Izzy's numbers

Izzy is an 11 year old Maine Coon diagnosed in early January. Prior to diagnosis he and his BFF Dash were free grazers on Purina Pro Plan Chicken and Rice as well as FF Grilled entrees. Once diagnosed I switched to what I thought was a lower carb canned food Wellness Chicken (not CORE) and EVO dry. The dry is only for Dash (a dry food lover) and I placed that on the kitchen counter as Izzy is having trouble jumping that high so he could not access it. And I only place 1/3 of a cup out each day for Dash.

I started him on 2 units twice a day. (8am/8pm) He is fed at shot time and then since he has been a grazer, I leave out extra canned food while I am away. Fast forward to two weeks post diagnosis for his first recheck. His BG at 4 hours after dosing was in the high 400s, so not much change. The vet instructed me to up the dose to 3 units per day. I was nervous about the big jump so over the course of a three days upped the dose .25 at a time to reach 3.

At this point made the discovery that the Wellness food I thought was low card was not. Sigh...but that hard lesson led me to the Cat Carb Calculator which has been a godsend. I tried a bunch of different varieties (he likes what he likes) and have found he prefers FF Classics and Weruva Chicken Frick A Zee.

Then I also decided to start home testing just to try and get a handle on things. The following weekend I performed Izzy's first BG curve. The numbers were still high but the curve looked good. A few days later was Izzy's next vet check. I tested him at home and it was 230! The vet did a blood draw and he tested 260 at the office. But the next day she called to say the fructosamine level had not changed much so I she instructed me to bump him to 4 units/twice a day. Again I was weary of making that increase so quickly so I spread it out again.

I tested him 3 days later (Friday) and his BG was 403. But then the following Monday, I discovered something. While he may not be able to jump up to the kitchen counter to access the dry food that I leave out for Dash, I caught him leaping from the kitchen island (which he has access to) to the counter with Dash's food. Immediately, that food went into the cupboard and I will figure out how to get Dash to agree to the wet food diet.

Tuesday I stayed home from work and decided to do some random testing. 5 hours after his dose of 4 units his BG was 180! Then 6 hours later it was only at 275. I was nervous if I should give him his 4 units at 8PM so I called the vet office. My vet was not in but I spoke with another vet and gave the history (high numbers but sneaking dry food then low numbers the next day) and she said to go ahead and give the 4. The next day my standard vet called and said to decrease his dose to 3 units again since perhaps the high numbers were from the food. So I did and now his numbers are wacky again. Some in the 300s, some 400s and one in the low 200s.

I am kind of at my wits end. My biggest concern is these high numbers doing damage to other things. As I have mentioned a few times, he is having trouble jumping. He can manage chair height but you tell his hind legs struggle to make it. I even put a box next to my bed to make it easier for him to access it.

Thanks for sticking with my long history and for any insight that is offered. It truly does take a village with these sugar cats.

Theresa

 

Hi Theresa and Welcome,

It does take a village and we will certainly try to help. It would be very helpful to put your Izzy's numbers in our color coded spreadsheet. It will help you, your vet and us see his history of levels and dosing. The instructions are here:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Once we can see his preshot numbers combined with any midcycle numbers, we'll be able to see if he is just high and flat or if he drops low at midcycle and bounces back up.

The first might mean increasing the dose. As you noted, his doses have been increased by whole units, which could possibly cause consistently higher levels. We suggest increasing by 0.25/.5 units and not increasing again until you get mid cycle info to see what the dose is really doing.

The second scenario (low midcycle numbers with high pre shots) is called bouncing. The easy explanation is that the cat's body perceives a lower number than it feels is "safe" and releases extra glucose. That causes the next pre shot to be higher than normal, and sometimes the next cycle.

Have you read our protocol and our beginner's guide? They are in my signature in blue. They will give you a good crash course in ProZinc 101

Please get the spreadsheet working. If you need help, ask. Then we can give better advice.

 

Thanks for your reply and the info.

I thought I did have his spreadsheet up. If you click on Izzy's Spreadsheet below my name it should take you to it. It is kind of random at the moment. I intend to do another curve this weekend plus knuckle down on pre-shot testing.

 

Well, duh. My bad.

Our theory is the more data, the better. Are you not able to get pre shots daily? It is hard to see what the cycle reaction is without them. The one 180 you got looked good as did the 275 later in that cycle. But hard to know whether the next cycle was just high and flat and could have been the bouncy cycle after the lower one the day before, or if he dropped lower the next cycle and bounced up to the 441.

Could you get some midcycle numbers this weekend? Maybe even two days in a row, in case his pattern is to have a higher cycle the day after a lower one. Get preshot. Then +2/3 to see if he drops early or has a rise from the food. Then somewhere in the 4-6 hour so we can see if his nadir is before +5/6 or later. Then a number in the 8/9 hour to see when he starts to rise, and the preshot again. Getting that kind of info would really help us see potential patterns.

 

I can see your SS. Sue might have missed seeing it in your signature.

 

This weekend is ALL about Izzy and numbers. Thankfully he is a trooper and puts up with the poking.

Any advice on the hind leg weakness?

Thanks again. It's such a relief to talk to people who know what it's like to go through all this.

 

The weakness might be due to diabetes induced neuropathy. It's a relatively common thing among FD kitties and many respond very well to B12 supplementation. You can post a separate question about that to learn more. I don't have any experience with it.

 

Here is some info:

http://petdiabetes.wikia.com/wiki/Neuropathy

The thinking is that it will improve with better numbers, but many people also use Methyl B12 as suggested in the article.

 

Hi Theresa. I answered your post over at Feline Health. Sue and Kris are the gurus I referred to. Kind and knowledgeable! Welcome over here on ProZinc.

 

Hi Theresa! Welcome to our little forum. Sue's already given you good advice on the info we need, so I won't repeat it. That info will help us to determine what's happening.

 

I have updated Izzy's SS with numbers from the last 36 hours. I will keep up with the curving through out today but it looks like he is stuck in the 300s even at nadir. Maybe he wasn't getting into the dry food as much as I thought which is what led the vet and I to agree to lower his dose. Feeling frustrated...

 

The beauty of our forum, lots of kind people here to bring us back if we get frustrated or discouraged. It might help for you to look at it as all information is beneficial. You now have Izzy only eating what you want him to have and you have seen what a dosing of 3u is doing. What if 4u and the food had been propping him up? Not trying to scare you about a hypo (which can of course be serious). Just trying to help you past the frustration by pointing out that all information becomes pieces of the puzzle. You now have a dose to build up from. The fact that you are now starting to test regularly will also really help you see how a dose is affecting him.