HELP! Hamilton is Nearing Crisis - increase or decrease

Our Hamilton was well-regulated for 5 months on 2u of Lantus. He is diabetic with stage II CKD. Just before Christmas his numbers started to increase. We found out that his canned food (Wellness Complete) was changed and while the "as fed" carbs were about the same, the dry matter analysis of carbs and phosphorous changed greatly. As he had already fallen out of regulation, we switched his food to Cats in the Kitchen - Frick a zee and Ilsa Bonita. That switch took place from January 10 - January 13. However, the carbs are lower than his previous diet, so there shouldn't be much impact.

His numbers have steadily climbed since Christmas from his normal preshots of 180 and nadirs of 90, to preshots of 400s with no curve. He has been to the vet for a full workup and there are no concurrent issues causing the BGs to be high. I test him regularly, everyday, and I have not seen any hypos. In fact, I've never seen a nadir below 80. However, it seems like the increase in insulin has been followed with an increase in BG. I've used three different Lantus pens to be sure and it's not the insulin. He gets no snacks and has no access to food. I truly have eliminated all but two possibilities I know of:

1) He needs more insulin, or
2) He's getting too much insulin.

I went back to the 7th on my alpha trak to gather numbers and have attached the spreadsheet. I would be happy to hear thoughts from those who have seen this before!

 

Bumping you up for help

 

Hi Elizabeth,
I can't see the numbers.

Do you think you could put them into the ss that we are all used to using. I feel bad asking you to do this, I know it can be quite a lot of work.

Here is the link of how to set up the ss we use and how to share it with others. If you can get that done it would be really helpful.
I'll also ask some veterans to stop by and take a look so that you don't get missed.
If you have Lab results there is a tab on the ss where you can put the data in from that, there are a couple of members that are pretty efficient at picking up discrepancies that the vets often fail to mention.
Happened to me, vet said, Labs are good, yet actually they indicated early CKD, when I spoke to vet, she said yes, but she didn't bring it up because there was no need to consider treatment yet.
Knowing that he is early CKD has allowed me to take preventative measures. More water in food, low phos......

I'm due to head out with my dogs and then I have a yoga class, so I won't be round for a few hours,I'll message some of the others so that you have someone stop by.
(NB without the regular ss any help/advice they can offer will be really limited)

 

Bump

 

I attached the spreadsheet to the first post. Can people open that attachment? I will see if I can use the google doc spreadsheet this evening.

 

Hi Elizabeth, I was able to open the attachment but I had to download it and save it on my desktop first. I took a screen shot for those who can't open it. It's blurry but I hope helpful non the less

 

Can you please post it to your signature block? That way we can see it better and it will be attached to each post you do.

Open it as if you were going to edit it, click on “file” and then “publish to the web”. When the box opens, click “publish” and copy the address. Come back to FDMB and paste that link into your signature block.

Do you have any BGs for 2017? That would be helpful.

Thank you.

 

Unfortunately, I saved over his 2017 sheet. I can tell you his curves were insanely consistent and would look like this:

AMPS - 180
+2 -165
+4 - 120
+6 - 95
+8 - 120
+10 - 165
PMPS - 180

He was textbook. Until right before Christmas, he hadn't seen 200 since the first weeks after diagnosis.

I am trying to do the spreadsheet, but I don't have the options you mentioned above. I will save it as a google doc and try again.

 

Just a thot ...did vet do thyroid panel ?? ECID but when Elmo’s thyroid was unregulated it drove his BG higher . Once thyroid was stabilized his BGs came down .

 

Thyroid was normal.

 

Good to know

 

I managed to post the spreadsheet. At least I can see it. I'm not sure if everyone else can.

 

Good job! SS opens fine.

 

Thanks for putting the SS in your signature block. It would be really helpful to see even Dec 2017 data but if you have all his BGs in SS format, that would be excellent so we can see where things started to go bad and see what we can pick up on.

 

FWIW, if you were doing the SS in Google Sheets, even if you overwrote the values, you can go in File > Version History to go back in time. Or if you were on a computer, and are using a Mac, and have Time Machine running, you can also use that to go back in time and grab an old version of your spreadsheet.

No idea if this helps but just throwing it out there on the off-chance it might.

 

UPDATE: His glucose has stayed lower today and was 387 still at 4:00pm. Unless someone has a better idea, I'm going to hold him at 4 units for another 3-4 days to see if things smooth out. I wonder if he's just fighting the fast increases in TR.