Crazy numbers....

Silverado remains on low carb wet food (Fancy Feast and Sophisticat from PetSmart). There is no access to high carb food or treats. The low carb food is available at all times. He does not go outside. He had a recent dental and check-up.... no infections, no dental issues. He has never tested positive for Ketones. He does display physical symptoms of acromegaly, but I'm not convinced enough yet to go for the test. Acro symptoms are pot belly, big feet, large lower jaw, broad face, enlarged heart, snoring, insatiable appetite, and as yet uncontrolled diabetes at 5 units BID. If I can get the diabetes under control, I will consider the other symptoms to be coincidence.

On 05/08, his numbers got well into the green. There was no lifestyle change to account for the drop on 05/08, but it got really scary for me when he hit 50, so I gave him a couple of tablespoons of high carb canned friskies with gravy. The next day, I decided to temporarily lower his dose and then gradually work his dose back up if his BG tests warranted it.

Does anyone see anything in the spreadsheet to indicate that I'm doing anything wrong?

There seems to be no end to the frustration for me. I'm just glad that Silverado seems oblivious to his health issue.... he's a happy and loving little guy.

 

Hey Jane! Without more mid #'s to be sure, I would say his dose is slightly too high (even though he's not in the greens.) When you switched back to the 16th is what's making me think this among a few other things. When you switched to the 5, he hasn't started his rise when you gave the next 5 units. He went:

PS 232
+5 204
+7 165
PS +12 135 -- where you gave another 5 units. He hadn't started coming up yet, so he may have still been going down which may have led to rebound.


I'm seeing a pattern of successively lower PS's until they then jump like a reset. If the dose is slightly too high, then his liver eventually dumps glucose to protect itself. If he hasn't seen many lower blue and high greens that can happen even in the mid 100's because he's used to flying high. So you may be just enough off to get through a few cycles before his body panics and give you a number that starts the cycle all over again.

I'd like more eyes on this, but my suggestion would be to reduce his dose back to 4 for a bit and try and get more mid #'s to see what he's doing. I'd also suggest taking the +11 test or +11.5 so when you take the +12 you can see if he's truly on the rise. If he's still dropping or if he's staying at the #, don't shoot yet. I don't know what your shot times need to be or your availability to take tests and I don't want to completely throw off his schedule or yours, but if you have room to adjust, I'd say wait it out until a rising #, shoot a lower dose, since the previous was going too long and work your way back out.

 

Thanks for the feedback. What you're saying makes sense. I dropped him back to 4 units this morning. Should I wait a few days before getting any mid day #s? or start right away? By mid numbers do you mean +5, +6, and +7 in addition to the +11 and +11.5? or do you need more than that?

Thanks again.
Jane & Silverado

 

I would get him tested.... that is too many 'coincidences'. AND acro routinely "fluctuates" so the sudden drop is another 'symptom"
Some studies have suggested as many as 1/3 of diabetic cats may have acro.

If he is acro, than your goal of regulation is nadir around 150 i think, not the lower goal of a normal diabetic. This is because if he is acro, his growth & IGF1 hormones fluctuate, his pancreas still works, and suddenly his numbers can drop out the bottom, which can be very dangerous obviously. For that reason alone, if you can spare the approx $200, you should find out. If the $ is a problem, than I would continue to be on the very conservative side with your goal nadir, and I would definitely treat any number under maybe 80 with high carb immediately. On an acro, LC can actually lower the BG by stimulating a working pancreas.

 

Looking at your SS. Looks to me that he's probably at 4.8U range. On 5/7 PMPS 5.2U put him at a no shot the next morning. I would read up on this link. Read everything. You may not go by exactly what it says, but it helps give you more info to have under your belt. http://www.felinediabetes.com/bg-curves.htm

Try to get more data if you can. Sending you good vibes!

 

Jane--you need to be getting more tests. Dosing adjustments should never be made based on preshots alone. In addition to mid-cycle tests, you need some at +1 and 2 but especially you need some at +10 and 11. You need to know how long the current dose continues to drop him before you make another adjustment. Dropping back to 4.0 units without more data is likely to cause you more headaches rather than less.

 

Hi Jane, I agree with Terri. Making big jumps will kind of make you back track again. Keep us posted on here so we can help. :smile: Don't be afraid to ask any questions. This whole process is a challenge, but you'll be fine. There are so many ppl on here that want to help, ok ;-) Looking at SS tonight. If you read the link I posted. His mid-point is above 250... most likely dose is too low, but then again w/out more data like Terri mentioned. Getting +2, +4, +6 and +8 will let you know exactly where his nadir is... and when he starts to raise.

 

Michelle, thanks for the link about the curves. I had read that way back when Silverado was first diagnosed, but didn't understand it at the time and then forgot about it. Knowing what I know now, it makes perfect sense. Thank you for bringing it to my attention again.

Thanks also to everyone else who has offered help. Your advise is understood and well taken.

Nancy, as soon as I can work it into my budget, I do plan to have him tested for Acromegaly.

I'll post a full curve next weekend.

Jane & Silverado