Molly's BG is staying high recently

Discussion in 'Feline Health - (The Main Forum)' started by Sue Hammond, Dec 30, 2017.

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  1. Sue Hammond

    Sue Hammond Member

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    BG tests remain high, I haven't changed diet, shes been on Mac's and Lily's kitchen wet food from day 1, her routine hasn't changed, she seems well in herself, , no abnormal drinking or weeing, she seems happy, it's just dissapointing when in the past she's been much lower, she's having 2u twice a day...maybe it isn't enough? Any advice please, thank you xx
     
  2. JanetNJ

    JanetNJ Well-Known Member

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    Definitly time for a dose increase. Try 2.5 for a few days and let's see what happens. Insulin needs change.
     
  3. Sue Hammond

    Sue Hammond Member

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    She's never had a dose that high before though, so a bit worried about increasing it, she's lost all her excess weight, and I was hoping that would have made a significant difference to her doses, but apparently not
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    She needs what she needs. A few weeks ago my cat was on 1.5-2u and now is on 2.5-3. Your cat is in the pinks. We want her in the blues.
     
  5. JanetNJ

    JanetNJ Well-Known Member

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    I'd you are concerned try 2.25 and see what happens.
     
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  6. Critter Mom

    Critter Mom Well-Known Member

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    Hi Sue,

    Perhaps a vet checkup might be a good idea. Tooth and gum problems are notorious offenders for driving BG up, as can other infectious or inflammatory processes in the body (plus diabetics may be more vulnerable to infection; healing may certainly take longer). My vet told me that diabetics tend to be very prone to gingivitis (and more vulnerable to infection in general). Also, I see that Molly seems to be spending a fair amount of time above the renal threshold. Sugary urine may make a kitty more susceptible to urinary infections.

    If you're not already doing so, it would be a good idea to keep a regular check on Molly's urine to make sure she's negative for ketones while you try to identify other factors which may be elevating BG levels.

    I see from Molly's spreadsheet that she can get some very steep drops on her Caninsulin. It might be worth discussing a switch to an insulin with a gentler action profile with a view to improving Molly's overall regulation (e.g. Lantus, Levemir or Prozinc). Gentler-acting insulins typically don't tend to produce such wide swings in BG level (though every cat is different) and it can assist with finding a suitable amount of insulin to keep a kitty below the renal threshold most, if not all, of the time but still in safe numbers at nadir.


    Mogs
    .
     
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  7. Sue Hammond

    Sue Hammond Member

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    Hi
    Molly had a check up with the Vet two weeks ago, when she had her boosters and health check, her teeth and gums are good and her urine test was good...so I've no idea what's going on...My vet isn't keen on prescribing different insulin, he wants to stick to Caninsulin I've already asked if maybe a different one would be better, he said he's not happy to change her to another just yet... She's been high since having her booster vaccinations, could that have anything to do with her bg results xx
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

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    How old is your insulin? The immune response caused by the vaccinations could involve inflammation. That can raise BG.
     
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  9. Sue Hammond

    Sue Hammond Member

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    She's not weeing or drinking abnormally either, her appetite is normal, her coat is glossy, no dandruff which she had when first diagnosed... She's alert and playful xx
     
  10. Sue Hammond

    Sue Hammond Member

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    The new insulin cartridge was started on Wednesday
     
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  11. Sue Hammond

    Sue Hammond Member

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    Her boosters were on the 14th and her numbers have been high ever since
     
  12. Sue Hammond

    Sue Hammond Member

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    Molly's BG test +3 this morning is 10.3, so glad I didn't increase her Insulin at 9am
     
  13. JanetNJ

    JanetNJ Well-Known Member

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    Glad you are seeing better numbers. Can you test at +4?
     
  14. Sue Hammond

    Sue Hammond Member

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    Yes I will do
     
  15. Sue Hammond

    Sue Hammond Member

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    +4 is 13.2, creeping up again :(
     
  16. JanetNJ

    JanetNJ Well-Known Member

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    10.3 is better but still too high. Can you try 2.25?
     
  17. Sue Hammond

    Sue Hammond Member

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    No, I have a pen, not syringes... I thought 10, ( in the blues) was good
     
  18. Sue Hammond

    Sue Hammond Member

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    I'd hoped that with her losing her excess weight, around 5lbs, that would have made a significant difference to her Diabetes, but its made no difference at all... I'm wondering if I should have a stricter feeding timetable, because at the moment I've been feeding little and often, several times a day..and leaving food down when I'm not here in case she goes low, which she has on the odd occasion in the past...
     
