Can't get his levels down.

Discussion in 'Welcome to the Group - Post an Introduction Here' started by Cherieeastman, Sep 22, 2015.

  1. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    Hi I'm Cherie and my baby's name is Gato. He is à 9yr old american bobtail. He was diagnosed in June 2015 and I can't get him regulated. I test him at home at different times during the day....not everyday, and its always high. He is doing ( acting ) much better then he was in June and has put weight back on but the levels are just too high.
    I slowly increase his insulin once a week by a half unti. He is currently at 8units of novolin-n.
    I am going to test him tomorrow in the morning,afternoon and night to get his curve and post the results but its 5:30pm and he is registering high.
    I feed him the lowest crude protein flavors of science diet with a grain free kibble because of his aggressive appetite... Per doctors suggestions.
    I want my boy happy an
     
  2. Shiloh & Rhonda

    Shiloh & Rhonda Well-Known Member

    Joined:
    May 9, 2015
    A couple of things that draw my attention right away. Increasing by half units at a time, kibble, and not testing everyday.

    Any dry food, unless it is one of the two low carb varieties available is going to raise his glucose. The two are EVO and Young Again.

    By increasing by half units, you could have missed a .25 or .75 dose that might have been a good one. Too much insulin can cause the body to overcompensate and produce more glucose to combat it.

    By not testing everyday, specifically before each shot, you are not getting a good picture of how the insulin is influencing him. Is that 8 units twice a day, or 4 units twice a day?
     
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  3. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    The dry food he gets is Merrick 74% protein 26%carbs and fiber.. It's grain free so I thought it was OK. Yikes
    Also I am so clueless and wasn't aware of only doing. 25 increments.
    Yes that's 8 units twice a day.
    When is the best times to test and when should I give him his shot...how long after he eats?
     
  4. Shiloh & Rhonda

    Shiloh & Rhonda Well-Known Member

    Joined:
    May 9, 2015
    With Novolin, I'm not sure about the shot. I know that the preshot test, AM and PM, should be before any food, and if at all possible, take up all food for the two hours before the shot. I know that some of the insulin suggest or require that you feed at least 30 minutes before the shot as it kicks in fast. So if that is the case, it would be test, feed, then shoot about 30 minutes later. BUT......don't take that as fact yet, until I see what I can find about Novolin. I will see if I can find some Novolin users or those experienced with it and get some eyes on your post. Also any mid-cycle tests that you can get are helpful to show how the insulin works, how quickly it lowers the glucose and when it starts to wear off.

    As for the .25 increments, do you have syringes with the half unit markings? That makes estimating the .25 increments easier.

    Be back in a couple.
     
  5. Shiloh & Rhonda

    Shiloh & Rhonda Well-Known Member

    Joined:
    May 9, 2015
  6. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    OK my needles don't have increments of .25. They go by half.
    My vet, knowing I use novolin-n said to give him his shot 15-30 min after meal..however my Gato eats a little then takes a break then eats and breaks...not sure why, .I has total control over his food because he can't jump and I have it up on the counter.
    What do u mean by mid cycle testing?
    I have become very good at getting his blood so I can do it whenever I need.

    Thank you for taking time for us
     
  7. Shiloh & Rhonda

    Shiloh & Rhonda Well-Known Member

    Joined:
    May 9, 2015
    No problem at all. Mid-cycle test are test between the shots. The 12 hours between the shots are called a cycle. So testing anytime between the shots will give you good information. A good indicator of how a cycle is going to go is +2, which would be two hours after the shot. We also use a spreadsheet to records the tests, so that if we need advice from others, they can see at a glance how Gato has been doing, without having to pepper you with you questions. Here is a link to the spreadsheet instructions. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    Also if you could add some information to your signature, such as your name, kitty's name, type of insulin, type of meter and type of food, it will help others as well. You can do that by clicking on your name in the upper right hand corner, then click on signature on the left hand side.

    And unfortunately, no syringes come with the .25 markings, but having the half unit markings makes it easier to estimate a .25 increment.
     
  8. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    Thank you so much. So glad I stumbled into this site.
    I will keep you posted.
     
  9. Shiloh & Rhonda

    Shiloh & Rhonda Well-Known Member

    Joined:
    May 9, 2015
    So glad I could provide you some information. :)
     
  10. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    I know this may sound crazy but I cannot figure out how to fill out that Spreedsheet... I dont understand what to do and what the +s are for...
     
  11. Shiloh & Rhonda

    Shiloh & Rhonda Well-Known Member

    Joined:
    May 9, 2015
    You have got it added to your signature. That appears to be the difficult part when I am trying to help with that. The +1, +2, etc., are the number of hours from the shot. The AMPS and PMPS are the test before the shot. The U is the number of units given.

    And I must say, I love Gato's picture!!! Love the sunlight behind him.
     
