? What the hell am I doing wrong.....moving in the wroug direction

Jackie's #s just keep getting worse. Can you experienced eyes take a look and make possible suggestions?

 

Hi Sarah - you sound pretty discouraged. I wouldn't be surprised if it isn't the budesonide that's increasing Jackie's numbers. Looks like the last green test was the last day of the prednisolone and then it's all higher.

I'd get at least one mid-cycle test in per day so you have a better idea of what her blood sugar is doing. The before-bed test is a good one because often cats go lower in the pm cycle. But mixing it up when you test is helpful - in other words, don't just always test at pm +3. Vary the times a bit.

That's going to give you information that will help you decide what to do with the dose. I'd guess you need to increase the dose, but without the midcycle tests I can't suggest doing that. We do have plenty of cats here that can go from amps 400 to +3/40 to pmps 400 - so that's why those midcycle tests matter so much.

Hang in there - a little more info will help you know what to do next. If the Bude is raising the blood sugar, then you can increase to compensate for it.

 

I agree that it's likely the steroids that are affecting the numbers. If you can consistently get at least one additional spot check each cycle, I'd encourage you to increase the dose. The other factor may be that you're holding the dose a long time. You've held Jackie's dose at 2.25u for over a month. If you're still planning on sticking with TR, the dose is evaluated every 3 days. The longer a cat sits in higher numbers, the more their body adjusts to being in high numbers and treats that range as the new "normal". This makes it harder to get the numbers to come down. (This is called glucose toxicity.) A couple of more tests per day and being a bit more aggressive with dose increases may help.

 

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Is it common that budesonide would increase the BG more than prednisilone? I guess I kind of thought the opposite was true, which was why I wanted to switch him. I must admit, I was concerned that maybe that had been a mistake when he started not feeling well a bit after the switch.

Do you think I should maybe stop the bude. and just go back to his old pred dosing?

I should also mention that I have been mixing in a slightly higher carb wet food (FF grilled, only 2v flavors that are lower in carbs and phos.). I read the post about that here and tried it as Jackie was getting fussier about eating his CITK and TIKI alone.

I am also now using Lantus from pens I got through Marks Marine in Canada. How much do you think these factors might play a role here, if at all?

I have been running low on strips AND Jackie seems increasingly upset about both testing AND injections. Due to that, I admit, I have been holding off on mid cycle tests I would have liked to have. But I did receive new strips yesterday so should be able to get some next couple of days.

 

All the FF grilled flavors are above 13% carbs, which would be MC to HC. That could be raising the numbers, if Jackie is carb sensitive.

I, too, had always thought that Pred was more likely to raise BGs than the Budesonide, but ECID! I would discuss that with your doctor. How long ago did you make the switch from Pred.

I can only echo Sienne and Julie about the mid-cycle numbers. I know it's tough when your kitty is resistant - Harvey is a HUGE problem to test - but it's important, and in the long run could lead to fewer tests if it helps you get the numbers down and more consistent.

 

I don't know much about either of those (Prednisolone or Budesonide) but I'm just looking at the spreadsheet and it definitely looks like his blood sugar increased after you switched to the Bude. Maybe that was a coincidence, or maybe some other factor changed at the same time.

Are you always giving a treat after testing? that can make a huge difference in how much a kitty accepts testing. I gave punkin tiny bits of cooked chicken breast for pokey treats and he was willing to sit for the poke and then would leap 5 feet out from the sofa on his way to the kitchen for his chicken. It was a powerful incentive. Many others here used freeze dried meat and kitties seem to like that. I know some who used a shrimp too.