  19. JanetNJ

    JanetNJ Well-Known Member

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    ITs definitely better! Ideally you want to get her under 7. You can use syringes with the pen. Just use the pen as a mini vial.
     
  20. Sue Hammond

    Sue Hammond Member

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    What I meant was I don't have any syringes I had a look at one, but I can't see the measurements, they went up in .5, not .25....Would it be better to have a stricter feeding routine, rather than having small meals several times a day, have just 2 maybe? The trouble is she only eats very little at a time, so could end up by evening very hungry, and I have two cats, so could be difficult
     
  21. JanetNJ

    JanetNJ Well-Known Member

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    U40's have half unit markings but not 0.25... But if you go half way between the whole number and half line, that's 0.25. Syringes that hold only 3/10 cc are easier to see. A magnifying glass may help if it's still hard to see.

    These are the ones I use https://www.adwdiabetes.com/product/18553/ulticare-u40-pet-29g-3-10cc-1-2in-half-unit
     
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  22. Sue Hammond

    Sue Hammond Member

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    I've just done another test +6 is 21.9, I really don't understand these results at all..:(
     
  23. Sue Hammond

    Sue Hammond Member

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    I've checked the pen and it's working fine
     
  24. JanetNJ

    JanetNJ Well-Known Member

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    Probably a bit of a bounce. Your cat isn't used to being in lower numbers so the body is releasing stored glucose to protect itself. Hopefully once her body adjusts to lower numbers some of the bouncing will subside. I understand how frustrating it is. But on the positive side, yeah for a blue number today!
     
  25. Sue Hammond

    Sue Hammond Member

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    What I don't understand is her bg is high, but she's not drinking or weeing more than a non Diabetic cat, surely if there was this much glucose in her, she would be urinating frequently and drinking more too, as she was before diagnosis...Her last urine test was normal too
     
  26. JanetNJ

    JanetNJ Well-Known Member

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    Can you add what kind of food you're feeding to your signature? To answer your questions about food from before, most find several smaller meals to work better then just two larger meals, so keep doing what you're doing.
     
  27. JanetNJ

    JanetNJ Well-Known Member

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    She is probably getting most of the water she needs from her food. You are giving her insulin so she's feeling better... So that's a great thing!
     
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  28. Sue Hammond

    Sue Hammond Member

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    I just can't help thinking she's never going to get better, and that makes me think her life will be cut short because if it...
     
  29. Sue Hammond

    Sue Hammond Member

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    Added.....She has mostly Mac's wet canned food, and occasionally Lily's kitchen
     
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  30. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    @Sue Hammond

    Hi Sue, I think there may be a couple of things going on.
    I think Molly is getting some bouncing (from numbers dropping too fast and/or too low for her comfort); and I also think she's not getting good duration from the Caninsulin, so this is possibly exacerbating the bounce problem (the numbers are going higher than they otherwise might, and maybe for longer).

    It may well be that a gentler, longer-lasting insulin would suit Molly better. However, we've talked about this before and I know there are some things that mean this isn't currently possible:
    1. Your current vet doesn't want to change insulin.
    2. You don't feel able to use syringes (because of your vision problem).

    A different vet may well be willing to prescribe a different insulin.
    And maybe it's worth just practicing using the syringes that you have (the ones with .5 unit markings) by drawing up coloured water into them. I practiced on oranges when I first started injecting, and quite a few people do that. It may be that using syringes isn't going to be as hard as you imagine. But if it is too difficult, then at least you'll know you gave it your best shot (no pun intended! ;) ).

    If none of the above is possible then your only option, with regard to insulin, will be to experiment with the Caninsulin dose to find out what works best for Molly at any given time. And it may well be that her numbers do even out over time.

    It might also be worth experimenting with different foods. Some cats are quite sensitive to foods for all kinds of reasons (carb sensitivity, or sensitivity to one or other of the ingredients), and their BG can spike as a result of that.

