm only having to stick him once and he bleeds easily now. I don't even have to warm his ears up. We've got it down to a science and testing every 2 hours today is giving us LOTS of practice!

He's up to 90% canned - Fancy Feast classic pate, Friskies pate, Nutro Soft Loaf Duck, Nutro Soft Loaf Cod & Catfish, and Purina ProPlan Chicken & Spinach. I believe all those are very low carb. The Nutro I'm not 100% sure of, but there are no grains or veggies of any kind in the two varieties he eats. They're smooth pate's and appear to be just meat and added minerals/vitamins. He is eating a very small amount of Glycobalance Dry - about 10% of his diet now. And a couple of Temptations treats after each ear stick.

His numbers climbed after the AM shot and as of the last test are staying pretty steady in the mid 400's. I guess I just expected the curve to start showing numbers going down by 4-6 hours into a dose. Maybe he's a "late bloomer". We'll see. The 6 hour BG test will be in about an hour. I do think it looks like he's probably going to have to be increased. His numbers have been very high all week.

 

That could be it. A couple of those is like a chocolate bar for you. You may want to try some freeze dried treats instead or maybe some just cooked up chicken chunks.

 

Helo and welcome,

Good job on the testing and ss


Temptations treats are very high in carb, some use it when their kitties BG gets dangerously low (though I've always preferred to use a HC wet food for that purpose) a couple after each test will be increasing his carb load considerably.
A better testing treat is something zero carb, my lot go mad for origjen freeze dried 100% meat treats (come in variety of flavours) they are zero carb. Some folk use poached chicken breast cut into tiny pieces.

If I remember right the glycobalance is also HC, and even though he only gets a little of it now, that will also be messing significantly with his BG,

To give you an idea of how dramatic an impact, we had a cat here who was sneaking the odd bit of dry HC kibble from the civies in the house, when all dry food was removed from the house, cat went from 5u to Off The Juice(remission) in a blink of an eye, it was a heck of a ride for the cg. Here's a link to the thread and the ss, look at Feb 19 ( all dry removed from house on 18th)
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=114022
https://docs.google.com/spreadsheet/pub?key=0AqyJS-ud54lgdHU2S2FwczByM3YwU2JjRFduOWJLUHc&output=html

Something to bear in mind when you finally cut out the kibble, not all kitties react as dramatically, but you may want to make sure you are around to monitor when you do cut it out completely.

Especially in the beginning it's important to know that the PS number is not good influenced, so you know if it's safe to shoot. Freefeeding is fine, but you might want to use an auto feeder so that it turns and hides the food two hours before shot time, I used to do that with George for his night time feeds.

Another possibility is that he is bouncing, you got a blue (168) 5 cycles ago, he might have even drooped lower than that, getting into numbers that they are not used to can trigger the liver into dumping glucose into the blood stream, the result is we see high flat numbers, almost as though the insulin is not working, these bounces can last up to 6 cycles, if you catch him dropping lower than those reds tonight, that could be the bounce clearing and if you can that's when I would try to monitor more.

The starting dose your vet had you start on is higher than is usually recommended, so I'm glad that you've got up and running with the tests and the ss.

Keep asking questions.

 

Hoss is a cutie-pie!

Adding my voice to the 'cut the kibble' chorus

Knowing how insulin affects your cat is key to managing FD however it takes time - time to collect enough data to identify the following cycle 'landmarks', all of which vary from cat to cat. And with regards to nadir, it can and often does move around.

• onset
• Nadir/Peak
• duration

Next time you are able to run a curve consider testing every 3 hours for 18 hours.
By alternating a 'test every 2 hours for 12 hours' curve with a 'test every 3 hours for 18 hours' curve you end up capturing more of the true picture and getting closer to the ultimate, very important goal, which is to "Know Thy Cat"

Hang in there and hang in here - -plenty of experienced folks to point you in the right direction

 

Beautiful kitty!