  12. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    Well that makes sense...I had a feeling about some of it but I didn't wanna guess.
    Thank you, I adore this picture. Gato is such a sweet loving boy..its breaking my heart that he isn't at his best.
     
  13. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Understanding the spreadsheet/grid:

    The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

    Each day is 1 row. Each column stores different data for the day.

    From left to right, you enter
    the Date in the first column
    the AMPS (morning, pre-shot, test) in the 2nd column
    the Units given (turquoise column)

    Then, there are 11 columns labeled +1 through +11
    If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
    If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
    and so on.

    Halfway across the page is the column for PMPS (evening, pre-shot, test)
    To the right is another turquoise column for Units given at the evening shot.

    There is second set of columns labeled +1 through +11
    If you snag a before bed test at +3, you enter the test number in the +3 column.

    We separate day and night numbers like that because many cats go lower at night.

    The nadir is the lowest glucose between shots. There is a general period when it will happen which is specific to the insulin being used and testing then helps make sure your cat doesn't go too low.

    It is merely a grid for storing the info; no math required.
     
  14. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Some important notes:

    We suggest you always test before you shoot.

    Do not shoot below 200 mg/dL until you have tests around +3 to +4 hours post-shot and know how low he is going and that he will be safe.

    The insulin dose is adjusted based on how LOW he goes, not on the pre-shot test values.


    We frequently eyeball 0.25 increments in dose, or use calipers aligned with the syringe to ensure consistency.

    Very high glucose can be from not enough insulin ... or TOO MUCH insulin. Too much insulin will set off compensatory hormones which release stored glucose (glycogen) and raise the glucose up to protect the cat from going too low (below 50 mg/dL on a human meter). You may well be on too much insulin.


    NPH only lasts around 6-10 hours in most cats. It is very likely the insulin is wearing off before 12 hours, so when you test before a shot and it is high, that is because the insulin has worn off, not because it isn't working. Testing around +8 to +11 hours post-shot will show you when the insulin is wearing off.

    Some important reference materials for you:


    Humulin/Novolin NPH Guide

    How to Handle a Hypo
     
  15. Cat Ma

    Cat Ma Well-Known Member

    Joined:
    May 21, 2015
    Only experience I have with Novolin N is that it made my cat hypo and didn't last very long. It is a very fast acting insulin and harsh on the cat. You've got your cat on a very high dose of Novolin. It will help for us to know Gato's BG (Blood Glucose) #'s.
     
    Last edited: Sep 28, 2015
  16. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    I am willing to switch to a different insulin..
    Most important question is this...because I've been a bad mom and increasing his insulin on my own without having the proper data on his levels what should I do as far as his dosage????
    I just checked him at 6am which would be 11 hours after his last shot and he is 415. I checked him right before his dinner last night and he was ”high". I am going to try and cut out his kibble all together and maybe he will eat a little better for me and react better to his insulin.
    I rescued Gato from an abusive house...he was kicked when he was bad and this baby deserves only the best in life. He is as sweet as can be and wants to be loved on all day long. He has problems walking because of this disease and seeing him not smiling is hurting my heart. I MUST get him healthy.
     
  17. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Hi Cherie, don't beat yourself up about being a bad mom. The fact that you rescued Gato and are willing to do all you can to help him now proves that you are, in fact , a very good mom! I too am having trouble regulating my cat and look back at all the things I've done wrong since his diagnosis. We can't change the past, but we can try to do better going forward. I can't help with dosing(I'm new here myself) but wanted to offer support and encouragement. Good luck
     
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  18. Cherieeastman

    Cherieeastman Member

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    Sep 22, 2015
    Thank you so much....good luck. Hugs
     
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  19. Cherieeastman

    Cherieeastman Member

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    Sep 22, 2015

    I have a question... I am unable to add anything to the Spreadsheet. Did i do something wrong?
     
  20. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    I am going to update his levels here because I may have done something wrong with the download of the spreadsheet because I cannot add any info to it.

    Last night at 6pm before dinner Gato was "HIGH". He ate and was given 8 units
    This morning before eating 6am he was "415". I gave him 7.5 units
    9am 2 hours after shot he was "465"
    11am 4 hours after shot "399"
     
    Last edited: Sep 23, 2015
  21. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    Good morning Cherie and extra sweet Gato!

    Spreadsheet - first, be sure you're logged into google. Your email address should be showing in the top right corner of the ssheet. If not, log in and try it again. I should be seeing a 'share' button but I'm not....

    I'm suspecting Gato is diving steeply overnight then shooting back up due to the liver panicking. Novolin N is good at doing that especially with that high of a dose. I see your note that 2 hours after his shot, he's at 465. Part of that may be the food but there's really not much difference in 415 and 465. There's an allowance of +/-20% with glucose meters - the higher the number the more that can vary.

