Consistent high bg readings

I'm concerned about Zoozey. His bg has shot up the last three weeks, and we can't get his numbers under 350. My mom took him to the vet last week, and he upped Zoozey's dose from 1.5 u to 4 u then to 5u. I'm using a new Lantus pen. I started using it three weeks ago when his numbers started going up. (I thought perhaps the vial of insulin I had been using was no longer effective)
A little background: He's 7. He eats 1.5 cans of FF classic twice a day and he has for the last eight months or so. Me and the cats have been at my parents' house for an extended visit since June 17th. I came back to Arlington for a week to do some research and I left all three cats there. The high numbers started two weeks after we got to my parents'.. For months I've been getting readings in the 100s, and three weeks ago I began getting readings in the 200s and 300s. Last week he went up to the 400s (that's when we decided to take him to the vet). He didn't have a uti, he was negative for ketones , he hadn't lost any weight, and he's acting completely normal (grooming, eating, playing, exploring, begging for food and attention, etc). I'm guessing he's bouncing right now, but why aren't his numbers coming down? Shouldn't the increase in insulin (Lantus) lower his numbers?
I've been out of town for the last week, so his spreadsheet isn't updated and my mom is not tech savy enough to do it. She's also only reading him twice a day because it's really really hard for her to see the blood on Zoozey's black ear because of her cataract and kerataconus.

I'm going to be back at my parents' tomorrow evening, so I will update his spreadsheet when I get there. And I definitely intend to do a curve on Wed. or Thurs to see what his entire cycle is like right now. I'm just stymied as to what's going on. I have to go to California at the end of next week for a week long intensive conference (and the English dept picked me to go and the uni is footing the bill , so I can't back out) and I won't be as available to my mom or the message board if there's trouble. I just don't want him to dka again. He lost almost half of his body weight and he was so close to death. He was so sick. He was too weak to walk, he was dizzy, nauseous, he had cerebral edema and he was having trouble breathing. I never want him to go through that again.

That's a big increase in dose you just made, you may have missed a good dose and be bouncing. So we need to get a better idea of what's going on.. That means update the spreadsheet and get more tests.

We will need to get reasonable amount of tests over a few days to get enough data to see if he is bouncing. That means preshot tests but also a +5 to +7 midcycle test, and a before bed test too... For 3 consecutive days.. And possibly some spot checks and maybe nighttime tests too depending on what he is doing, Can you do that?

Let me know


Wendy

It's a huge increase. I was really surprised when my mom told me that the vet recommended it. When she told me, I was worried he was going to hypo on a dose that high, but thus far that hasn't been the case. Unfortunately, I can't do anything until I get back to my parents' house tomorrow. She's put a call in to the vet, so I'm hoping he'll get back to her before I get in tomorrow.

I do know that my mom has been meticulous about doing ps readings, feeding, and giving him his shots on time while I've been gone the last week. And I record absolutely everything, and I made sure that my mom does the same while I'm gone. I'll transfer the numbers when I get to Houston tomorrow afternoon/evening I'll have 8 1/2 days to do bg checks myself before I head back out of town again.

It's just frustrating. I want to know what's happening now, so we can get his numbers down.

That's fine, if you are diligent and keep us up to date we should get a real good idea of what's going on in 8.5 days. Although i find it suspicious that the high BGs started a few weeks after the trip to your mums. Stress maybe?

Also while you are there
1. Check there is no Incursions into contraband.. Ensure she is still giving the classics only and no table scraps or high carb treats.. Or getting into Dog food or whatever.
2. Check his ears for dirt/ infection and his litter box habits for possible UTI
3. Maybe schedule a vet visit to check his teeth and for infections
4. Check your mums injection technique and that she is pulling the right dose.

Want to be sure we exhaust all possible avenues of issues..

Let me know when the SS is up dated and you start getting readings and we can go from there.

Wendy

I took a safety razor and shaved a tiny patch on Wink's black ears. He has long, black fur and it was really hard to see, even in bright light. It made it easier to see the blood drop with the bare skin as a background instead of that long, black fur. Just an idea to maybe help your mom see better to test.

Increasing the dose from 1.5U straight to 4U and then to 5U is too much, too fast. We recommend 0.25U increases in most circumstances. Holding a dose for a minimum of 3 days. I think you may have bypassed your good dose.

Too much insulin can cause high numbers as can too little insulin.

The dose increase was done on the advice of the vet. And I was pondering a small increase before I left. If it had been just me doing it, I wouldn't have upped his dose by more than .5u. But I wasn't there, and my mom was just doing the best she can.
I suspect stress too, because the really high numbers in the 400s started the day after I left. But Zoozey usually displays his stress pretty clearly and he's not exhibiting any of his typical signs of stress. Of course that doesn't mean that he's not feeling stress. But he's going to be at my parents' house for another four weeks and there's nothing I can do about that, so I've got the make the best of the situation

I'm going to try shaving a patch on Zoozey's ear. If it's easier for my mom to see the blood, then hopefully she could take more readings when I'm gone next time.

You don't need to shave the ears to see; you can poke the ear on the underside of the ear. See if your mom can test on the other side of the ear.

You are right that such a dose increase is wrong, and I would be worried about the cat going way too low. Too low can end in a coma and seizures, and that's about as much fun as DKA. Is he being checked for ketones?

Your parents are testing before the shots, yes? Is there any way that they can do a curve soon to see what that dose is doing? If they can test every 2 hrs between two shots, and give you the numbers, you can post them.

