Meowmeow's numbers

Hi everyone,

I've been having a few issues with my cat's, Meowmeow, glucose numbers. I don't do any spreadsheet kind of thing, nor do I check his blood glucose with the glucometer regularly. I just check it when I feel like I haven't in a while.

Some background info first, Meowmeow is my first cat, though now I have 2. We got him as a stray and he's been very healthy until this past year. He's approximately 13 years old and currently weighs around 5kg but was weighed in at around 4kg when he was diagnosed with diabetes. At his maximum he was around 7kg (15lbs) and he's a black american short hair. I first noticed Meowmeow was losing weight after he had a bout of fleas in the summer time. His back became really raw and scabby because he kept picking off the scabs and there wasn't much fur left there. The vet ended up giving him this shot that, at the time, I was not made aware could give him diabetes. After he got better and his fur grew back, we started noticing the pee in his litter box was extremely sticky and hard to clean. He also started losing a lot of weight and was constantly hungry and drinking water. After we brought him back to the vet they informed me that it could have been due to the shot they gave him to stop him itching his back. Honestly, I'm pissed off that they didn't tell me about the possibility that he could get diabetes and it would become extremely costly for me. Not to mention the fact that he's the only cat I don't have pet insurance for. I could have put an e-collar and gone with some other method than the shot that would help calm his itching, if only I had known. But all is done and now Meowmeow has diabetes. I can't do anything about the past. Now Meowmeow is on Lantus, with 2 units in the morning and 1 in the night. The vet said we could go up to 2 in the night, but I haven't gotten around to doing that and I wanted to keep him at 2 and 1 until I got used to the whole shebang. I've been giving him Insulin for about 3 months now and he's gotten significantly better since he was diagnosed...until where his health is deteriorating again.

The issue is that I went away a few days ago for 8 days and my mom has been taking care of his insulin doses and feeding in the morning and night. When I returned I realized his weight has decreased noticeably, which could have already been occurring slowly, and he has more excess skin than before. I haven't noticed the extra water drinking or litter box differences yet because I clean it more often than before (ever since he started peeing a lot more). Anyways, the reason I chose Lantus instead of caninsulin is because I did some research and found that I can keep Lantus for as long as it's good for. In the long run it'd save me money and the vet wouldn't pester me to buy a new vile every month. My mom also learned how to give the insulin to my cat correctly, and feed him the proper amount. So I'm not concerned with her being the issue. Meow meow gets his breakfast at 9am, a small midday snack around 3-4pm depending, and his dinner at 9pm.

Because of his physical appearance I checked his glucose rather often these past few days. Although I should really try to check in the morning as well. I'm going to list his numbers that I've taken previously (stored in the memory of the glucometer) so you can see how his numbers used to be when the insulin looked like it was working. I apologize in advance for the erratic readings at the beginning, I was still getting used to using the device:

Just a reminder that he gets 2 units in the morning with his breakfast at 9-10am and 1 in the night with his dinner at 9-10pm, with a mid day snack at 3-4pm. He did go in for a curve a while ago and that's when the vet told me I could go up to 2 units in the night.

DEC 10 11:23pm 16.6 mmol/L

DEC 14 9:09 pm 18.3 mmol/L before eating and before insulin

DEC 26 2:20 pm 11.9 mmol/L after eating breakfast and after insulin, before snack.
DEC 26 9:26 pm 16.8 mmol/L

JAN 1 8:40 am 21.6 mmol/L before eating and before insulin

JAN 22 10:03pm 19.8 mmol/L after eating and after insulin

JAN 23 9:42 pm 20.1 mmol/L before eating and before insulin
JAN 23 11:31 pm 19.4 mmol/L after eating and after insulin

JAN 24 9:01pm 19.5 mmol/L before eating and before insulin
JAN 24 10:58pm 22.4 mmol/L after eating and after OLD insulin (to test it's effectiveness) then I gave him 1 unit of a new vile of Lantus and tested:
JAN 25 12:56am 19.6 mmol/L This was after opening a new vile of Lantus

The part that is confusing me is that his numbers went up after he had his nightly dose on Jan 24.
Shouldn't the number be at least maintained if he has eaten but has gotten insulin?
I took this to mean that the OLD insulin hadn't worked.
But the thing is, his numbers didn't drop much after I gave him 1 unit of the NEW insulin. It's probably because his numbers are too high to begin with to be noticeably affected by merely 1 unit of insulin, right?