    With the 'N' insulins, getting tests during the cycle is hugely important. You may test and test and just see high numbers but keep at it, you'll catch him falling off a bounce and suddenly see a low number. THAT is what you want to catch. Too much insulin looks a lot like too little insulin.

    HUGS and welcome!
     
  22. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    Ok, I think i got the spreadsheet done properly if you get a chance to check and let me know Id appreciate it.

    Thank you
     
  23. Merlin

    Merlin Well-Known Member

    Joined:
    Mar 18, 2014
    So glad Gato found you...bless you Cherie. It sounds like you are getting the things that you need. Here is some additional information.

    Diabetic Neuropathy: Merlin had this condition and it was really severe. The symptoms are walking on their back hocks. Severe conditions may also include their front feet. Merlin could never go more than a couple of steps before sitting down. We had to put down rugs all over the place so he wouldn't slip on the tile. To help this condition is to regulate the diabetes and to give them methyl B12; Zobaline. If you go with another product, you must make sure that there are no sugars. It is a small pink pill and can be crushed and put in his food. Today, you can’t even tell Merlin had it. He can run, jump and walks on his tippy toes now.Here is a link to Zobaline. http://www.ilifelink.com/zobaline-for_diabetic_cats-3_mg_x_60_tablets.html

    Good Reading: This is a must read. It is an excellent 18 page informative document that covers feline health and nutrition. Don't take short cuts and read it all. www.catinfo.org

    Ketones: Diabetic cats are susceptible to diabetic ketoacidosis (DKA). It is best to buy testing strips that will measure (if any) ketones in the urine. One brand is Ketostix which can be found at Walmart or any pharmacy. You will want to test periodically unless you continue to get high numbers, then it is suggested to test more frequently. Basically all you do is take the strip and when they are in their litter box, you just hold the strip in the urine stream. Ketostix typically costs around $10.
     
    Last edited: Sep 23, 2015
  24. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    @Cherieeastman - I can see your ssheet with numbers just fine! Good job!

    I think you ARE seeing action from the insulin but there's just not enough info yet to know for sure. Keep testing like you are adding numbers and times - the patterns will emerge! If he's just started another bounce due to a sudden dive that wasn't caught, it could last as long as 3 days so don't get discouraged, just keep 'doing'. When the counter-regulatory hormones are still swimming around, the numbers won't change a lot. That's the body's way of survival.
     
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  25. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    I am trying. He is my baby and I will do anyting I can to help him. Thank you for your kind words. Gato has Neuropathy, he can only walk for a few steps and down he goes and he walks on his hocks. Where do I find Methyl B12??
     
  26. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    I dont know what has happened but I can no longer add info to my spreadsheet...im getting frustrated. UGGGG
    I tested Gato at 1:30 and he is at 289
     
  27. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    Did something log you out again? An automatically pushed update can do that and you never know. If you're on a LAN, there may be an 'auto log-out' bot that runs too. I know it's frustrating!
     
  28. Merlin

    Merlin Well-Known Member

    Joined:
    Mar 18, 2014
  29. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Are you doing the SS from a desktop? I'm not sure why you can't add info....we haven't had anyone have that problem. You do need to be logged into google to add info. I just stayed logged in and leave Gracie's SS up on my desktop all the time.

    If you are willing to change insulins, you might considering changing to lantus or levemir. They are long duration insulins and will give Gato a better chance of going into remission especially if you switch him to a canned or raw food LC diet. They are more expensive than Novolin N but safer for Gato as well.

    I also agree that dose seems high but since you are doing a curve today, we can see where it takes him. He might be coming down and bouncing right back up.
     
  30. Cherieeastman

    Cherieeastman Member

    Joined:
    Sep 22, 2015
    Do you feed Gracie a raw diet? I looked into it and my husband is a hunter and can get me rabbit but I am afraid of the vitamin information...So I thought to save money I could do science diet for breakfast/ dinner and raw diet ( Just meat and veggies ) for the other..That way he gets the needed vitamins through the canned food and I wont have to worry about messing anything up. Seems like it may work but Im not sure.
     
  31. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Don't click on the link in your signature. That is for the rest of us to see, not edit.
    Go to Google.
    Log in.
    Find the spreadsheet in your list of files
    Double click on it.
    That should allow you to edit.


    You may want to bookmark Drive to make it easier to get to it.
     
  32. Cat Ma

    Cat Ma Well-Known Member

    Joined:
    May 21, 2015
  33. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    I fed Gracie raw as a kitten but then she stopped eating it. I've tried to get her back on raw but it's just a little too rich for her and she vomits. She's the only cat we've ever had that couldn't eat raw but she also has some mild chronic liver issues that might contribute.

    I do, however, feed Primal raw to my other non-diabetic cat, Tobey. It is a fantastic food and I love it for him...and he loves it. If you make it yourself, you might want to read this website which is done by an FDMB member who has designed pre-packaged vitamins/minerals that you just add to the raw meat: Know What You Feed
     

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