Gayle

Yes, my mom is doing pre-shot readings. She can't do a curve because she works. And the vet tested him for ketones, and he was negative. He ruled out a uti too. I'm bringing my Nova Max meter back with me, so I'll be able check Zoozey's ketones myself. Maybe he's stressed, maybe he has some other sort of infection, I don't know.
I'll be back at my parents' tomorrow evening, and I do intend to do a curve Wednesday or Thursday. I was trying to conserve test strips because I'm on my last container and neither I nor my parents have any money to buy more right now, but with these high numbers I don't really have a choice.

Time to pick up a relion prime or confirm or micro. Cheaper and reliable.

emchic said:

Yes, my mom is doing pre-shot readings. She can't do a curve because she works. And the vet tested him for ketones, and he was negative. He ruled out a uti too. I'm bringing my Nova Max meter back with me, so I'll be able check Zoozey's ketones myself. Maybe he's stressed, maybe he has some other sort of infection, I don't know.
I'll be back at my parents' tomorrow evening, and I do intend to do a curve Wednesday or Thursday. I . was trying to conserve test strips because I'm on my last container and neither I nor my parents have any money to buy more right now, but with these high numbers I don't really have a choice.

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Yes, the Relion meters are the best for economy and are quite good meters. You will save a good chunk of money. For the ketones, when you are at the pharmacy, pick up a container of KETOSTIX so you can test his urine at home yourself for ketones.

How did the vet rule out a UTI? Did the vet get a urine sample and test? Can you get the test results? Usually a C&S takes a few days to rule any infections.

Stress can really upset the cat's numbers, so he may well be stressed with you gone.

It's OK to wait for the curve; most people who work can't do any curves until they have days off, so no problem with your mom waiting. What would be nice is if she can get a before bed test number as some cats do go lower at nite.

Gayle

Poking the underside of the ear is another option for some cats. My Wink had black edges to the ear and long black fur on the inside edges and sticking out of his ear in huge tufts! My presbyopia is getting bad and the hairy inside black edge of his ear wasn't much easier for me to see.

With these vision issues you mentioned for your mom

She's also only reading him twice a day because it's really really hard for her to see the blood on Zoozey's black ear because of her cataract and kerataconus.

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you do what you can to make it easier for her to see the blood drop. Weather that is shaving a tiny patch on the ear or testing the inside edge or using a really bright light or some sort of magnifier, is up to you.

Here are some tips from BJM that I found with a search for magnifier.

BJM said:

You may want to pick up some magnifiers, too, as the half unit syringe markings are tiny. Anyone whose vision is less than stellar has found some sort of magnifier helpful. Check our shopping partner Amazon (click on link at top of page) for syringe magnifier, magnifier visor, clip on magnifier, or stand magnifier. I've used the Carson Clip 'n' Flip and found them quite helpful (severe myopia,then cataracts, and post-cataract still need 'em!)

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Where to buy the magnifier links from BJM.

BJM said:

Syringe magnifier

Magnifier visor

Clip -on magnifiers

Click to expand...

Thanks Deb for passing on that info. I'll relay it to my mom and see what she wants to do.
I got home this evening and Zoozey looks great. He wanted loads of attention and head butted me for petting for some time (I guess he missed me!). I have now updated his spreadsheet up through a +2 reading after tonight's pm shot. I'm going to go take the +4 in 10 minutes, and if I can get to sleep without any trouble tonight I'll do a curve tomorrow. He's still high. His pmps was 388 and +2 was 436. I'll post his +4 in a few minutes.

Zoozey's +4 is 409. I'm going to try and stay up and get a +6. Fingers crossed I can stay awake!

Because of the dark fur, you may want a magnifier which is lighted too. I've seen them on lamps for sewing, for example, and I've seen lights mounted to a visor type magnifier.

Your colour coding has all disappeared? Can you use the little paint roller icon to click on a cell with the coding and "paint" it on to the ones without?

Looks to me that the high readings started immediately after you dropped him off at your mums. Could well be stress. But also that dose increase was too much so keep looking for a low he could be bouncing off.

Wendy

I reached the end of the spread sheet, so I had to add more rows, but when I added them, the new rows didn't have the color coding, and I couldn't figure out how to make the color coding apply to all of the rows. I tried changing the conditional formatting for the new rows to exactly what is in the original spread sheet, but it would only do one row at a time. Does anyone knows how to apply the conditional formatting to new lines on the spread sheet?

We took Zoozey to the vet again this morning, and I'm glad we did. Apparently when my mom took him last week, the regular vet was out of town. Some other guy was filling in for him. Dr. Crum agreed with me about the high dose increase, he recommended backing it down to 3u. Zoozey still isn't exhibiting any signs of infection, and he's eating and generally having a fabulous life, but Dr. Crum gave him two antibiotic shots,one fast acting and one that works over a period of 10 days, in case Zoozey has any infection brewing. I'm to do a curve in 5 days. If he's still all over the place then, then we're going to have to bring him in again (so keep your fingers crossed!)

Select a row which has the highlighting.

Click on the roller paint brush and highlight a row which is working.

Brush the first row that isn't working correctly.

Repeat as needed.

Or, follow these instructions to Color Code Your Spreadsheet

I think you use the little paint roller icon to click on a cell with the coding and drag to "paint" it on to the ones without?

Looking forward to PMPS reading.

I figured out how to add the formatting to the ps rows, but not to the mid-cycle rows. I just did those manually. But it's all color coded now.

Did you get a PMPS reading last night? I dont see anything.. also are you testing for ketones?