Mr. Binx - High BG and can't get it down

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Timbo418, Dec 2, 2018.

  1. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    Hello! First time post here and have already gotten so much out of this forum! I have an 8 year old male domestic short hair cat, Mr. Binx. He weights 15 lbs now, but was 24 lbs just 5-6 moths ago. The weight loss and increased awater consumption led us to taking him in and He was diagnosed 6-7 weeks ago with diabetes. Since then, he has been on Purina DM dry food. And, we have been gradually increasing his insulin, slowly. We started at 2u, and his numbers were still over 600. He's current dosing for the past 2 weeks has been 5u twice a day (12 hours apart). We have been giving him insulin right after feeding him. Accoridng to the Vet, His blood work all looks good. He's ketone levels are good and no UTI. She thinks he may have a insulin resistance.

    We did a glucose curve today and looked like this:
    7 am: feeding and insulin
    8:52 am: 572
    9:38 am: 467
    11:37 am: 524
    3:23 pm: 579
    5:23 pm: 428

    We'll be feeding him at 6:30 pm and giving him insulin again at 7 pm. He is having accidents and drinking lots of water still, but otherwise happy and acting normal. Our vet has written a script for Prozinc, but I'm not confident it will work. We are going to switch to wet food starting tomorrow. We greatly appreciate any additional guidance or advice on how we can get his #'s down to within range. Should we increase more then 5u?? switch to Prozinc? Hospitalize him for 24-48 hours? Thank you!
     
    Last edited: Dec 2, 2018
    Reason for edit: more info:
  2. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Which insulin are you using now?

    The dry DM is too high in carbs for a diabetic cat despite what your vet tells you. You need to feed a low carb canned or raw food that's less than 10% carbs. Most of us feed Fancy Feast Classics or Friskies pates but there are many commercially available foods that are much better than ANYTHING dry or anything "prescription".

    Your vet also has been increasing his dose of insulin way too much, way too quickly. We usually start at 1U and go up in .25 unit increments, never in whole units. By going up too much, you can bypass what could have been a "good dose" for your cat.

    Most vets know very little about treating feline diabetes. They only get 5 hours of formal education on diabetes in school and that covers both dogs and cats.

    Are you home testing or are those numbers from testing at the vet? Vet testing is unreliable because the blood glucose can raise as much as 200 points just from the stress of being at the vet. Just like our blood pressure is higher at the doctors office, our cats react badly to the stress of being at the vet.

    If you're going to be changing to a low carb food, please make sure you're home testing first! Dropping the amount of carbs can greatly reduce the amount of insulin they need.

    Keep asking questions! The people here have many years of experience dealing with this disease and are very generous with their time and experience. We want to help!!
     
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  3. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    Thank you for the quick and helpful response! To answer your questions; We are using Lantus (Glargine) and We are testing his BG at home with the Alpha trax.

    Since the 5u has not resulted in an improvements over the 2u, should we start to bring him back down? and at what rate?

    Thanks so much for the support!
     
  4. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Do you have a record of his numbers since you started? (or at least the last couple of weeks)? Your meter should be recording them if you don't have them written down somewhere.

    We have a special spreadsheet we use here that's a very valuable tool. Here are the Instructions on getting the FDMB spreadsheet
     
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  5. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
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  6. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    I have some records from his last curve when he was at 2u/twice daily back 11/4
    6:30 am: 659 - fed and then injection
    8:30 am: 640
    10:30 am: 521
    12:30 pm: 611
    2:30 pm: 576
    4:30 pm: 665
     
  7. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Hello and welcome. Take a read of the Sticky Notes on the top of this forum, if you haven’t already.

    That spreadsheet Chris mentioned is key in helping us help you with dose. It is possible Mr. Binx needs the amount of insulin you are giving or more even. One in four diabetic cats has a secondary condition called acromegaly that cause the diabetes and some acromegalic cats need quite a bit more insulin than other diabetics. But it’s also possible the dose is too high or just right and he is bouncing. The clues are in the patterns of blood glucose data we record. Gathering data will help solve the puzzle.

    One though on dry food, we have had several cats have their insulin dose reduced to very little, or even nothing, when dry food was removed from the picture. Low carb wet food or raw is best.
     
  8. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    I would not swap from Lantus to Prozinc at this stage. Lantus is a very good insulin for cats. You don’t want to be doing more than one thing at a time. I would change over the food to wet first and see how he goes.
     
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  9. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    I have populated the spreadsheet. Lots of black cells :( we have the wet food arriving tomorrow and will start the transition and continue to update. Thanks all!
     
  10. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Good job starting the spreadsheet. We put the dose in the U (units) cell. With AMPS being the AM preshot value, ditto for PMPS. We recommend always getting a test before you shoot. Lots of us started with ugly colour spreadsheets but by following the dosing methods here, got much better.

    A couple other items to add to the signature, first date of diabetes diagnosis, any special health concerns, andmeter type, which looks like you are using the AT.
     
