Please help

Discussion in 'Feline Health - (The Main Forum)' started by Bellasmom, Feb 12, 2018.

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  1. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    can someone please help me, I have a 13 yo male named Bella who was diagnosed with diabetes 10 months ago. He was put on nuvolin n, 4u am, 4u pm, it was working very well but now his glucose levels are over 600, after I give him his insulin I wait about 2 hrs and it’s down to like 465. I have been giving him half cup Orijen cat and kitten daily and natural balance high protein wet with extra water, last night I only gave the wet and his glucose level was again over 600, I can’t afford to take him to vet at this time due to I had to take him to emergency vet w weeks ago he was having trouble peeing and he had crystals in his urine, they gave him antibiotics, Xanax and something to relax his urethra. Please help me and I am so worried
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I didn't realize you had two threads when I responded on your other one.

    Was this the starting dose or was it increased up to this level by the vet?

    Unfortunately, too high an insulin dose can cause high BG levels from a rebound process we call "bouncing". It's also possible that the dose is too low but without a lot of blood glucose test results it's impossible to know. Insulin doses aren't a "set and forget" thing - they will need to change over time and can fluctuate both up and down.

    Almost all dry food is too high in carbs for a diabetic cat. I don't know the carb level of the wet food but it's great that you give him wet with extra water added. :)

    We can help you figure out what to do if you're willing to do some things differently. Testing his blood glucose at home is the absolute best way to keep him safe, learn his responses to insulin and get his BG under better control. We can help you with tips and tricks for that.
     
    Myagi (GA) and Heidi likes this.
  3. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    Yes I’m willing to do whatever it takes, his starting is the same as now 4 units am and pm
     
  4. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    This am at 5 his bs level was over 600, I only gave wet food with extra water in it, it’s 437 right now and he gets insulin and food again at 5pm. I get up everyday at 445am to make sure he gets the same dose am and pm
     
  5. Kris & Teasel

    Kris & Teasel Well-Known Member

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    So he was started at 4 units twice a day? That's a VERY high starting dose. However, until you begin to gather blood glucose test results at this dose and while feeding him as you have been don't change it.

    Do you have a blood glucose meter to test him at home? If not, go buy a human meter at any pharmacy or go to Walmart and buy one of their ReliOn store brand models. You want one that uses test strips that give a result with a very tiny blood drop. I believe two popular ReliOn models are the Micro or the Confirm. You'll need test strips that work for the meter you choose - somewhere around $30 for 100 strips.
    ______________________________________________________________________________________________

    Here's the basic testing routine we recommend:
    1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
    2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
    3. do extra tests on days off to fill in the response picture
    4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
    5. post here for advice whenever you're confused or unsure of what to do.
    We all rely on a member logging their BG data on this spreadsheet:
    http://www.felinediabetes.com/FDMB/forums/suggestions-tech-support-testing-area.6/
    It's viewable by all members and is the first thing we look at before offering advice. There are techies on here to help set it up if you have a problem. Here's how the spreadsheet works: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

    If your kitty is easy to handle doing the blood testing by pricking his ear will be no problem. You might need to work a bit on desensitizing him to having his ears handled and it's best to set up a whole ritual around testing. Here's a link to a lot of helpful info: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
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    Here's an explanation of why too high a dose can lead to high BG numbers because of bouncing:
    1. BG goes low OR lower than usual OR drops too quickly.
    2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
    3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
    4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
    5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
    6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
    7. Many vets have little/no understanding of the bouncing phenomenon.
    ______________________________________________________________________________________________

    When BG numbers are high we also recommend that you test urine for ketones. If ketones build up the kitty can become very ill and treatment is $$$$. Urine ketone test strips can be bought in any human pharmacy. Here are some tips for testing:
    • put the end of the test strip right in his urine stream as he's peeing
    • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
    • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
    Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

    That should get you started. Ask lots of questions. We're here to help! :)
     
  6. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    Thank you so much I really appreciate your help, last question of the day, he has appointment in the am at the vets, he is the 1 who put him on such a high dose, should I still take him, I had to borrow money from my mom to take him running short since the emergency vet visit
     
  7. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If he’s feeling well and acting normal you could postpone that vet appointment. Was it only for his BG and insulin dose?
     
  8. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    Yes and yes acting fine
     
  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Then I would say postpone a vet visit and start testing and logging BG data.
     
  10. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    I am setting everything up with the spreadsheet right now, thanks again
     
  11. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    Do you see his spreadsheet, I wanna see if it’s set up right
     
  12. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    Under amp on spreadsheet, is that where what his blood sugar is after I take it with the meter, I noticed you have different types of numbers on yours
     
  13. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    You need to put a link to the spreadsheet into what's called your signature. Go up to the top right of the page, click on your name and in the menu that drops down, click on "signature". A text box will open. Copy the URL of your spreadsheet into the text box. You have to click the "share" icon on your spreadsheet to allow us to see it.
     
    Last edited: Feb 13, 2018
  14. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This explains the spreadsheet: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

    The numbers I have for blood glucose are in different units than what you use in the US. I'm in Canada and we use the "world" units of mmol/mL. You use mg/dL and the numbers are higher.
     
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I've looked at your SS and, yes, those are high BG numbers. Here's what to try:
    • keep feeding him as you have been for now
    • aim to get at least one BG test today somewhere in the +4 to +6 time frame because you need to see how low this dose is taking him
    • try for one evening test before your bedtime
    • make sure your take away all food at least two hours before the pre shot BG tests because you don't want to inject on a BG number that's higher from food - important!
    • keep your SS updated all day
    • keep this routine today and tomorrow - will reevaluate as needed.
    The goal right now is to establish a baseline set of data to see how he's responding to this dose with your current feeding regimen. A few days' worth of data should help in deciding what to do next.

    Here's something else to put into your signature text along with your SS link:
    • Bella's age and date of FD diagnosis
    • what insulin you use
    • what glucose meter you use
    • what you feed him
    • any other health issues/meds he has.
    This allows people viewing your thread to get the basic facts in order to know what advice to offer. Without it we'll be asking those questions again and again. :)

    Re food: low carb wet food is best. Adding quite a bit of extra water to all wet food meals can help crystals prone cats but it's an issue you have to pay close attention to. Fancy Feast and Friskies pate versions from the grocery store are used by many of us and they're fine for FD kitties.
     
  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Your signature test looks good. :)
     
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I suggest you move the info on your SS about what food and feeding times over to the right hand notes section. You'll need those +1 and +2 boxes for BG numbers sometimes.
     
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