What am I doing wrong?

My scamp was just put on lantus (1/2 unit/ day) last week after being otj since July. I took her to the vets and it appears there may be an underlying liver issue and that the DM is flaring up because of that (trace ketones but have turned a corner with Scamp eating again and fluids given). but her numbers are just not making any sense so I decided to do a curve today.

The first test of the day she was at 241.2 ish and I did not give insulin cuz I have been trained to not shoot under 250 but now her number (2 hours later) she is at 322.2. I fed her at her first testing a can of beef fancy feast pate.

What am I doing wrong that her number jumped so high.?? Or am I doing something wrong???


Alix & Scamp

 

Alix,
I'm not sure you're doing anything wrong - in my humble opinion, Scamp needs more insulin. Also...don't know if this plays a part here or not but all beefs spike KT's numbers, especially Fancy Feast. It's considered low carb but for KT, some of the gravy foods don't spike him as much!

BIG HUGS!

 

Re: What am I doing wrong? Updated

Her number is now 302 and that is four hous after feeding. I appreciate the quick response Squeaky and KT and it is interesting about KT reacting to the beef - in Canada the beef is chicken with beef flavouring. I forgot to mention that I also gave Scamp a spoonful of A/D which may or may not have caused a jump - maybe I should consider giving her insulin now? Any Thoughts?

 

If you shoot now, you'll need to get back on schedule 30 minutes per day. Easier to just wait to your next shot time.

Yes, A/D is high carb.

Have you reviewed either the Start Low, Go Slow or the Tight Regulation protocols? With good data collection, you can shoot lower than 250 mg/dL on a human glucometer.

 

She jumped back up to 308 so I fed her 1/2 can of chicken FF. And gave her her shot and will back down to her morning schedule - this May end up being an okay thing as I have to fast her Monday night because she gets an ultrasound of her liver on Tuesday morning! She is just confusing me with her numbers.
Thanks BJM. I appreciate the help

 

You're welcome.

You can pay it forward by encouraging new people in Health, directing them to resources they need, or learning something so thoroughly, you can explain it in your sleep!

 

Not sure why you have the no shoot number set at 250. In Feline Health, it's 200 for beginners just learning the sugardance. In the Lantus TR forum the no shoot threshold is 150. You might want to seriously consider dropping your no shoot number, at least down to 200.

 

My number is at 250 cuz that is what the vet said and I haven't totally learned to question someone who is schooled in taking care of animals - this is the same guy who started Scamp on caninsulin so maybe I should know better but old habits are hard to break. I will from now on drop the number and trust in all of your experiences as there is more knowledge on this board about diabetes then the knowledge my vet has. I am not knocking my vet because he is very good but he hasn't had hundreds(thousands) of cats with diabetes. I appreciate the help I get here.

Thank you,
Alix & Scamp

 

Maybe take it down a little every 3 days or so, so you can see what happens gradually. That way, you will be comfortable with your testing and shooting. Also, Lantus takes roughly 3 days to stabilize when you make dose adjustments after the first one (which takes about 5 days due to build up).

If you get mid-cycle tests between +5 to +7 hours after a shot showing he is well above 50 mg/dL, he is safe.

When making dose adjustments up or down, we do them in 0.25 unit amounts for Lantus. The syringes don't measure that finely, so you have to eyeball it.

 

Ok, so pick a shoot/no shoot threshold that you are comfortable with for now, and we can slowly drop that lower and lower as you get more experience and data.

What would you think of using 200 as your shoot/no shoot threshold for now?

Once you gather more test data, you'll get more comfortable with shooting those lower numbers. There is even a sticky over in the Lantus TR forum about becoming data ready to shoot lower numbers. STICKY: LANTUS & LEVEMIR - SHOOTING & HANDLING LOW NUMBERS You're here in relaxed, so I realize you are not following the TR protocol, but this sticky is still good, informative reading and knowledge to have.

p.s. The shelter gave me a shoot/no shoot threshold of 100 mg d/L, on an Alphatrak no less, when I got Wink from them as a foster. :shock: I certainly would not do that now with a diabetic kitty new to my care. Not enough data in a situation like that to make good judgment calls.

 

My kitty Max has just been on Lantus for 1 month, so I'm still new to it. As others have mentioned, I have slowly moved my "no shoot" number down as I've gotten more data from testing and seeing how the insulin is working. It just takes a little time. What I did in the beginning, when Max was a little too low to shoot, based on my limited experience, was wait 15 - 30 min and retest. In most cases, he went up just enough to meet my threshold. It looks like you did that in this instance, but I would re-test a little sooner to help keep you from getting too off schedule. Now that you've seen how Scamp did with a no shoot of 250, you can think about if you feel comfortable moving that to 200 as others have suggested.