Lucky BG at 297! what do I do?!

Tested her this am and she was 297! What do I do? No vets are open! I don't understand why in the am with no food her numbers are higher but in the pm she's much lower?

BG levels fluctuate throughout the day. My cats were normally higher in the morning than at night. Also, does Lucky eat all of her food at one sitting or does she graze on it through the day/night? If you leave it out, she may have had an early morning snack.

Looking at your previous posts, it looks like Lucky is not on insulin yet. I would not worry about a single higher reading. Test as you normally do and if you see a pattern of higher readings then I agree she may need to go to the vet. She may need insulin or she may have an infection that is making the BG higher.

Well I did think of something. It's higher in the AM and she did not have any food since 5:30 pm yesterday. She had Friskies in the AM, I tried giving her fancy feast at noon which she ate half of it. Then I gave her the rest at 5:30 she cleaned that up. Then she didn't have anything until this morning.

Here's something that I thought of. She has lower BG numbers on Friskies. But friskies has more carbs so it may keep her fuller longer. I've been feeding her 2x day on the Fancy Feast which is lower in carbs. Thus she'd be hungry more. In the AM she normally has had nothing over night at all. Nothing to snack on. Accept water. Could it be that she is really hungry in the AM, starving so it's stressing her out causing higher BG numbers? I think I'll test her BG numbers two hours or 3 hours after she's eaten to see if it's lower. If it is, then I think her being hungry is a big part of the problem. She's not active over night at all. Though last night I did play with her and she had fun. But I doubt from last night at 10pm to now it would stay high from activity.

Can cats if they are not getting enough to eat cause their BG numbers to rise because they are hungry? confused_cat

Which would be better 2 hours after she's eaten to test or 3? If her numbers have gone down, then my guess is that it's from hunger. Because if her blood sugar is higher than 297 then that means that's not the case. Now do I need to worry if her BG numbers start increasing in the PM too. Her AM numbers have increased steadily and specifically since i've changed to fancy feast. And the only thing I can think of is that with less carbs it doesn't keep her as full. And over night she goes, probably 10 hours, or Today over last night she went 12 hours without food. And only had 1/4 of a can in the AM and she cleaned it up. She had Fancy Feast at around noon and ate 1/2 of that. Then had the other 1/2 at night. And in thinking she was probably starving this morning. But she didn't eat all of the Mixed Grill I put out for her though. I left it there for her to finish.

The number of calories shouldn't effect BG. There are variations in BG. Many cats run in lower numbers at night but not every cat. It's an ECID (every cat is different) thing. If you're feeding twice a day, you might want to break up the feeding so you're giving a second meal before nadir during each 12-hour cycle.

She's not on insulin at this point. She's OTJ. So if she's hungry it's not the calories wise but the stress of being really hungry that could cause her BG to rise. If I don't see a difference with FF I will go back to Friskies. It makes no sense that on FF she's has skyrocketing numbers in the AM but on Friskies she has consistantly been under 200 in the am. If Friskies has more carbs why is her BG Rising in the AM so much with FF? I don't get it.

First, if a cat's numbers are consistently above 120, and at times close to 300, I would get your kitty checked by your vet. Those are not normal BG numbers. If this was my kitty, I'd want to make sure there's no infection or inflammation or pain (like from a dental issue) that's effecting BG values.

There are some cats that have better numbers if they are on a low carb food that's in a higher range. It may stimulate the pancreas to work a bit harder so that numbers are better.

Just one other thought. Are you feeding fish flavors in the FF? If Lucky is allergic to fish, it may be causing an immune response that's causing BG to rise.

And some of the fancy feast flavors have fish in them even though the name doesn't suggest it is in there too.

No the Friskies that I've given her is Ocean White Fish and her numbers were lower. So I don't think it's an allergy. Right now no vets are open. I've already had her into the vet and she does not have a UTI. I tried to check her teeth and I don't see any signs of something that would cause an infection. I thought of infection as a cause but if it was an infection, her numbers would not go down in the pm at all. But I know that pacreatitis can cause a cat to have high blood sugar readings. But she is showing NO signs of that at all either. And usually on wet food it tends to get better. I know she has seasonal allergies and right now they are digging up across the way widening the highway. It's been driving my allergies nuts. I've checked her ears. She does have a little gunk in there but nothing that would suggest an infection. She acts normally. Her urine out put has gone down from like 4 or 5 times a day to about two. And sometimes they are a lot smaller, and other times they are a little bigger but MUCH better than she had been before being diagnosed. She is more playful, and I notice she's been loosing some weight.