    It's still relatively 'early days' so there's every chance that Molly's BG situation can and will improve.
    And there have certainly been improvements in Molly's health since she's been on insulin, despite the fluctuating numbers. This is really good news. :bighug:

    Eliz
     
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  31. Sue Hammond

    Sue Hammond Member

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    Hi Eliz,@Elizabeth and Bertie
    I feel like I'm at my wit's end to be honest with you, I really feel like it's all going wrong for Molly....I have been feeding Mac's and the occasional Lily's kitchen, the same variety's, which are both low carb, high protein, and high moisture content, I haven't changed her diet at all since she was first diagnosed...Maybe I should increase to 2.5u but only when I can be home all day to watch her and test several times a day...I'd worry about giving 2.5u at night in case she dropped too low during the night, sometimes on the odd occasion she has been as low as 5 pre am shot, so giving 2.5 could send her crashing, that's my only worry :(
     
  32. JanetNJ

    JanetNJ Well-Known Member

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    It’s only 4 months. Not a super long time, and you’ve already said that she’s feeling better. My cat Cc didn’t even see a yellow number until 3 months and 3 units.
     
  33. Sue Hammond

    Sue Hammond Member

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    @Elizabeth and Bertie we don't have another Vet in our town, and I don't drive, so it would be difficult travelling on a bus carrying her, and also more stressful, so we'll have to stick to our current Vet I'm afraid
     
  34. JanetNJ

    JanetNJ Well-Known Member

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    I dose my own cat more aggressively when I am home and more conservatively when I am not. I can’t test at all during the day because I work. (In home this week for winter break). So I do a little less then I would give otherwise. In the evening in home, so unless I'm really tired and not sure I can be up, I dose a little more aggressively.

    Your other option, but it doesn't work for most people's schedule, is to dose smaller doses three times a day. So instead of 2-2.5 units twice a day you would do like 1.5 units 3 times a day every 8 hours. That's a pain in the ass though.
     
  35. Sue Hammond

    Sue Hammond Member

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    I think that's what I'm going to have to do, but I'm out most of tomorrow so will start 2.5 on Tuesday when I'll be home all day, if her am test is high. Dosing every 8 hours won't be very convenient really, but it would probably be better for Molly... I'm going to email her spreadsheet to my vet on Tuesday, see what he says about maybe changing her Insulin, but I'm pretty sure it'll be a no again
     
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  36. Critter Mom

    Critter Mom Well-Known Member

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    Dosing every 8 hours can be a complete an utter nightmare and takes an extraordinary amount of work on the part of the caregiver to keep the cat safe. I've seen a few members here go through it and it's not something I'd recommend undertaking unless there was a dire medical necessity to do so.

    Perhaps request that your vet asks an external feline diabetes specialist to review Molly's case - or to refer you to one for a consult - because that might help you to secure an Rx for a different, longer-acting insulin. Our vets routinely consult external specialists when the occasion calls for it. It may not even be necessary for you to travel.

    Are you in the UK, Sue? If yes, I'd suggest the Feline Diabetes Clinic in the Royal Veterinary College (Herts). They have done extensive trials with Prozinc which is now the next insulin a UK vet is legally obliged to try if Caninsulin proves ineffective. If the external referral is agreed then it helps to provide them with a brief journal of clinical signs as well as Molly's BG spreadsheet data. Note things like general behaviour and sociability, energy levels (e.g. sleepy/lethargic when insulin is at peak effect?), appetite, GI upsets (if any), peeing, pooping, drinking, etc.

    (Note: Based on my experiences with their consultants I wouldn't recommend referral to the feline diabetes specialists at Langford Vet School in Bristol. I found them very backward and inflexible in their approach to feline diabetes - and I had no hesitation telling our own vet how unhappy I was with them. FWIW, the vets at Langford did do a great job with my civvie's radioiodine treatment, but they suck when it comes to FD.)

    Sending out positive vibes for your vet to be amenable to the insulin switch.


    Mogs
    .
     
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  37. Sue Hammond

    Sue Hammond Member

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  38. Ann & Liz

    Ann & Liz Member

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    Just joining in to say we have some U100 syringes (need to use conversion chart) to enable more small increment dosing changes if you would like to try them. Others will be able to support with advice in the use of U100' s if you are unsure. If you are in UK we could arrange to post them (only asking for postage costs) if this would help. Just a thought.
     
  39. Sue Hammond

    Sue Hammond Member

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    Thank you very much for your kind offer, I'll send the spreadsheet to my Vet, and see where we go from there first, then I'll get back to you, thank you xxx
     
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  40. Ann & Liz

    Ann & Liz Member

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    No problem, wait to hear if you would like to try after vet advice. Our experience was that vet won't necessarily suggest alternative syringes but was happy once she knew we had researched and were using the conversion chart.
     