I know I don't have any consistent previous numbers to go by but I am really trying to get my act together and will be testing much more frequently (including tomorrow morning). I'm also looking for a more holistic vet clinic that can give me advice on raw food together with diabetes maintenance. Meow meow is currently on Purina DM diabetic wet and Royal Canin Diabetic dry food and I'm hoping raw can help him in some way..

My ultimate dream is that Meowmeow can go into remission, but I've heard it's very unlikely if it's been a few months after beginning treatment. Honestly, I just want him to be a healthy cat again. His having diabetes has brought us closer, but has also made me that much more worried for his health. I know he's an old boy and some people lose their cats at his age, but he was doing so well until recently.. I just want him to be healthy for the last few years he's got.

 

I would increase the dose to 1 /4 units. I also recommend that you record yur BGs and other things is a spreadsheet. Here is how to create the SS
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

Also, before you do that it is easer to present the info is terms of writing like for Jan 24
Jan 24
AM PS (BG in the morning before shot and feed) 19,5
+222.4 ( the + with value after that indicates the time after the shot BGs were taken)

 

First off I am not going to offer you any advice about the actual dose as I am not experienced enough. I however would like to make some observations that might help you.

Lantus likes consistency and so it is unusual to dose 2 units in the morning and 1 unit at night. You also need to give lantus at the same time both morning and night each and every day. You can vary the shot time by up to 15 minutes each shot without any effect.
Deciding on the best dose with lantus initially goes on the weight of your cat. Then from there is it changed according to the nadir ie the lowest that your cat goes. Therefore at the moment we are missing some data in the middle of the cycle. Ideally you would always get a pre shot reading each time and then at least one other reading during the cycle.
Too much insulin can look the same as too little. If a cat has too much they can drop too low and then bounce back up. So on just the odd reading you can miss these low drops.
The dose is usually only increased by 0.25 units at a time, it is very easy to miss the optimum dose.
Switching to a low carb food can help bring down numbers and this in turn can reduce the need for insulin. But this must be done carefully when you are testing consistently.
As everyone is on different time zones using the spreadsheet helps set the results out so other members can easily see what is happening. Larry has linked you how to set one up and I would recommend doing this.

Finally I would edit the title of your post so that it also says something like help needed lantus dose. I will go over to the lantus forum and flag up your thread and ask for others to advise on dosage.

 

The Lantus will work better if you give 1.5 units both AM and PM, at roughly 12 hour intervals.

Note: insulin doses are adjusted based on the nadir, the lowest glucose post shot. This often happens between +5 to +7 hours after a shot of Lantus, although it does depend on the cat

If possible, please take a day to run a curve. This is when you take serial glucose tests, from pre-shot to pre-shot, every 2 hours. That will tell us how well the Lantus is or is not working.

Also, you might like to do some reading on feline nutrition at Cat Info, and download the food chart.

 

Thanks for your advice everyone. I'm going to contact the new vet clinic when they open up tomorrow. All the doctors at the new clinic I found have much better reviews than the sole doctor that has been treating meow meow. I don't feel comfortable adjusting Meowmeow's insulin dosage on my own, so I would want to speak to a professional about it. Especially if I intend of changing his diet to raw food. I'm trying to switch over my other cat to it and Meowmeow's tasted and loved it right off the bat. I've read that the amount of insulin needed can change shortly after changing the diet to raw food, so I want that to be monitored the proper way.

I will definitely bring this new information about uniform dosing to the table when I meet with the new vet.

I have also decided to permanently dose at 10am and 10pm. I tend to wake up late and get home late, so 10 would be a better time for both me and my kitty.

Larry and Kitties, I will work on a spreadsheet and update the thread when I can!

Phlika29 and BJM, I didn't know it's unusual to dose 2 in the morning and 1 in the night. I've been doing that since Meowmeow started on insulin. I guess it was just starting dosage, but I haven't upped it at all since he started. On the curve they did at the vet's office, they said that with a midday snack his lowest numbers was at 14mmol/L.. if that means anything.

