repost: Need serious help, curve not showing a curve

Hi, been here before. Life has been hectic and I've only just been able to get around to figuring out and inputting all the data into the spreadsheet.

Otto was diagnosed in June? I think. We were using Alphatrak 2, switched to a human meter, it is Freestyle something. I believe all the data I've put on the spreadsheet is from the Freestyle. There are some issues with the data, as my mother has been keeping track in a notebook, but sometimes makes some mistakes and it's been difficult to decipher in some parts. I also know we did a curve just a week or two ago before another dose increase, but that data has been lost in the wind I guess. We have consulted vet with each dose increase. Though vet recommended going up by 0.5 increments, I have learned from this forum to do 0.25.

He has been on Lantus this whole time. About two months ago he started getting exclusively canned food, no dry. He is currently now up to 5.0u of Lantus ... which from reading this forum is super high. We did multiple curves before this spreadsheet is filled out. I just only found the new notebook for the last two months. I do have records since his diagnoses though.

Start of this month he developed pretty bad neuropathy. His rear is almost completely useless, going to the litterbox is very difficult for him. Its so hard to see him struggle ...

TLDR:

• 7ish year old male cat
• Was obese most of his life but started losing weight - diagnosed with diabetes. He is a big cat.
• Started on something like 2.0u of Lantus, has went up to 5.0u as of today
• Wet food only. Has some fairly extreme intolerance to certain proteins so its been really difficult to find lower carb.
• Now has fairly bad neuropathy, has been getting B12 supplements for a month, no help
• Diagnosed since Juneish, but spreadsheet only shows last two months (we have been testing AMP and PMPS every single day though with curves before major dose changes).
• Gets fed about an hour before his injections, and sometime +5 in the afternoons.
• I have never, ever, ever, since his diagnoses, seen him get to an actual low number like the ones I've seen on here. He had dipped to I think 7.2 one reading. He wasn't sick, he didn't vomit or anything like that ... there's literally no rhyme or reason as to why it occurred.

This needs to change. He has done nothing but go downhill since his diagnoses. I will do anything recommended here. I know people usually say money is tight, but money is really tight right now, I cannot take him to the vet for further testing. I've been lucky enough as it is to avoid a trip to emergency with ketoacidosis ... so far. Please help. The vet seems absolutely useless. And when I told her he developed neuropathy to the point he needs to lay down for a break when he pees, she seemed like it was no big deal ... very frustrating. I am aware of bouncing ... I read the sticky about bouncing and quote "if the cat is unregulated and never has a BG reading below 200, you're probably not seeing rebound." So it doesn't seem likely.

I will be doing a curve tomorrow just to get some actual data on the spreadsheet. I sincerely apologize for any mistakes in the spreadsheet.



https://docs.google.com/spreadsheet...uLyV0IvVA4h8OOk7fHeSkovSGS4JqCUmQe4Dr/pubhtml

I'm in Canada so I use mmol, the US version is displaying a little wonky.

As you can see I did his curve today. If you can call it a curve. Its more of a flatline. Which any other curve this hasn't happened - I'm now even more confused. I'll be emailing his vet tonight.

 

First off, just take a deep breath, there are many people here who can help you through this. I'm in Canada too, so those mmol/L numbers look familiar . The numbers are running a bit high, but there are a lot of pieces missing, most kitties like to drop lower at night, and with Lantus, you want to try and get more than just a few cycles before increasing. With Lantus, you want to test, feed, shoot, all within about 15mins or so.

There are some high dose conditions like IAA and acromegaly, and tests that can be run, that may account for the need for higher insulin amounts, maybe Wendy @Wendy&Neko can comment.

I know it's a lot of information, but the stickies in the forum really do help. Can you try and get a few before bed tests to see what Otto is doing? You mentioned there is some intolerance to certain proteins, what are you currently feeding?

There are members who are familiar with neuropathy, I believe they give B12 to help with that also, but it takes some time (months) to see results. Hopefully others will be by to offer some additional input.

