Jake's Numbers - A little wacky!

Hey everyone, it's been months since I've been able to come here. Lately the computer has been acting poorly and we can't afford a new one so we get to be in the dark ages! ARG!

Anyways, Jake's numbers have been a bit wacky... he's gone a couple days without insulin (yay) but the next day he's pretty high. The past two morning he's tested "HI" (My meter reads high for anything over 500). As you can see with his numbers he's going all over the spectrum... from 39 to over 500. What's he doing? Any thoughts?

Thanks again!

-Breayle and Jake

JAKES SPREADSHEET:http://spreadsheets.google.com/pub?key=0AgUMsjJc7hILdGNqR0VCRVBGbnI3c0o0U1VzYUdfVmc&output=html

 

couple of things:

1) how old is the lantus you are using? When did you open a new vial/pen? While you can get more than 28 days out of opened lantus, it doesn't last forever and if you haven't changed pens, I highly suggest you do. And that may help with the wonky numbers.

2) you have skipped several shots, why? Shooting is not based on just the PS number, rather it's based on the previous cycle and where he may go in the next cycle. If you are concerned about shooting due to a low PS, you can wait 30 minutes and test again to see if the BG raises and then shoot.

It may be a good idea to re-read the lantus protocol and stickies on the lantus forum.

viewtopic.php?f=9&t=1581

viewtopic.php?f=9&t=150

viewtopic.php?f=9&t=147

 

There are a quite a few lows in those skipped shots, no way I would have given even a token dose at 59, 64, 42, 40, or 51, so I don't think the skipping shots is the issue, nor would I suspect the insulin has gone bad.

I would, however, want to get on a schedule where I could shoot twice per day. It looks like you changed his diet in April, removed the dry? Is that correct? I'm just skimming your posts, I don't post on the Lantus ISG so I'm not familiar with your kitty.

Once a diet change has gone into affect the dose of insulin has to be monitored as your cat's need for insulin almost always goes down, sometimes very quickly.

If it were my cat, I'd consider a dose decrease, maybe 1.5U for a while and see how your kitty does. It's a big reduction, but skipping shots is not a great idea, nor is getting these big swings in the numbers.

Can you check the AM number for 7/4? Monitors don't register an 8 so I think you may have typed that incorrectly since you gave insulin that morning.

 

Jake has been off of dry food since he was diagnosed, back in February. Also, I was told by my vet not to give him an insulin shot at a number below 150. I suspect he's eating outside food from another house, he's kind of a food freak. The insulin was opened back at the end of February... I also read on this site I think that many people have used insulin for up to 6 months after it's been opened and had no problems. He started gettin' extra low numbers when the days got hot, and his appetite is usually pretty low when that happens. So I'm wondering that just the lack of him eating all his food, and not searching for more is giving him the 39's and 50's.

-Breayle

 

I don't know the specifics of lantus dosing, but I would like to know why you didn't reduce the dose as those numbers got low, rather than either shoot 3 units or hold......

 

I decreased the dose back to 2.75 and got high numbers again.

 

Hi after reading, you need a gameplan.

Lantus will notlast 6 months. What I thinkyou may have got confused with is people stating a 5 pack of 3ml carts last them 6 months.
The longest I have seen is 9 weks and that'spushing it.
Are there any floaties in the cart? Cloudiness?
And how oldis the insulin your using? We typically changed our cart every 42 days (Lev which is slightly more stable than Lan, action of them is almost identical)

You needKetodiastix to test for keytones.
As has been suggested,I would cut to 1.5u for 3-5 days and see what readings you get.You must check for keytones though if you do.

Your absoutely right, kitty not wanting to eat because of heat=lower bg's.There's nothing(carbs) for the insulin to work against.

Anyway you can try and source where Jake may be getting extra food from? This couldmake it harder for you to acheive regulation /remission. Maybe flyer your neighbours asking them not to feed him and why?

It's a shame you can't post daily in the Lantus forum. Always someone around to help and advise, even if only moral support.