 

Hi before you speak to the vets have a look at the current treatment guidelines contained in this link

http://www.felinediabetes.com/FDMB/...-from-aaha-convert-your-vet-if-needed.131187/

There are many approaches to using lantus. On this board there are two main protocols that members follow as their guide (although they are often tailored to the specific cat). The tight regulation protocol is used by members who are able to monitor there cats blood glucose at home
http://www.felinediabetes.com/FDMB/threads/sticky-lantus-levemir-tight-regulation-protocol.1581/

Alternatively if you are not able to monitor your cat's blood glucose as closely then there is the start low and go slow protocol
http://www.felinediabetes.com/FDMB/...levemir-start-low-go-slow-method-slgs.129446/

I guess the trouble with doing curves at the vet is that if they are stressed their blood glucose can raise a fair amount and so it may not a true reflection of how low he is going at home. Also as lantus works by building a 'shed' in the body the 2 and 1 unit dosing may make that a little erratic. Could you get a mid cycle reading tonight and in the morning to see what is happening now. The other issue that I think will help the numbers is removing all the dry food and transitioning over to a low carb wet food but this needs to be done with care, careful monitoring and after you have settled on the dose of insulin.

From now on I think you need to try to get some more data on his figures throughout the cycle if you can. Even it is a +1 or + 2. Is that possible at all.

 

Today I'm testing his BG every 2 hours. I've set up the spreadsheet and link is now in my bio. Although in the first few rows the numbers all show up green and I'm not allowed to edit the colour (might have to do with my copying and pasting from the US template). Anyways, the numbers show up correctly coloured for the new figures I'm entering in today.

Phlika, I read through all the links you provided and decided I will still talk to the vet before changing his dosage and diet. I just don't want to do anything wrong and I'm still new at this. I'm attempting getting his numbers every 2 hours since this morning.

I have another question, is a mid day snack a bad thing?

 

I let mine graze all day.

 

I see.. I just thought that midday snacking would affect his figures on his spreadsheet. But if I mention it in the sheet then I guess it shouldn't be a problem, right?

I have a few other questions..
Does resistance to insulin occur suddenly or gradually? I haven't read much about resistance yet..
and also, does anyone think a raw food diet could change my kitties' numbers more noticeably?

 

My cat also on lantus (now off the juice) and I would feed my cat mini meals throughout the first half of each cycle. Mini meals are easier on the pancreas and can help to slow down any fast drops in blood glucose. Your cat is classed as having an empty tummy 2 hours after eating and so this is how I used to feed and test

AMPS test, feed and give insulin
+2 test and then feed again
+4 test (if doing a curve) and then feed again
+6 test (if doing a curve) and then feed again
Then carry on testing every two hours with out any more food unless ofcourse he was low). I wasn't always 100% on target with the feeding and would vary it depending on his numbers but when doing a curve I would just make sure I gave food as soon as I had tested him so in two hours time the next test was not affected by the food. Other people just free feed and take the food into account.

 

Hi everyone, just a report and another question. Meow meow's bg points have decreased since switching over to raw food. He eats raw venison every meal. It's commercial raw.
My question is if there is any reason for a cat's bg to jump up really high halfway through a cycle? I mean.. is this normal or a typical inexplainable occurrence? I don't consistently check meow meow's bg in the middle of the day, but i'm just really shocked at the number I got now Feb 24 at 6+. Please check out his spreadsheet if you have a moment.

 

Hi,

There are quite a few reasons why a cat's blood glucose can jump up high during a cycle.
A very common reason is that the blood glucose drops too low for the cat's comfort and triggers a 'bounce'. (The body releases stored glucose into the bloodstream to raise the BG level. It's a protection mechanism).
This may have happened with Meow Meow if his BG dropped low during the night. (But without test data it's impossible to say.)

Other reasons for BG spiking include things like; furballs, constipation, stress, infection, intolerance to certain foods; and sneaking some high carb food from somewhere...
Let's see what Meow Meow's blood glucose does later on today. Maybe it'll settle out again.

Eliz