 

Hello from another Canadian. My girl had two high dose conditions and got over 5 units. We have some cats here on much larger doses. A cat needs however much insulin they need. ECID (each cat is different) is a true saying here. Not saying your cat has a high dose condition. We just don't have enough data to say so or not.

Christie had made some great suggestions. I would stick with this dose for now, and try to get some more spot checks so we can see what this dose is really doing. Many, if not the majority, of cats go lower at night. We determine how to dose the cat based on how low the dose takes the cat. So we need to get some data in the white space that is your PM data. Any spot checks you can get mid cycle during the day when you are not curving will also help, By the way, most meters will hold the last two weeks of data, if not more, so you should be able to retrieve it.

What food is Otto eating now? What proteins can he eat? Might have some suggestions there.

Are you giving methyl b12?

 

Yes it is methyl b12. He was on RC hypo, but for last few days he’s been on Turkey with gravy fancy feast. He’s already plucking his fur out here and there but we’re getting desperate to get his diabetes under control. I’d rather have a bald itchy cat than a dead diabetetic cat. I tried to find the Friskies everyone here seems to recommend but I couldn’t find it anywhere I went. Saw a few posts that said fancy feast turkey was at least okay and lower carb than what he was currently on.

Anyway I am back because someone on my other post said to adjust his feeding schedule (we were getting food influenced numbers, oops) and for last seven days his numbers have mostly reflected the change.

This morning he couldn’t make it to litter box and urinated all over himself and the floor. My mother is quite distressed to see him only getting worse. Our vet washed their hands of us and said she can only refer us to an internal medicine vet, which we definitely cannot afford. I was hopeful I’d be able to handle his diabetes but with his constant struggle to get anywhere I am getting frustrated and wondering if I’m only torturing this poor cat.

Spreadsheet has been updated. I had one partial furshot where I can only be sure I got in 3.5 that night.

I have been trying more frequent spot checks. He lives with my mother, and she cannot inject or test him. So really all I can do is test/inject every 12 hours and do curves some days, anything else is a bonus. I have thought about bringing him with me but that would only stress everyone out I think and give him stress induced numbers. I will try to test him more in PM, perhaps tonight I will try for a 5+ around where he usually dips. Though I know from his earlier days (when I made lots of mistakes and would test because I was paranoid) is only going to reflect his AM numbers for the most part.

I thank everyone for their help. I’m honestly trying my best. I’m starting to lose hope though and I feel like I’m only prolonging his suffering.

 

Rggggh- This is a cause for a HIGH reading... feed at or shortly thereafter injection, not an hour before !
Please, other senior members pipe in...

 

Yes another member has already corrected me. This is our vets fault, as her explicit instructions upon his diagnosis was to feed and THEN test/inject. For the last week, if you check the spreadsheet, we have been feeding after testing and his numbers reflect this. But he has also had a few HI readings regardless.

 

Ok. Whew...
The highs since, aren’t “too” unusually wracked, based upon the pattern you were on- hang tight, honey... within a few more days you should/will probably see some good change.
There are many, many knowledgeable and skilled (more so than me) members on this board that can and will help you

 

Hello from another Canuck. Happy Thanksgiving.

It is the Fancy Feast pates that are low carb. Fancy Feast with gravy is very high carb (roughly 3x more carbs than the pates). If you switch to the pates, you should see more of a drop during a cycle. When you do switch, however, do it on a day that you are home to get some mid-cycle tests in case your cat drops too much.

 

Where is your SS?

 

Link posted in first post on this thread

https://docs.google.com/spreadsheet...uLyV0IvVA4h8OOk7fHeSkovSGS4JqCUmQe4Dr/pubhtml

@Newpowers
Welcome

You are doing fantastic with the testing. Keep at it. Keep posting. We have all been where you are right now and just know you are not alone.