Let us know how you get on if you can.
Good luck :mrgreen:

 

I used to post every day... then my computer/internet was busted. Then I got it back and got little response for my daily postings. Sometimes no one would even answer the question so I started talking more to my vet. I disposed of the old lantus, and gave him a 3u shot of it this morning. His BG simply read "HI" after three tests. Also, I've asked the neighbor to keep food in but she said her kitty is totally outdoors and wont come in because of her dog. She promised to shew him away if she saw him.

I've got ketone stix and I do test... he generally tests no ketones to trace ketones.

I'm worried about him... he's also gettin' picky with his food. I have to find him new flavors or he wont eat

 

I know that Jake is an indoor/outdoor kitty, but do you think for a few weeks you could keep him inside so that you can monitor his food and see if he is getting into stuff that he shouldn't.

It's not easy, I know that. I have a harness for kitty that is off insulin, Mr. Darcy, we go outside on that each day. It's not the same as the freedom your little man has, but I know that Mr. Darcy is eating only the canned food and he's still in remission since December.

Can you monitor his BGs today? I understand why you gave 3Units, when a high number is present, we do want to get it down, but you've had so many lows that I think the 3U is a high dose for him.

Please feel free to continue to post on Health, there is no steadfast rule that you must post on an ISG. There are more Lantus users there, but I'd hope that some wouldn't mind coming over here and helping out

 

Welcome to my HELL! I try to keep him inside... I live with my parents in their "garage" that's been converted into a house. However, I have three male indoor cats, and Jake has been living in the parents house because I didn't feel it was fair to him to bring him into my house and be tortured by three younger, healthier cats. And my parents don't keep such an eye on him. I tell them to keep him in, they say he gets out meows blah ****in' blah. I just tested him again and it's at "HI" still.

Jake was on 2.75 for weeks and still maintained high BG levels. He didn't start gettin' the lows till he was on 3u for quite a while if you check. I have given him 3u this morning. And I'm hoping to lock him in my nephews room all day but I don't want him to get hot, or pissed.

I'm stressed... I don't want him hurt.

-Breayle

 

Do you really think he'll be tortured by your cats?

The cat, Mr. Darcy, that I mentioned, I adopted him in December, also adopted another in May of this year, that brings my total to 7 cats in a small house. Both cats were FD when adopted and both went off insulin, even with the short term stress of being rehomed.

You might be surprised how well kitties can adjust to each other.

We do have lots and lots of climbing trees and beds, I think that helps them because they each have places they can call their own.

I'm sorry that you are stressed. It's been a long time since Tucker was first diagnosed, but I do remember how heartbroken and stressed I was. It's not a fun time, but I can promise you that things do get better.

 

Breayle, I'm sorry you are so stressed. It is very frustrating when you can't get results no matter how hard you try!

I'm not a lantus user, but I have been reading up on it lately, and I have a few thoughts for you. Keep in mind that a lantus user may have different advice and I would defer to their experience over mine!

It is clear that the 3.0u dose is too high for him. It may also be true that the 2.75u dose was too low, but it might not be too low NOW. Things do change, and sometimes you have to go up to go down....meaning raise the dose to get into better numbers, then lower it back down when you see the numbers going too low. That's a general observation based on PZI experience, but I suspect it applies universally.

With lantus, you need to be able to shoot every 12 hours in order to maintain the shed and allow the insulin to work on the BG. If you skip shots, it depletes the shed, and the next shot goes to replenish the shed first, and BG will rise. You end up in a yo-yo pattern. This is where you are. You need to lower the dose so you can shoot every 12 hours.

I strongly suggest that you re-read the stickies on the lantus ISG, and print out the protocol so you can refer to it often. If you follow the protocol, you have a much better chance of success.

Hang in there, and keep us posted on how you're doing!

 

For someone who doesn't use Lantus, Laurie has pretty much got it spot on.

With Lantus, it always fills the shed first and then bgets to work on the bg's.Thus as Laurie has said your yo yoing and this willbe frustrating.

You could try intorducing Jake to your other kitties when your around to monitor how it goes.

