Constantly high blood sugar

http://www.felinediabetes.com/FDMB/threads/recently-diagnosed-and-uncontrolled.192277/#post-2146575



Hello Everyone,

As I sit here looking at Thomas's mainly pink and red spreadsheet, I start thinking about what I can do to change it. Wonder what I'm missing.

When he was diagnosed, February 5, he was excessively eating and drinking until we started feeding all wet low carb food on March 8. In the past week he has become ravenous again, constantly begging for food. He hasn't been drinking excessively but I've always been adding extra water to his food. He seems just as hungry as he was right before he was diagnosed.

I have been testing his urine for ketones whenever possible and it has thankfully been negative. He's shy when it comes to the litter box, so I sneak a test in whenever possible.

He has mostly been tired and lethargic but we get glimpses of him playing with toys and wanting to cuddle, for a few mins. In the past week we've been seeing these glimpses and thinking his blood sugar would be good but when we take it, it's near 360. When his blood sugars are below 300, he acts like a kitten again. Before diagnoses, he would spend the whole day, every day, with his humans.

When we were initially upping the dose from 3 units to 4 units, February 24, our vet entertained the idea of insulin resistance. We treated for a possible UTI at this time. The next day Thomas started having diarrhea. A return visit to the vet on February 28 for the diarrhea, lots of bloating a gas had them offering another antibiotic, metronidazole. We left with fortiflora and I picked up some florastor instead. He poops became formed but still very soft and smelly. They continue to be the same consistency. Could this be due to the blood sugar being so high? I was using florastor and the ultimate multi probiotic topped with fortiflora for a month, there were a few days of normal poops but most were soft. I'm now trying pumpkin, slippery elm and florastor. I'm thinking about visiting the vet to get the metronidazole. I don't like antibiotics but I do want to see his numbers go down. With the blood sugar being elevated, he is more likely to get a UTI, I'm considering starting D-mannose prophylaxis. Went to pick some up today but they're sold out at all locations in the city so I'll be ordering it online.

I will be doing a curve tomorrow to see how he is responding to 4 units. I have been increasing by .25 and I know we like this to avoid missing the correct dose but with the nadirs being above 300, following tight regulation, can I increase by .5 units based on the curve results tomorrow? There is still a part of me that wonders if 3.0 units was the right dose because of seeing the numbers that we blue and all the numbers I've seen since are terrible.

Initial blood work confirmed that he was not hyperthyroid. At what dose should I start to think about testing for high dose conditions? He is 8-9lbs. When we reach that dose would it make sense to try a different insulin to see how he responds to it before doing the testing?

That covers my thoughts for the moment. I welcome any advice or experience you can offer.

 

His labs shows no infections? His teeth are OK? I would think once you hit around 6 or 7 units of you see no movement in the numbers consider testing for acromegaly.

 

Sara, Thomas must be on insulin 73 days minimum to be tested for insulin resistance or it could read false. I am having Olive tested in May. I knew early on she needed to be tested. The insulin was like giving her water. I decided if she hit 5 units the tests would be done. She is up to 8 units now and starting to have better readings. I didn't know about the 73 days though. I did test for cushings already, that was negative. I am doing the resistance and acro test. Since they go to same lab, why not do both.

 

Your best place to post is on the Lantus forum. It certainly looks like Thomas needs more insulin. He might have built up a high degree of glucose toxicity and careful dose increases will get you to a breakthrough point. The other possibility is a high dose condition. The Lantus people can help guide you through this.

 

His WBC was normal in his blood work. The vet looked at his teeth and didn't say there was an issue. He was on a dry oral diet for his whole life before diagnosis.

Thank you for letting me know about the 73 days, we'll be able to test next week at the earliest then. If I go to get blood work done, I would like to test for everything that it could possibly be. One poke is better than multiple visits and multiple pokes. I poke him enough at home and drawing blood work really stresses him, and me, out. Cushings, IAA and acromegaly are all tested through blood work?

I see that you've switched to levemir, how are you finding it? Your numbers are looking way better than before. I am considering switching if higher doses don't change Thomas's numbers much.

 

Cushings is the first urine in the morning. My vet said I needed to get the urine into them with 4 hrs of getting it. I used lentil beans in the box (Olive is a digger). Gave her breakfast and shot in spare room and closed door. Got sample about 2 hrs later and ran it to vet. It gets sent out. I will have to look it up and see where.

 

@Love-Paula aka Woodsywife
I am in Canada so I'm betting the testing facilities are not the same.

 

I don't know about Canada. Michigan state university does it here. I guess if you Google it maybe you can get answers.