Chloe has crept over the 100 mark...sigh.

107 just now. Would you guys recommend that I test +1 or +2 after she eats tonight?

I'm bummed. We're in the blue...I thought she'd stay steady under 100 and we'd be the vets FIRST remission kitty. But she's creeping and creeping...maybe she will eventually need the reduced dose of ProZinc.

Blah. :cry:

 

Has Chloe ever been on insulin? And don't despair! This is still considered a non-diabetic number! Test her again in a few hours or in the morning, could have been a loud truck, vacuum cleaner, she ate a carb, she just ate a big meal, she feels gassy.. doesn't take much to punch those numbers a little. I would consider her creeping if I saw staying over 120 and heading for the 200s. This often happens to cats coming off the juice, and my PZI kitty bounced several times from double digits into the 110-120 range for a couple months after becoming diet controlled.

 

She still can be! It could be any of the possibilities that Carolyn suggested. But even if it's not, it might just take a smidgen of insulin to get her into remission. (It counts as remission if they need insulin; few cats do it on diet only) Not to worry, you already have all the hard stuff done - shooting, poking, food.

 

Thanks guys. Carolyn, she was on 1 unit of ProZinc BID. She was on it for a week before I started to test. I tested in the morning of last Wednesday, 12 hours after her shot, and saw she was at 93. She's been low ever since and hasn't had insulin since then.

I tested her +2 after food last night and she was at 79. Finished most of her FF from pm to this am..tested again before feeding again, and she was 78. Phew.

Calling the vet after 12 to see if their blood test match with the BG test I did at the vet. I did a control test yest and it was in range, so his lab # better be near mine.

 

Expect some differences between your meter and the lab result. This is why:

http://www.bolohealth.com/expertspeak/Admin/heart-health/177-is-your-glucometer-accurate

 

I see she dropped again.. she might do this for a little while, don't worry! Lookin' darn good!

 

It might help to know how insulin works in a non-diabetic.

Normally the pancreas just chugs along putting out a little insulin, roughly constant, to keep the body happy. The constant (low-level) amount is about, say, 25-30% of total pancreas capacity.

When food comes in, the pancreas swings into action, cranking out 50% or up to 100% of capacity, to keep blood sugar down and send the excess sugar into the cells, where it's either used or turned into fat for later.

Within an hour or two, blood sugar is back to normal, and the pancreas goes back to its normal (basal) production level.

It seems a diabetic cat is first able to go off the juice when their pancreas is healed to the point of producing maybe 40-50% capacity. This can not only produce a basal insulin level, but can handle some food spikes.

But the speed of bringing those spikes down will be reduced! Without 100% insulin production available, the blood sugar will remain high for longer than in a healthy cat. When that sugar is 'high enough', its concentration in the blood physically burns the beta cells and damages them, reducing their capacity a bit, and slowing or reversing healing. If that happens, her numbers will rise further and she's likely to lose her remission.

Bottom line: Her numbers are creeping up slowly because her pancreas is still a bit on the low-production side. If you can keep her numbers from getting into the 'burn' range for a few more weeks, the pancreas will keep healing and she'll be able to take it on her own. For now, you're the training wheels.

At some point those numbers may (or may not) get high enough for a smidge of insulin to help. I don't know (and I don't think anyone knows) what the threshold is before I'd help out, or how much insulin I'd give to make up the shortfall. But there's a right number for both of those, for Chloe.

A radical suggestion that might be a bit much, and is not medically 'necessary':

For any creature, there's a safe amount of insulin you can give, because it's just too small to matter. When you're around to test, try some tiny experiments with micro-doses and a glucometer, trying to find a dose that lowers her blood sugar by just 20-30 points at whatever ProZinc's peak time is in Chloe... (Start with the zero line on the syringe and work up to 0.1, 0.2, etc)

Once you have a good idea of that dose, you can give it when she runs over 110...

 

Oh Steve, bless you for explaining all that! It took me a few reads to get down pat, but I got it now

As for the spikes, do you mean right after she eats, when her BG will go up and the insulin will have to start doing its job? Because I got this 107 reading before I fed her, which was confusing to me. Then after eating and testing again, she was down to 82. Maybe something just spooked her?

I'm a little nervous about your radical advice, though, and messing with the insulin. nailbite_smile

Vet called and they said that the lab test put her at 120. I read 97, so my number is still within a 20% range of his, which is accepted. Does anyone know which number is MORE accurate? The glucometer measuring the whole blood or the lab measuring the plasma?? Hmmm.

They want me to call back so they can go "over some things" with me. I'll call during my dinner break.

