Year later and still High BGs

Hello again. I’m here to see if anyone can help me solve this on going problem. I have read up some things why insulin wouldn't work and it seems there are many reasons, and its taken me a year to come to a... I have no idea whats going on, conclusion. ... Well, there has been times where the insulin "was" working and then there was a time of 3 months were it turned out to be the "insulin solution" itself not working, expired or whatever. Then another time she had an infection. Also It was a rocky first half of me dealing with real high and low BGs (the roller coaster). Got that mastered... with 3 other kitties and living in a bedroom does not help with her diabetes. Other than them being little sneaks sometimes, somethings just arnt physically possible for me.

I have a vet appointment for next week, but this being my 4th vet up here I really should start here first. :idea: ;-) (I've seen these guys b4 for my other kitties so I know there good, just waaay expensive. But I dont know if they know anything from this century about diabetes or not...lol)

What I think is going on is that her numbers dip too low and she goes into insulin resistance. I think??? Or infection??? Dont know. I was having trouble with the last half of her old bottle of pro zinc... so I got her blood checked, shes good there so I switched to Lantus to see if that wud help. It did, wonderfully!! :mrgreen: ... but only for the first week and half. I'm in 4th week of trying to fix possible insulin resistance, and I'm almost back up to 1 unit of Lantis, where she was at when I first put her on it... which was too high. (just a tad too high I think) I was getting good readings at 120's average. Then wud feed to kept in that vicinity for the rest of the insulin cycle. ---- I came home late for her afternoon feeding 2 days from work and ever since then her sugars have been high ,avg 315 in the morning and evening to 270 in afternoon. :sad: *sigh* Back to her old numbers... She is getting so skinny now, I hate it!

I feed her, (more when insulin is working good) 1/4 can (friskeys classic only) when I wake up, and 1/4 can with insulin, and half can when insulin gets in good numbers and the same for evening routine, which includes waking up in night to feed her. (and the rest of furry kids too. :smile: ) All at same/ similar time. every day.

I hope this all makes sense, I'm a slow typer and its crazy late now. My blurry vision and blurry brain seem to think its fine so I'm going with it. :lol:
(lol thank god for "text cache" the text saving add-on for firefox, I got logged out)

I would greatly appreciate any advice or suggestions in helping little Cleo feel better! <3
Thanks you

 

Hello!

Is there any way you can set up and publish a spreadsheet with Cleo's numbers so the experienced Lantus users can see what's going on? Lantus is dosed a bit differently than Prozinc, so it may just be a matter of getting you on the right dosing protocol. Here's the link on how to set up the spreadsheet and put it in your signature: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

 

There are a number of things which can affect how well insulin works, and getting them all stabilized can take a while. (Spitzer is just getting there after 1 1/2 YEARS)

First, diet. Are you feeding low carb versions of canned Friskies? Generally the pates such as Tukey and Giblets are low carb. Check out Binky's Page for some information on the % of calories from carbohydrates in many of the Friskies flavors. We recommend staying below 10%, and 6-7% seems to work well for many cats. And, are you feeding any dry at all? If so, it needs to go - most dry food is around 30-40% calories from carbohydrates.

Second - the amount you are feeding may not be sufficient for your cat. It sounded like you were adjusting the food amount to control the glucose levels. What you want to do is feed the appropriate amount for the cat's ideal weight, plus some extra to catch up (see Cat Info for information on feeding and calorie needs) and adjust the insulin dose based on the Lantus protocol to control the glucose levels (see sticky posts at the top of the Lantus forum). Some of us feed on a schedule with several mini-meals in the first half of the 12 hour Lantus dose schedule, to pace the incoming food with the incoming insulin.

I don't think you've hit insulin resistance the way we use the phrase, with a dose of 0.5 to 1.0 units twice a day. Cats with conditions like acromegaly, on high insulin does twice a day are what we generally see if there is insulin resistance.

Lantus and ProZinc work very differently. Prozinc is in and out within 12 hours, give or take 2 hours. Some cats may have very steep curves with ProZinc - in Spitzer, it only lasted 10 hours, so it didn't work for him. Lantus has carryover - any dose works for 12 hours plus, and the overlap (aka 'shed' or 'depot') results in smoother glucose levels. Dose adjustments for Lantus are based on the nadir - the lowest glucose level during the 12 hour period or cycle.

 

Thanks Julia I will try and get a spread sheet for you all. There's not much to say on it as her levels are the same day by day unless I do something different with food or whatever. They have always been High until I get a new kind of insulin and then it works for a while then stops. From what it seems like anyways....
Can't wait for the Vet next week! My last vet I was with them for 6 months and they never did a blood test or gave her antibiotics so I'm hoping this one will jump right on the antibiotic to cut that off my list of possibles.



