3/30 Archie - sudden extreme numbers - all above 500 - what is going on?

Archie‘s numbers are skyrocketing - besides that I think it’s affecting his neuropathy, he seems fine. He eats, pees, purrs, poops. The only thing, He started having a bend in his front paw sometimes yesterday and hobbles then, but I think it’s from the high numbers worsening his neuropathy. I thought that after moving maybe the insulin got too hot and got a new bottle. But it does nothing to his numbers. What is going on with my little guy? Please advise! Using Relion Confirm.

 

Hopefully the new dose moves him lower. That was quite a jump in juice from 2.5 to 3.5. When did you start the new bottle?

 

Is it possible he's injured that front leg somehow, and he's having some pain that is spiking his numbers?

 

He’s not a very active cat, he mostly just lies under the bed and only walks when he goes for food or the litterbox, so I really doubt it that he’s injured himself somehow. I’m so nervous about the high numbers pushing him into ketoacidosis. I panicked and against all better knowledge upped the dose to 3.5 - all the readings in the spreadsheet that are ‚600‘ in fact just said ‚hi‘ (so could be well above 600) and I just wanted him down for a bit. Monitoring closely. The 3.5 was the first dose of the new bottle.

 

OK, monitor closely-- and, of course, check regularly for ketones! Just high numbers usually isn't enough to send them into ketones, but it is good to be wary in situations like this. If the high numbers are an indicator of something bothering them, and then they start to go into the slide of "feel yucky, don't want to eat, feel worse", that's when things start getting high-risk. As long as he's eating well and seems otherwise OK, though, the risk of ketones is a lot lower.

With that big jump in dose, be prepared for anything for the next couple of cycles-- the effect of that increase may not show up immediately. And I'd go back to the 2.5 tonight.

Hope he comes down (safely) soon!

 

It does look like there's a shift in Archie's numbers. A couple of thoughts

• Is there any change in behavior that suggests an infection/inflammation? Whether it's a dental issue, UTI, etc., illness will raise BG and sometimes, BG is elevated before you see a behavior change or your cat is behaving like there's something wrong.
• Any changes that you've seen in the litter box?
• Since you mentioned that Archie spends a lot of time under the bed, is this typical?
• Any chance of pancreatitis?
• Have you changed food? Alternatively, manufacturers sometimes change the composition of their food and the carb count is higher.
• Could Archie be eating contraband?

If you think he's potentially fighting off something or there's a chance he's sick, I'd get him to the vet for labs. I honestly think having him checked out is a good idea.

Just as an FYI, an 1.0u increase is a bit excessive. Lantus isn't good at "shooting down" numbers. You also increased twice in a relatively short period of time. Such quick increases can result in New Dose Wonkiness -- numbers go up, rather than down, for a brief period. Such aggressive dose increases may also mean you zoom past a good dose. I agree that Archie's numbers are worrisome but I would encourage you to not increase by more than 0.5u if his numbers are staying above 300.

 

Thank you all for your replies!! Archie did go down (so happy about this!!) - what do you suggest for his morning shot now?

PMPS 314, +4 141, AMPS 202

@Sienne and Gabby (GA) - I’ll reply to your points in a bit. These are great questions!