How much does insulin usually cost? I've tried looking online and I get ranges from $194.99 to $39.99. The later I can afford, the other....no way I can afford that. NO way. Second question is my grandmother was never on insulin at all. She took a pill that helped keep her blood sugar down along with diet. Is there something like that for cats? Or is it different because it's an animal and they need the insulin.

There are three types of insulin that we recommend for use in cats

Lantus (glargine)
Levimer (detemir)
Prozinc

If you go with Lantus - be sure to get a prescription for the solostar pens and then go to the Lantus website for a coupon to purchase the pens at $25 each. The pens are usually sold in a box of 5. Some pharmacies may be willing to sell one pen at a time which will help if cost is a concern.

http://www.lantus.com/sign-up/offers.aspx

When completing the offer, be sure to list your cat's name, your last name, and that it is 18 years old -

Also, please take some time to read the information on the Insulin Support Group forums to better understand how these insulins work.

viewforum.php?f=5

I would go with Lantus and use the coupon like Hillary said.

The pills dont work well in cats - they stress the cats pancreas to produce insulin and damage it even more than it already is and the cat ends up on insulin anyway with no hope of remission.

Wendy

Well I'm going to try my experiment the next two days. I'm testing her again at 10:30 to see if her blood sugar went up or down. If it's gone down and back in the 190's. Then my theory may be right that stress had something to do with it. Then I'll feed her some at lunch time noon, and test her around 5pm and feed after. Then I'll set an alarm for like 2 am and give her a little something to eat. Then test at 6am tomorrow and see if her numbers go down getting more meals. I know that if a cat is stressed for any reason the BG numbers will go up. Don't know about you, but if I didn't eat for 12 hours, I'd get absolutely starving. If my theory is right that she's really really hungry causing stress, then her numbers should stay lower. But I will call the vet and see if he'll prescribe latnus, and research what is the cheapest way to go. She may need insulin to start and then after a while may no longer need it. I was hoping just to have a food change, but maybe that's just not going to work out right now.

Also are there any supplements that help the pancreas? Like there are supplements or herbs that help the liver and kidneys. Just wondering.

You can't treat the diabetes with herbs or supplements or vitamins. If you use the pills, for example glipizide, like your grandma did, you run the risk of permanently damaging the pancreas and having your cat always need insulin. Success rate at one year on glipizide in cats is somewhere around 20%. Success rate with Lantus insulin in 6 months is >90%.

Cats are unique. They can regenerate the damaged cells in their pancreas and start to produce insulin on their own. In order to do this healing, they need the support of some insulin shots, low carb food and lots of love from you.

Food raises the BG, insulin lowers the BG.

If you are going to test, it's best to test about 3 hours after the food, to see if Lucky's pancreas is producing some of it's own insulin. You also need a test before the food so you can compare the 2 numbers. Remember, there is meter variance so two numbers that look different may actually be in the same number range and equivalent.

Being hungry does not cause the BG numbers to go up. Being hungry does not cause stress. If you did not feed your cat at all, the numbers would go down. You have to feed your cat, she needs to eat something.

The numbers will vary because your cat has played more or less, eaten more or less food, spent longer or shorter time eating the food you give, changes in your home, infection, inflammation, stress from a visitor, seeing something outside your home that scares or excites your kitty, slept more or less. Too many factors to name that you simply can not control.

You need to think about insulin soon for Lucky. The food change has not been enough to bring her numbers down into a normal range. She needs some insulin to make her feel better.

Would you please go to your first post, edit it and remove the 911 icon. This is not an emergency and we reserve that 911 icon for cat's in physical danger or potential hypoglycemia. Thanks.

High numbers are not immediately life threatening. Low numbers are.

There's absolutely no point obsessing about her elevated numbers. She needs insulin before the high glucose begins to damage things permanently.

The higher cost Lantus are good for about 6 months, so divide that cost into a monthly amount. If you can do mail order or drive up to Canada (with a prescription), that may be less expensive. You may find some on Craigslist, but check expiration date and how it has been handled (refrigerated if opened, stored in non-moving shelving.

The lower cost insulins like Humulin, Novolin, etc, only last 6-8 hours in the cat, may require dosing every 8 hours, and have steep onset and wear off quickly (think roller coaster and how it would feel to bob up and down like that 3 times a day!)

Continue feeding low carb food and spread it out into mini meals so it doesn't hit all at once. See the vet and get the Rx and do what you have to do.