Hi BJM,

Sorry for the quotes but I am a reeeeally slow typer!!
Hope that helps.
Thanks!

 

So 2 cans of food for her a day, spread out. You might try feeding 1/3rd of a can immediately post shot, 1/3rd at +2 hours, and 1/3rd at +4 hours. Feeding more once you've hit the lowest glucose level may actually increase the next pre-shot dose as the calories are coming in while the insulin is wearing off. You want the food going in at about the same rate as the insulin being absorbed.

You might need to rule out hyperthyroidism. It is one of the explanations for a cat losing or not gaining weight despite being fed enough food. Although ... what is her ideal weight? Is she a big or petite?

It may also be the insulin dose is not high enough yet, but we really would want to see a curve on a typical day to know how the insulin is working for her.

Once you've got your spreadsheet up so we can see what it looks like, folks may have some other ideas you can try, plus recommendations on how to adjust the insulin dose safely.

 

You can rule out insulin resistance with a lose dose as 1u and your thinking is suspecting going to low at times.

If you are using Lantus, do a curve one day when you are home, testing before the shot and then every 2hrs to the next shot, 12hrs later. That's the only way you are going to know if Lantus is at a good dose, or needs to be increased or decreased.
Generally the Lantus should be good for around 28days, and then you need to start a new container of insulin.

Sure you can tell the vet you want a full blood panel done as a snapshot, but there is no need for AB if the cat's not sick.

For the food, you should not be rationing food until the cat's regulated and you will find that the cat will eat less when not needed.

if you can post the numbers you have already from testing, and the times in relation to shots and food, it will be helpful to others in replying. Your meter will have the numbers in the memory too, I think.

if the numbers are still high all through the 12 hours, then just increase the dose. The insulin will work if it's handled correctly, and dosed as needed.

 

Thank you so much for the replys. They have helped me tones.
I am so scared to feed her more, thats why I cut her food down when her numbers went high again. But your right, I shouldn't cut back so much. :/ And thats a great idea BJM about feeding her on that scedule. I can't do that whole thing but I can work something better out when I get the insulin to work in her body.

:shock: cat(2)_steam
All I went through to get that bottle of Lantus... and it wasn't going to last me till the bottle was gone. :roll: Well I guess I will get a bottle of whatever I can next month. $$$...

And what do you mean by "handled correctly"? I'd be scared by that answer from what I've done to it but hey if it only last for around a month anyways... :mrgreen: I'm not gonna worry about it now!

I will be getting more test strips this week
But to give you whats off my meter may be a bit of a head ach for ya.. I know it is for me. lol The last week or so I've been kinda random with it and only checking once a day when I'm not at work.
I'll start with today (my last test trip) and go backwards:
7:00pm BG-246 ,ate at 2pm
11:00am BG-334 ~ate at 9am
2:00pm BG-307 , ate ...dont remember lol
1:30pm - 254
2:00pm - 325
2:30pm - 287
6:30pm - 385
11:30am - 363
8:00pm - 310
12:00pm - 277

Side note, my meter isnt that entirely accurate, it's about 15+ numbers off from the docs meter. Mine reads lower than hers.

 

Here's some info on how Lantus should be handled: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151. It's only guaranteed to last 28 days, but if you handle it right you can stretch that time out longer. One thing many of us do to save money is to get a pack of the Lantus pens rather than the vial--it's a little more expensive up front, but you get 5 3ml pens instead of 1 10 ml vial. Because the pens act like mini-vials, you use almost every drop of insulin and there's way less waste. If handled right, a pack of 5 pens should last you at least 6 months, but more likely a year. You can also order them from a Canadian pharmacy, which if way cheaper than getting it in the US. Here's as list of places where you can order the pens from: https://docs.google.com/document/pub?id=1FCnrPxpYD02Gp5hWtEIbhLXm0VOyaZlAT_qeCjlx-Js&pli=1

Human meters read a little bit lower (about 30 points) than a meter calibrated for a cat--but that's fine. You're making adjustments based off of trends or patterns, not specific numbers.

 

Thank you Julia, I really did not take that post on how Lantus should be handled seriously when I first read it a while ago. (and I didnt watch the video... that would of put in perspective more for me) I mean my bottle said good till 2013 if I dont open it, and Im never going to open it... just stick a needle into it... and I'll just put a couple of these guys ohmygod_smile ohmygod_smile instead of explaining the rest of what I thought.
I have dropped it a couple times, will that make it stop working? Or getting it to room tempature a couple times or injecting air bubbles into it?
Though I'm not going to get tooo fixated on that as she had problems with ProZinc too. Works for a little while then stops. But Im adding it to my list. ;-)
Oh and thanks for mentioning the pen, knowing me it may of not registered in my head when reading it again that "that" Lantus would last much longer.

Ok and I'll stop freaking out at my, what I thought was a broken meter. X)