  41. Sue Hammond

    Sue Hammond Member

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    I really don't like syringes tbh, as my sight isn't great drawing up the dose, even with a magnifying glass , and also have never been shown properly how to use them... I've only ever used a Vetpen....I know with prozinc it'll be syringes, so I guess one way or another I'll have to get used to them, I'm just terrified of giving the wrong dose..x
     
  42. Ann & Liz

    Ann & Liz Member

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    Totally know where you are at. We went straight to syringes so don't know about vet pen. But found the u100' s not too bad. It really does get easier the more practice you have. I used to double and triple check before injecting!. Once you start to feel a little more confident with how Molly reacts to doses and can perhaps adjust more precisely you will feel happier I think.
     
  43. Sue Hammond

    Sue Hammond Member

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    Is it easy to convert to u100 syringes
     
  44. Ann & Liz

    Ann & Liz Member

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    Yes you use a conversion chart would send you a copy with syringes. Very easy. We worried when we thought about doing it but it really is no problem and ultimately gives you greater control and safety.
     
  45. Ann & Liz

    Ann & Liz Member

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    However we only ever used Caninsulin. You would need to check with others on here re the use of u100's with Prozinc ( as I do not have experience to advise on that at all).
     
  46. Sue Hammond

    Sue Hammond Member

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    How have you found Caninsulin, have you had good results with it
     
  47. Ann & Liz

    Ann & Liz Member

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    A difficult question. Lila was 16y at diagnosis and at times I think it was ok. But we never achieved good regulation consistently. In hindsight a different insulin may have helped. But Molly is an individual and it really is difficult to generalise. Take a step at a time and be guided by the wealth of advice that people have on here and of course by your vet (but don't be afraid to research +++ and question your vet as you will quickly realise that there are gaps in vets experiences of diabetes).
     
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  48. Sue Hammond

    Sue Hammond Member

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    It's all very confusing isn't it,. I hoped by now after 4 months she would have settled a bit, I know it's still early days, she has had the occasional yellow sometimes blue and even though rarely has been n the green for her amps test, but the next morning it's up in the pinks again, that's what I'm having problems understanding, why it's fluctuating so much..We had a period of being in the blues for a few days only some weeks ago...When we took Molly to the Vet a couple of weeks ago he said she's doing well, so I really don't think after saying that he will change her to prozinc..
     
  49. JanetNJ

    JanetNJ Well-Known Member

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    New year new dose. Starting tomorrow let's do 2.25.
     
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  50. Sue Hammond

    Sue Hammond Member

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    I don't have syringes Janet, also have never been shown how to use them
     
  51. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sue, I can't remember where you live in the UK, but it's possible that someone might live near to you, and may be able to help you to learn to use syringes, if that would help... Just a thought....
    .
     
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  52. JanetNJ

    JanetNJ Well-Known Member

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    My own Cat is on vetsulin/canisilun. Since she's been out of remission it's been a little up and down. She showed such promise that first month I thought she would be back into remission quickly.... Then she became a bit insulin resistant, and her arthritis grew worse, and her numbers started climbing. Now what used to take a unit to get her where I want her, it's taking 2-3 units. (For example on 10/14 a preshot of 256 I gave her 1.25 units which got her down to 84. This week she was 229 preshot and needed 3 units to get her into the 80's). But I learned that I can't dose CC based on how he body responded a month ago or two months ago, but only look back the last 5 days or so to know what she needs.

    The difference this time around verses Two summers when she went into remission after just 4 months is:

    1. Two summers ago she was able to move a bit better. Just like for people who are diabetic, EXERCISE lowers bg. She lays around a lot more since her legs are achy, and I'm not home during the school year to get her moving as much.

    2. As a teacher I was home most days so I was able to test constantly and really push her mid cycle down to the 70's and 80's (alphatrak) because I was home to steer if I needed to. She came out of remission just as school was starting

    So this week I've been home for Christmas break. I've seen improvement the last 10 days.