 

Another observation -- the Royal Canin you were feeding your cat is very high in carbs.. Fancy Feast -- any of the "gravy" brands, are also high in carbs. If you want to use Fancy Feast, you need to use their Classic variety -- it's a pate style and is low in carbs.

Also, I'm confused by your spreadsheet. You have some dates in January then a series of consecutive numbers. Could you take a look at any of our spreadsheets to compare or at least explain how you have been entering numbers.

With the amount of data you have, there's no way to determine if your kitty is bouncing. I realize the situation is not ideal if your mom can't test. Providing she's physically able to do so, is there any way you can teach her to do so? You need to get a pre-shot value and at at least one test during the AM and PM cycles.

 

He has been on multiple types of food since this started, lamb, kangaroo, chicken, beef, pheasant, just recently been trying Fancy Feast Turkey. All caused problems with hair plucking, vomiting, and diarrhea. The Fancy Feast Turkey with gravy seemed to be okay for 2 weeks he's been on it 100% (no old hypo mixed in), but this morning was vomiting (but eventually kept it down) and then at his +5, vomited right after. As far as carbs, I was going by the food charts I've found floating around on here, and I thought it was at least a better bet, and still better than the Hypo he's been on.

Unfortunately I've just come to the conclusion he literally can ONLY have duck. And so many duck formulas I've found have turkey or chicken or other garbage thrown in. And I have been to PetSmart, Petland, Bosleys, Pet Planet, I have looked for limited formula duck with no luck. I have even tried cooking duck meat (I know I need to add additional nutrients for it to be a proper diet, but he refused to eat that as well). I am going to put him back on RC Hypo today, as he's back to his usual food intolerance of vomiting and hair plucking. I literally feel I HAVE NO OTHER OPTION CURRENTLY. He has been on at least 6-8 different kinds of food since this started in July. I've had pets my whole life, I know how to transition foods without stomach upset, that's not whats happening. He is borderline unable to keep anything down today. I have seen this happen each time, with each food. His body either rejects it immediately or it takes a few weeks and then he starts the puking.

As for the graph, all the dates appear correct, I am going by the day/month/year format which may confuse those in the US I suppose. So the SS starts sometime in August, and continues through to Sept and Oct. Please look at the mmol/L version of the SS as the american one is displaying all kinds of crazy stuff and I have no idea how to fix it right now. I'm run thin atm.

Well ... I'd rather not go into the whole mother situation but lets just say she's been difficult throughout this and besides his daily care all of his diabetes related things are up to me.

She is tired of seeing him suffer, barely walking with his neuropathy, is frustrated with the food situations as well as how difficult its been to control him. Today with the vomiting and then he had another intentional urinating accident on the floor, she is telling me she will euthanize him or I need to take him. I am not ready to give up on him yet, so I guess I will have to take him. And upset both my cats, as well as him. He will be staying in a spare bedroom alone. But its what needs to be done. I will probably take him over tomorrow. I don't think he's hopeless yet and I cannot in good faith euthanize him knowing I haven't tried everything. I guess the good news is I can test him whenever I need to now. I keep hoping I'll hit some magical breakthrough with this but its been hopeless so far, due to my own inadequacy and mistakes, as well as his disease. I feel so useless. He's only about 7 years old, I was hoping I could get this worked out and he could live out an expensive but happy life.

I'd like it if you guys could take a look at the SS since I started his new feeding regime October 1st and let me know what my next steps could be.

https://docs.google.com/spreadsheet...uLyV0IvVA4h8OOk7fHeSkovSGS4JqCUmQe4Dr/pubhtml

 

It would be helpful if you could set up a signature. Click on your name at the top right corner and choose signature. Add info such as your pets name, date diagnosed, age, insulin type, food you're feeding, meter you use, and any other health concerns and medications. What are you giving for the neuropathy? which dosing protocol are you going to follow?