I did test her again after the food it's been about 3 hours or so and her reading was WAY down it was 166! And that was after struggling to get it. I had to put her in a towel to get it this time. She did try biting me. When I was testing her once a day it was SOOOOO much easier. When I have to test her before and after eating it gets really hard. And I really need another person. One to hold so she doesn't move and me to get it. I felt bad for her so I gave her some turkey meat. She loved that.

Turkey is great, very low carbs :smile:
So she dropped from 297 to 166 three hours later? That's good as well. It would appear that something is happening, her system is trying to self-regulate. 166 is still above normal, but a lot better than 297.

If you can get a 'script for Lantus, you may be able to find a pharmacy that will sell solostar pens individually. I think they usually come in sets of five. That could reduce your cost significantly.

I think Hillary gave the $25 lantus coupon info above if you want to read back?

Well I can call my vet for a prescription for the Latnus and maybe specifically state I want the solostar pens. But won't be able to get a prescription probably until Tuesday unless I bring her into an ER vet. I can try calling and see if he'll call in a prescription for the solostar pens to like walgreens.

You might want to call around a few different pharmacies as not all will sell the pens individually.

Yes, we think Lucky needs some insulin. No, I do not think it's so urgent that you need to go to an emergency vet to get the prescription. It can wait a couple of days, until your regular vet is open again. After the holiday weekend. Just my opinion.

Her body is definitely doing something to produce at least a little insulin, if the BG dropped from 297 to 166 in 3 hours.

Okay called the vet. He said there was an oral medication we could start her on to help. It sounded like he said acadabos or something like that. I said that I was told oral does not work for cats and insulin is needed. He said that he has many cats at his clinic that are diabetic and are on the medication and that tolerate it very very well. He said this was something new that came out. He said the injectable pens are costly. (and I've called about 10 pharmacies around here and all say I need to buy them in a pack. They come in packs of 10 or 20. At $25 a pen. Yeah...no that's way too expensive. He said there was something else he would order that also just came out I think he called it petsalin? like insulin but with pet instead of in? No clue. He didn't know how much it would cost. But said he'd call in the prescription tomorrow to the pharmacy of my choice to see if they had the oral stuff. I said to hold off on the oral and I'd call him back. The oral stuff was not something that was a human medication for diabetes. I checked online for all the oral diabetes medications for humans and it wasn't one of those. So not sure what the heck that was but it sounded like A-KA-Da-Bos. Maybe someone here will know what he's talking about . Have no clue!

Was the pills glipizide? That's not good if your goal is good regulation or remission. Might work short term. Causes more damage long term.

The other insulin he was talking about is vetsulin. That's better.

Wendy

I think you mean Acarbose.

From Wikipedia article on Diabetes in cats

Pills

Oral medications like Glipizide that stimulate the pancreas, promoting insulin release (or in some cases, reduce glucose production), are less and less used in cats,[14] and these drugs may be completely ineffective if the pancreas is not working. Worse, these drugs have been shown in some studies[15] to damage the pancreas further, reducing the chances of remission for cats. They have also been shown to cause liver damage. Many owners are reluctant to switch from pills to insulin injections, but the fear is unjustified; the difference in cost and convenience is minor (most cats are easier to inject than to pill), and injections are more effective in almost all cases.

Click to expand...

From the Merch Veterinary Manual

The use of oral hypoglycemic agents (glipizide) has been evaluated in diabetic cats. Glipizide is a sulfonylurea that stimulates the release of insulin from functional β cells. Glipizide should not be used in thin or ketonuric cats when absolute insulin deficiency is likely and exogenous insulin administration is required. Glipizide is administered at an initial dose of 2.5 mg, bid, PO, in conjunction with dietary management. Clinical response is seen at 3–4 wk. Short-term success is seen in 50% of treated cats, with longterm success rates (>1 yr) of ~15%. Alternatively, glimepiride and glyburide (other sulfonylureas) may be administered to cats at 2 mg/day (glimepiride) or 0.625 mg/day (glyburide). Acarbose, an oral α-glucosidase inhibitor, has also been used in cats at a dose of 12.5–25 mg, bid-tid, in conjunction with diet and/or insulin to control hyperglycemia.

Click to expand...

Success rates with the oral hypoglycemic is dismal (15%) and causes more damage to the liver.

The 10-20 count you are quoting from the pharmacies sound like insulin syringes, not the insulin itself. Ask about the Lantus Solostar pen. Those are sold in 5 packs. Some Target stores will split them up, some Wal-Mart stores will split them up, try hospital pharmacies. Mom and Pop pharmacies. It's up to the individual pharmacist.