    1. I've been able to push her lower during the day and tweak the dose... This has helped bring down the preshots. (Knock on wood)

    2. I called the vet and got the ok to give her more frequent adequan shots for the arthritis. This means her legs are physically feeling better, and although she's still not running to play (yet) she is in less pain and not limping as much. I even found her in her cat tree 3 times in the last two weeks which she hadn't done since September. I also went back to consistently giving her 1mcg of vitamin b 12 methylcobalamin.... (500mcg twice a day) I don't think she has neuropathy, but it can't hurt, and is supposed to help with energy. I give her one and pop one myself. I could use the energy too. Lol

    3. I'm making more time to play with her. Even if she isn't running after the shoelace, laser pointer, or stick, she swats at it and twists to reach it, mini pounces, and it makes her happy and purrs.... Purrs I believe are healing to the mind and body. I'm sad my 10 days home ends after tomorrow.... But I will try continue to make that extra time to play with her and keep her moving. I think people underestimate how effective the exercise component is... Plus it's positive bonding time with your cat.

    Cc had made progress this week with extra focused attention.... Hopefully it will continue. But if she backslides I will just adjust my strategy and do the best I can to help her.

    So my suggestion to you is don't be afraid to adjust doses as needed. Yes be conservative if you know you won't be able to test, but if a dose isn't getting her where she needs to be, then change what you're doing.

    Get your cat moving as much as possible. It will help lower bg, and make her happy. Just like with people, a happy state of mind is very healing.

    Take care of any other issues she might have that's making her uncomfortable. Does she need a dental? Arthritis bothering her?

    Giving up isn't an option. Well it is, but not a good one.
     
  53. JanetNJ

    JanetNJ Well-Known Member

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    Then I would either learn how (maybe someone with a vet pen that uses a syringe could make a how to video for her?) or try the dose of 2.5.... When you will be home of course, and Be prepared to steer if needed. But honestly I think she won't get TOO low. Have steering (mid-high carb) on hand just in case.
     
  54. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Don't you have the syringes that have .5 unit increments, Sue..?
    Those are fine. All you need to get started is an orange to practice on. :smuggrin:
    But if you have difficulty with them then you may find the U100 syringes with a conversion chart easier to use. (They have a narrower barrel than the U40's but more markings to make it easier to measure small doses).
    .
     
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  55. Sue Hammond

    Sue Hammond Member

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    I'm in Surrey @Elizabeth and Bertie I don't know of anyone near me in Chertsey, but I can ask my Vet, unless he insists I carry on with the Vetpen
     
  56. Sue Hammond

    Sue Hammond Member

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    Yes I do, but I can't see the in between measurements even with a magnifying glass and good light..
     
  57. Sue Hammond

    Sue Hammond Member

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    I know you have to draw back once the needle is in in case there's any blood, which I know will be difficult, you see I have weakness in my left hand due to prolapsed discs in my neck, which is why the Vetpen is easier to hold whilst holding Molly so she doesn't try and run off
     
  58. JanetNJ

    JanetNJ Well-Known Member

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    I have never ever done a draw back in injecting cc. Just pull up a tent of skin stick it in, push the plunger. Easy peasy.
     
  59. Sue Hammond

    Sue Hammond Member

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    I definitely won't give up @JanetNJ ....I'll try and do whatever it takes to help her, providing I can afford it, and able to claim it on her insurance...She had a check up 3 weeks ago, her teeth and gums are fine, no sign of any other problems, apart from the start of cataracts, which may in time need surgery, she's quite active since losing 5lbs excess weight and is now a healthy 4.3 kg ..because of the weight loss and increased activity, I thought it would reflect on her numbers, but it hasn't so far
     
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  60. JanetNJ

    JanetNJ Well-Known Member

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    Well you control what you can and accept there are things out of your control for which you will just have to go with the flow. All we can do is take our best educated guess and hope it works. Their pancreas sometimes has other ideas.
     
    Last edited: Jan 1, 2018
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  61. Sue Hammond

    Sue Hammond Member

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    Thanks for your advice, much appreciated x
     
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  62. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    I don't think any of us do this, Sue.... And when (in the early days) I asked my vet about this he said it's not necessary....

    I'm on Cobham/Horsley border, so not very far from you. If you want help figuring out syringes I can visit to try to help you with that.
    Or you're welcome to come to my house for a cup of tea and a chat. (I'm 4 mins walk from a train station).
    It's entirely up to you. :cat:

    Eliz
     
  63. Sue Hammond

    Sue Hammond Member

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    Sorry I've only just seen this, thanks for your kind offer, I'm still using the pen at the moment, but I would take you up on your offer if we end up sing syringes x
     
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