The fact that your getting such swings suggests you haven't got a kitty that needs large amounts of insulin, what you need is to stabilise how much and give consistently every 12 hours.

I saw what yu said about posting. Lantus is excellent but you can find if you don't post in others condos, it's not always repaid.It's not meant in a bad way, but with such a large group, I think beans tend to pick. I know I had to in the end because it can be very time consuming. Now I look out for condos where either hep is directly requested or someone hasn't looked in on them.I have been off the board of late for personal reasons, but if you post and ask for advice, honestly you will get it.
If you post in health, just put Lantus at the end in brackets, will catch their eye easier. People should always be very clear about their experience with an insulin as they can vary widely in their action and flexibility.

Do you think you could at least find out what food your neighbour is feeding her cat?
Maybe try and persuade her to switch to low carb? I've managed it with quite a few people taking about how FD can come about.


Please don't give up, you've come a long way.

How do you feel about cutting dose whilst monitoring for keytones?

 

Today's just not a good day for Mister Jake sugar wise. Personality wise, he's totally fine. Doesn't seem groggy or anything... he's always been slow and dopey so I can't really say when that happens.

I read his BG at 6a it was "HI" then I gave him 3u. I tested again at 7a still read "HI."

When I got home from work I tested him again 6:45pm read.... "HI"

My mom is a diabetic and she said give him more insulin, so I did... I gave him an upped dose of 3.25u and I am going to monitor him every two hours to make sure he doesn't get too low.

When I had him on 2.75u 2x a day, people in the Lantus thread group said they think he needs more insulin. So I upped it to 3u. Now people are saying too high! ARG I'm SO CONFUSED! Do I give him different amounts of insulin on the same day if he's low in the morning and high in the night? Would I give him 1.5 in the morning and 3 at night? Can this be possible? Do I need to move this thread somewhere?!

I tried to keep him locked up in my nephews room... but my brother is a heaping pile of crap... and basically hates my cat immediately let him outside when he got home when I went to tell him nicely that I wanted him inside all the time because his sugar was crazy he replied "I don't care, he stinks up the house with his poop. I'm over it." Basically saying he doesn't give a spit if my cat dies. I really... really don't like him much.

So after sobbing from getting my feelings hurt, worrying about Jake and finding yet another "HI" reading when I checked him I just figured I would bring him into my house. The biggest problem is my cat, Otter. He has real issues... when Jake first got sick back in November, I put him in a cat cage outside my door downstairs. I walked into the house for 1hour to do some stuff and came back. When I got back Otter was completely freaked out and staring at the door, I picked him up to cool him off and he freaked out and attacked me. So I let him chill and took Jake out of the area, and brought him back into the parents house. When I cam back Otter was still freaked out so I spoke to him all soothing and sweet and pet him a bit. Then he hissed at spat at me, after that he ran away and attacked the other two cats... and I mean ATTACKED not playful fighting, but beat down super mad angry cat sounds. So they both hid and Otter is just walking around all puffy.

This basically happened for the rest of the day and Otter continued to beat the living hell out of the other two cats for about three days... and this was all after Jake had left the building completely for 48 hours. I'm going to have to bring Jake into my house, because now I know out of spite my brother will leave Jake outside on purpose. I'm really worried about Jake getting hurt more so from his diabetes than gettin' beat up... he's 16 years old, has 10 years at least on my other kitties and I'm afraid the stress might break him. He's a pretty chill cat so I'm not sure what to do. I think tomorrow I'm going to start introducing him to my cats and hoping that Otter will just be nice.

Here's another problem (I know I'm venting and I'm sorry... I don't know what else to do).
Jake's brother Winston is 17 years old and going senile. I would hate to make Jake a 100% indoor kitty 'cos my Winston (Pooh Bear) will become very sad. I suppose I could make sure Jake spends quality time with him by bringing him out each time I can to get his Pooh time in.

I dunno... I'm kinda lost. Totally freaked Jake's sicker, and I did it to him because I'm a bumbling fool with all the best intentions.

I'm sorry for the long post, and thanks for helping I appreciate it.


-Breayle