I found this.. http://petdiabetes.wikia.com/wiki/Oral_medication

I agree with deb, the pens themselves are only sold in packs of 5, which some pharmacies will break into individual pens. Make sure you are asking for the lantus solostar insulin pens. Sounds like they are getting confused.

Wendy

Acarbose is probably what it was, but that's not how he pronounced it. Is the vetsilin good? which is better vetsilin or latnus? Which has a beter success rate of cats getting off insulin and how long does it last? Will I have to give her insulin 2x a day? When calling about the pens I specifically asked for the solostar pens by name and that's what I was told. I only have one mom and pop pharmacy in town. And they are closed until tuesday.

Is the vetsilin good?

Click to expand...

The Vetsulin was developed for dogs. It does not usually last long enough in cats with their faster metabolism. Success rate for remission for vetsulin is 20-30%. Success rate of remission for Lantus is >90%. No guarantees of remission for any cat, but it's worth striving for in my opinion.

Here is what the slideshow from the University of Queenslandhas to say about Vetsulin.

Good clinical but poor glycemic
control in many cats
• Vetsulin/Caninsulin : Porcine, Lente
• Registered for Vet use – Europe legal
requirement that 1st insulin used
• Many cats good control of signs q12hr
• More accurate dosing
– 40 U/ml versus 100 U/ml
• More predictable than PZI
• In most cats has too short duration
for excellent glycemic control q12hrs
• Remission rates 20-30%
• 4th choice insulin for cats

Click to expand...

which is better vetsilin or latnus?

Click to expand...

Lantus has the longer duration and the better success rate.

Which has a beter success rate of cats getting off insulin and how long does it last?

Click to expand...

Lantus has the better success rate. I know a vial of Lantus can stay good for 4 to 6 months with proper storage, the pens can be usually be used to the last drop and the Lantus insulin has a duration of 14-20 hours in a cat. Don't know how long a vial of Vetsulin stays good for. ETA: the manufacturer website says 42 days before you need to throw out the vial and buy a new one. Duration in most cats is <8-10 hours from what I remember reading.

Will I have to give her insulin 2x a day?

Click to expand...

Any insulin needs to be given 2x a day, for the best control and chance of remission.

I tried to read the insulin message board but a lot of terminology is lost on me! How do you know how much to give? Is it based on test before giving insulin? Is there a chart somewhere that says readings between such and such give so much insulin? Or do you have to do trial and error. give a little and see how it goes. Start low and slow? Just scared. Don't want to give her too much and have disastrous results.

Also called the vet and he is ordering the latnus. He said it would take a few days to get it. I know it will be more expensive through my vet but this is the initial vial. The rest will be through my regular vet. She isn't open until Tuesday and it would just take longer. So I figured because he is the diagnosing vet I would order first through him, and then try to find it elseware cheaper.

It's ok. There are various protocols you follow based on what kind of insulin it is. We can totally help with it, and even recommend a nice safe starting dose... But first, get your insulin. Lantus would be best.

Wendy

Updated my post on the life of the Vetsulin. See above. Manufacturer says 42 days before you need to toss the vial and start using a fresh vial.

Sorry I missed the bit where you said you were getting lantus. That's good news but its probably going to be expensive like $100+. On the bright side, contrary to what it says on the label, it will last you for up to six months if you keep it in the fridge, don't shake or roll it.

Your vet may recommend a starting dose but What weight is she? Would you say that was her ideal weight? Let's us calculate a starting dose too..

Although given her numbers are borderline, You might not want to be giving any more than 1/2 unit to start. Which means you will need to get syringes with 1/2 unit markings ie the below.

For U-100 syringes (Lantus, Levemir), get 3/10 cc, half-unit marked, short needle, 30-31 gauge
ie
Relion 3/10cc 30 & 31 gauge short
BD Ultra fine 3/10cc short
Terumo Thinpro Insulin Syringe 31G 3/10cc
Kroger 0.3cc 8mm, 31 gauge

Let me know on the weight..
Wendy

She weighs 13.2lbs right now. Her ideal weight is about 9-10lbs So she's three lbs away from ideal. She is continuing to lose weight on the wet food. I give her a whole can of FF and she eats like 3/4 of it and takes her the rest of the night to clean it up. I plan on getting up at 3am to give her half a can of FF and then up at 6am to test her. I'm gonna be tired in the morning if I do this. But it's the only way I know she's gotten food, and i know when she's eaten it and when I can test.