Losing stability, starting to get worried

Hi guys!

I am helping a 6th diabetic kitty! All of my previous "little patients" are all OTJ. But the one I am currently trying to help is a more complicated case.

His name is Faya. Currently on LANTUS.
I dont remember how old he is. He is not overweight, eats the best low carb high quality canned food, doesn't drink too much water, has normal stool (since we have been increasing his fiber intake with psyllium, otherwise he is constipated).

Current symptoms that MIGHT (or might not!) explain the situation :
vomited this morning and 3 days ago
has an increased appetite
wakes up his owner at night cuz he's too hungry (or atleast this is what is seems like)
his bg values have been increasing

Here's his spreadsheet : https://docs.google.com/spreadsheets/d/1bfN3c7c4RPZuho4_XldyXhiFDX87sttZoKoPpRsnvVk/edit?usp=sharing

Since the beginning of October his BG values have been increasing for no apparent reason. Faya's owner and I are both starting to be worried since yesterday's dosage increase doesn't seem to help.
He used to be steady (blue-green values), now his average numbers are yellow....

Would you guys encourage us to increase the insuline dosage again? If, so, how much should we give?
Or am I missing something?
Any help would be greatly appreciated!

Oh and by the way, Faya's owner has bought a new cartridge of Lantus cuz we thought it could be the insulin that was no longer "fresh", but it doesn't make any difference!

Kim

 

Hi Kim.... Have you had a blood panel done to rule out other causes??
Dental issues/liver/kidneys??

bumping for experienced eyes....

 

If every increase winds up raising the glucose, you may be giving too much.

What kinds of feeding patterns do you use? Sometimes, adjusting those can result in better numbers - for example, feeding mini-meals several times vs single meal feedings or adjusting the carb level so that a meal just before nadir is slightly higher carb to smooth the drop.

 

I would try either increasing or decreasing the dose. I would opt for increase and see what happens since from the SS it doe not look like too high of dose but I could be wrong

 

Jayla : Yes, last blood panel showed increase in Bun and Crea. Like most old and diabetic cats, Faya is getting close to stage 2 of CRF. But the food he is currently eating is the lowest phosphorus and yet low carb food we could find. Dental is something we might have to look into, but since Faya's owner doesn't have a lot of money (and dental procedures are always very expensive) I wanted to eliminate all other possible causes. Also, last time the vet took a look he did not notice any obvious problem, even though he added that without an X-ray no one could be sure.

BJM : We thought of it! I am always puzzled when I think of increasing or decreasing Faya's insuline! Look at all the previous dosage adjustment we made. Some tend to prove that lowering the dose wasn't a good idea, some others were definitely the right thing to do. On September 20th, Faya's owner could not be there to give the shot. So she skipped the injection. I couldn'T wait to see if receiving no insulin would suddenly show us what his pancreas is capable of and if having no insulin might not be such a big deal (which would have pointed out the fact that we were probably giving too much insulin). But unfortunately, that time was the first time he got a pink value. And ever since that day, for some reason, he kept (and still keeps) having yellow values (sometimes pink).
So it's not as straight foward as "everytime we increase the dose, his BG values get higher" or "everytime we increase the dose his BG values get lower". Look at his spreadsheet... It is so complicated to decide what move to make!

Larry : I will talk to Faya's owner and see if she is prepared for an increase... He is receiving 0.7U, we might try to give 0.9U and see what happens... I hope something predictable is going to happen! No more messy cycles that are almost as ugly as it was when Faya was on Caninsulin!

Thanks for all your help!
Kim

 

I'd recommend checking for any potential causes of inflammation or infection (e.g. urinary tract issues). I'd also strongly recommend testing regularly for urine ketones.


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