 

He has been moved to my spare bedroom, unfortunately he can sense the other cats outside the door and testing him by myself is risky/dangerous as he turns bitey when upset. Its frustrating for both me and him. I feel like I'm just torturing this cat at this point.

I have been reading the tight regulation protocol for Lantus and I'm seeing that I should still be increasing his dose by 0.25 this next cycle, correct? He's still having consistently high readings. He has had a bad day today with the food suddenly not agreeing with him so his BSL are understandably wonky. I'm testing as much as I humanly able to. At this point I feel like I have nothing left to lose. This cat can basically not even walk at this point. He purrs and he watches bird videos on youtube with great attention but he's urinating all over himself, dragging himself around, I don't think he's got much quality of life anymore. Its increase his dose/improve his situation or euthanasia. I feel backed into a corner regarding his food issues and only worsening condition. I know I probably seem like I'm making so many mistakes and not doing enough, I probably look like a bumbling fool. But I'm trying.

I'm sorry if I seem grouchy in my posts I don't mean to sound that way I'm just so incredibly frustrated and upset with both myself and diabetes.

 

All we can do is the best we can. I'm sorry you guys are struggling. I'm struggling with my cat the past few months as well although without the diet frustrations you're facing. That's rough. I'll leave the dosing advice to the lantus experts but I'm here for moral support so you know you aren't alone. If you are doing tr the increases are fairly frequent. I'm sure someone can comment on that soon.

 

It sounds like you may be dealing with IBS. The only way to sort out if this is IBS or not is doing what you've been doing with food. This website is a good resource for information on IBS even if you don't want to feed a raw diet. They have a Facebook page, as well. You may need to talk to your vet since if this is IBS, most cats are prescribed prednisolone.

If you're going to need to stick with the Royal Canin, you just need to take into account that there's a good likelihood that Otto's insulin needs will be greater. Whenever a kitty has a health issue that causes numbers to run higher (e.g., needs a particular food that's not low in carbs, is prescribed a steroid), you can adjust the insulin dose to compensate.

If you want to feed homemade duck, FoodFurrLife has an excellent add in (EZ Complete) that will provide all of the nutrients you need for a nutritionally complete diet.

 

I'm guessing I'm still seeing some slightly wonky numbers due to him now living in my spare bedroom, as I know stress can effect blood sugar levels. I've been reading this forum and online about what I can do next, or what I'm doing wrong and I'm left feeling even more clueless now. I have been looking at his SS to see if I could see ANY kind of trend or HOPE or anything that I'm getting him to where he needs to be .... but no.



This is just his PMPS from August 11th to September 30. In this time period he went from 3.25u to 5.00u of Lantus ... I expected to see some kind of slow trend downwards or SOMETHING and I'm left with a literal flatline. The blue line is the trend ... and well, there's no trend. If anything it appears angled slightly upwards. Despite dose changes he has remained basically the same. I didn't include Octobers data because it would reflect his feeding schedule change and therefore altered BSL. This graph also does not display all of the HIs as it is not a number value. So imagine even more peaks. I'm aware this is actually only a tiny amount of his data, but from looking at other people's lantus SS, I've seen dose changes have at least some effect on AMPS and PMPS longterm.

What does this mean? Is he on too much insulin? Do I keep increasing? What is happening and how do I change this. I hate to euthanize a cat that still purrs and plays (in his limited way), still seems to mostly enjoy being alive and is eating well ... but he can't enjoy the incessant ear pricks and falling into his own urine and feces daily. Not able to climb, run, or even walk at this point. He just staggers around, barely. He can maybe take two steps before he collapses. I have to see improvement. I don't care how slow. Just anything. His neuropathy isn't a concern for me at this point, as the way to fix that is to get his diabetes under control. Of course I will keep giving him methyl B12, but its not going to help really until his numbers come down. I don't even know how neuropathy gets worse than this honestly; he has the worst. I've seen YT videos of other cats ... but most of them can still at least stand.

SS is in signature and original post.