 

I'm going through something similar with my kitty, and have been told to try feeding a bit when I see a # that is higher than I like. I'm not sure why the #s creep up between meals like that, but from what people have said eating kicks the pancreas in gear, and then you can see if that brings the #s down like it did here. I don't know if this is the ideal strategy, but I am now trying when I see a higher # to feed him some, and then test a couple hours after that. If the # is still high, then and only then I'm thinking I'll consider shooting. Hasn't been put to the test yet but that's my plan.

Thanks so much Steve for posting all this info. I have been feeling a bit in uncharted waters lately, with a cat with a clearly working pancreas but one that seems to hover a lot in the low 100s and then creep up. What a mysterious journey we are on! :?

 

A lot of this info is seen in a lovely online film by the makers of Levemir. Wonder if its still available.

Yes, it is normal in a recovering cat to be able to lower blood sugar in an hour by feeding low~carb. Eating triggers an insulin spike from the pancreas.
Your vet's number and yours, unless they were taken from the same blood drop at the same time, have no reason to match even within 20%. Blood sugar changes all the time.

But both numbers are high-normal.

Good luck on remission!

 

P.s. if you're too nervous to experiment with insulin microdoses, experiment with some zero-carb treats instead.

When you see her number getting too high, feed her a piece of nuked chicken or some other zero carb treat.
Then check blood sugar again in 30 and 60 minutes, it should come down.

 

The vet actually took the blood and from that vial, we got a drop for my meter. But it is in the 20% range. Her numbers have not gone over 107 since then (about to update spreadsheet). We even got a 55 yesterday!! Geez Louise. I bought FF Appetizers (chicken in broth), and she actually likes them, so there's her low carb treat. I'll try the treat next time I see a number over 100.

Yeah, Joanna, isn't it bizarre how numbers creep up in between meals like that? She's a grazer mostly, so I had thought they wouldn't. Hmm.

Seeing vet tomorrow (Saturday) about my civie and his silly rash, so will talk to him about Chloe's differing test results.

Thanks again!

 

It's really not surprising that numbers creep up in between meals. Like Steve said, the diabetic's pancreas isn't producing a full load of insulin. By feeding small bits of low-carb food/treats, you help the pancreas work without overloading it. If you've ever had to take time off from exercising, this is the same principle as you would use for your muscles. You don't want to just into a full workout unless you like to be sore. If you're sore, your next workout will be less comfortable and less productive. So you work up to a full workout/run to help your muscles stretch out and get back into the routine. That's what you're doing for Chloe's pancreas--helping it stretch itself out and get back into the routine.

My caveat to what Steve said is that I wouldn't use no-carb treats. The pancreas releases insulin to offset carbs--so if there are no carbs, the pancreas doesn't need to stretch.

 

My Chloe girl is a grazer, though...so she picks and picks at her wet food all day until it's gone. That should be good at putting small amounts of carb into her blood stream, right? To keep the pancreas going, but at a low capacity.

She was 55 the other day, then 80s...and a random 109 today. But there was a Basset Hound howling next door and the snow plow going up and down the street, so I'm not too worried, she was probably just a little weirded out by all the sounds.

 

Bix is the same way. I've wondered if perhaps it either keeps his BG almost constantly in a small food spike, or alternately isn't enough food at one time to really kick his pancreas into action. I haven't done a lot of testing on those fronts to see if changing the eating mode affects his patterns.

Nice that you saw a 55 with her!!!! That's awesome! Hope your civie is all better soon too.

 

I wonder that too!! But I can't force her to scarf down her food...this is just how she is

And Bix's numbers are all fantastic...but he's still on a smidgen of insulin? I guess if Chloe creeps into the 120s and 130s I'll give her a smidgen too and then monitor her.

Civie (Linus) has (supposedly) Eosinophilic Plaque and seems to be allergic to SOMETHING (I'm allergic to cats. I told the vet it'd be a riot if Linus was allergic to me). My poor boy...he goes into shock at the vet and it breaks my heart. He's usually this lovey dovey, happy go lucky cat. Sigh.

 

Just to clarify --

Chloe needs insulin at all times, not just after eating carbs, and not just after eating. Insulin makes small amounts of sugar available to all the cells of her body, and it's required just as much as oxygen. (What do you think the oxygen is there for? It's part of the slow-burn reaction that makes energy in the cells. The fuel is glucose.)

She needs more insulin after eating, and much more after eating carbohydrate.

Zero-carb treats will still trigger insulin spikes, because the act of eating hints to the pancreas that it's time to crank up a bit. Just how much insulin I don't know, but you can check by trying it.

Hoping you can keep her numbers reasonable for long enough for her to heal that pancreas some more!

 

Glad to see Chloe is back in the green!!!

Keep up the good work, kitty girl! party_cat And kitty Momma...