Wide variation

It was suggested I post this here.

Pumpkin was diagnosed and started 1 unit Lantus once per day on Thursday (7/6). Her BG was 367 on that day. I did not get testing equipment until Friday pm so started testing Saturday. Sunday she was at 186 in the morning and I gave her a dose (now vet says not to under 200). She dropped to 72 @ +3 and I fed her and had to leave to go to my aunts funeral. When I got back home (about +8) she was back to 84.

Yesterday she was at 94 when we got up and I didn't give her injection. When I got home from work 114. So I shot at all yesterday.

This am she was back up to 332 and received an injection. I have heard two things, 1) that in the beginning there may be some wide variation and 2) that Lantus doesn't have wide variation. These two statements seem to contradict one another.

Pumpkin has also been on prednisone for asthma and eating dry food. She is now off the prednisone and on a low carb, wet diet and vet said these two things could have a notable effect apart from the insulin.

So, should I panic about one day being normal range without injection and the next being above 300 or should I just wait a few weeks? I haven't been able to do a curve yet but plan to do that Saturday.

 

Cats will bounce if their bodies think they are too low no matter what insulin you are using, sounds like you might be on too high of a dose.

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

Is there any way she got into something that would increase her numbers? Dog food, other cat's food, human food?
Stressed by anything between the good numbers and the 300s reading?
I like to test twice if I get a number that seems strange/off. There are "wonky strips" sometimes that read too high or too low for an unexplained reason.
Normally lantus is a twice a day insulin for cats. Any special reason for the once a day dose?

 

Hi Tracy, it will be hard to tell at first, we you a spread sheet to track BG levels to look for patterns. Since she is just starting out, I would not worry about her pre-shot numbers being in the 300 / 200 range. It's normal to be higher pre-shot as Lantus is long acting you should see the lowest point at approximately +6. Plus since she didn't get any insulin yesterday her numbers would have climbed.

When you switch her to wet food, please monitor her closely the first day, some kitties react with lower numbers quickly when they start getting Low Carb diet, and you may need to adjust the insulin dose. You will learn too that BG numbers are always changing through out the day making it important to test before each shot and mid cycle, before bed to get the data you will need to understand how your cat will react to Lantus.

 

Welcome to FDMB.
The spreadsheet is your best tool and with asthma in the mix.... she could need the pred again some time in the future.

What you are describing is pretty normal. The 1 unit pulled her down and then when she didn't have insulin, she rose back up.
It is possible that 1 unit may be a bit more than she needs. Testing is key to determining what the right dose will be.
And many of us here see patterns when there is data to look at.

The lantus dose is determined by the nadir - the lowest point of the cycle .

 

No, I don't know of any way she would have gotten any other food. The reason for the once per day is the vet wanted to be very cautious in the beginning because of the prednisone she had been on. The vet believes she may drop a good bit just from taking her off the prednisone and changing the diet. Plus, she had no ketones and her fructosamine was in the fair range rather than the poor range. I live 85 miles from the vet so there is a bigger concern about hypoglycemic responses since I can't get to an emergency vet quickly. Vet said it's better to be a little high than to get too low until we have a clearer picture of what is going to be her typical response.

 

I think it is best too to that her bg be a little high than too low, until you know how she will react.

The high number the other day was from the skipped dose.

Since you are far from the vet definitely test before every shot to make sure you are comfortable giving the shot. Take a look at the stickies from the main forum page, and I suggest that you download the spread sheet we use here to track BG. It will help to spot patterns, for example onset when the cat starts reacting to the insulin, the nadir which is typically mid cycle (except mine who likes to keep me guessing). Some cats numbers go from one extreme to another so important to tests regularly. If you don't test minimum 4 times a day you would never notice how high and low she may get. Also take a look at what you should have on hand to address very low numbers to avoid Hypo. http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

When you are not sure about anything or just reach out here.

We love the spread sheet, so suggestion you try and set one up first

 

Tracy, I have a fairly new diabetic kitty on Lantus too, and I felt the same way at first. I also switched him from high carb dry to low carb canned, and that seemed to drop his numbers a bit, but then he bounces quite a bit too. I still feel like he's all over the place, but the folks on this forum are super helpful! It does help a lot to make a spreadsheet, and keep track of everything, as these guys can help you! Welcome!

 

Thank you very much. I did create a spreadsheet on my own the day she was diagnosed (before I did anything with the board) so I can easily switch that over. I have all her tests and do test every morning before I do anything. I test at least once after (2-3 hours) before I have to leave to go to work and then again when I get home at least once. Because of the timing, I have not had the opportunity to do a curve but plan to over the weekend so I have a clearer idea.

 

Looks like you are on top of it, that is great. If you like add the SS to your signature on your profile. When I first started with Marvin, it help me (hmm to calm down) to post his numbers here and see what the experience folks suggested. I am posting more these days as my cat is finally reacting to his insulin and many time I was very nervous, scared and didn't know if I should or should not give Marvin a shot, or when to increase, hold or decrease his dose. I am so grateful for the support I got here, and am starting to feel more confident about the whole journey I am on with my Marvin.

Pumpkin and his mom