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  11. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    Hello :) Just a word of encouragement that you are being advised by some of the very knowledgeable members of the board already . As I always say , if not for these experienced members my Elmo might not be here today . They can be trusted because they have /are living diabetes with their kitties . Keep up the good work !!
     
  12. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    Thank you for clarifying...I did not know what AMPS stood for! updated and he had his lowest number yet the AMPS. I have to work so can't do a full curve today, but will continue to update. You guys have been amazing. Really nice to know there is a community for this. It has been a very frustrating few months.
     
  13. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    He had a huge swing today from 365 AMPS to 630 PMPS(put on sheet)...Dinner is wetfood fancy feast classic tonight. Any thoughts on dosage? bring it down?
     
  14. LexaJoy

    LexaJoy Member

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    Sep 13, 2018
    Side note on the food switch (gonna let more experienced folks talk to you about doses, we're still new to it): when I swapped my boys over to wet from dry, we had some vomiting issues for a couple of weeks. Hopefully it's not a problem for you, but it can be a little scary when doing insulin at the same time since you need food on board. Just something to keep an eye on.

    Good luck to you and your Mr. Binx!
     
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  15. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    The spreadsheet shows no dose for the PMPS for the first 5 days. Can I assume it was also 5 units those nights?

    Do you have any data between 11/4 and 11/25? It would be helpful to know how the dose was increased during that time.

    Some cats need much more than 5 units, some a lot less. Without knowing more about how he got to 5 units and the numbers along the way, it's hard to say what to do next with the dose. If you go back and he needs more insulin in stead, you lose a lot of time. I think I would suggest getting a couple more days of data at this dose, and then reevaluate. Get at least a preshot number for the AM and PM and some tests at different times in the cycles.
     
  16. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Jun 19, 2018
    Once I took my cat off of the Vet-Vet-recommended dry food, her blood glucose levels normalized instantly form 300 and 400s to 100s and below. You are going to see a rapid change once you feed canned food!
     
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  17. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    ------- I update between 11/4 and 11/25 with data from the ALpha trax and included how his dosage was increased. I'll continue to pull as much data as I can. I'm off tomorrow for GHW Bush rememberance, so I will use that time to do a curve with Mr. Binx.
     
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  18. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    Transition to wet food has gone smoothly. He loves it and has not thrown up anything. it's only been 24 hours, but his #'s are coming down, albeit not close to where they need to be, but in the right direction.
     
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  19. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    Now that I've found this treasure trove of information on this niche subject(read all the stickys), I'm realizing I may have broken the golden rule of "Go Low Go Slow" without first switching him to a wet food diet. We raised him up to 5, 1u/week, on dry food the whole time. I'm going to mix the wet and dry for a few days (50/50) while closely monitoring and preparing to bring his dose down 1U. He is at 5 U which is very high compared to some of the sheets I've seen on here. I realize he is my responsibility, just writing out my 3 day plan trying to stabilize my patient for sanity check! Thanks for listening.
     
    Last edited: Dec 4, 2018
  20. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Cats needs as much insulin as they need. My Neko got as high as 8.75 units. I can point you to spreadsheets of cats who needed a lot more, even on an all low carb wet or raw diet. Good plan to slowly transition him to a lower carb diet and monitor closely.
     
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  21. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    Chris/Wendy Thanks for the notes. Do you mind taking a look at his readings and providing a suggestion on Dosage? Really appreciate your input at this stage.
     
  22. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Now that wet food is out of the diet, I would hold this dose another three days, unless he goes below 90, in which case you would reduce. It can take a few days for the effects of dry food in his system to wear off. A few days should give us an idea how he doing with the food change. If you could do a curve after that, we can figure out where to go next with the dose,
     
  23. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    Thank you! We have't had him under 279 yet, so I'm more concerned with him being too high, than too low. Will hold the course until next weekend when I can do a curve. Appreciate it!
     
  24. Timbo418

    Timbo418 New Member

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    Dec 2, 2018
    So confused by how his numbers are raising back up again. We had a perfect Saturday with him in the blue the first time ever, and now back in the red. No change in diet, dose, timing....uhg. I'm not going to be able to do a BG curve until Sunday at the earliest. Easily one of the most frustrating scenarios I've ever encountered.
     
  25. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    What you're seeing is a "bounce." It is an irritating but perfectly normal response. Binx has been spending time in some rather high numbers. As a result of his visiting a MUCH better range, his liver and pancreas panicked! As a result, a stored form of glucose along with counterregulatory hormones were released and this causes numbers to spike back up. The more time your kitty spends in better numbers, the fewer and less dramatic these bounces will be. It takes roughly 3 days/6 cycles for bounces to clear and even the time to clear a bounce will be less as numbers improve.

    Just an FYI housekeeping note. Most people will post one thread/condo per day for their cat. Even if you're not posting daily, you may want to post a new thread.
     
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