Help BS very high +4 and +6

Hi, I am hoping someone can help me with Sumo's BS. He was diagnosed 9 days ago and has been on Pro Zinc 1 unit bid. Strict low carb all wet diet. I am sorry I haven't had time to establish a spread sheet for him, but will do so soon. These are his readings since Monday. He is on a 12 hr dosing, and these numbers are preshot for 6 AM and 6 PM

9/19 am 384 pm 299
9/20 am 405 pm 298
9/21 am 376 pm 217
9/22 am 369 pm 383
9/23 am 415 pm 358
9/24 am 198

Yesterday I gave him 1.5 unit both AM and PM because of his high numbers. I know this is a NO NO but I couldn't wait. I was happy with this mornings reading. I decided to check +4.5 and +6.5 and was surprised at his readings.
At +4.5 it was 335 and then checked 2 hrs later at 6+5 it was 425 ! Can some one please guide me as to what I should be doing with this high BS.

Thanks Mary

Re: Help BS very +4 and +6

Hi Mary and Sumo,

This sugar dance is very confusing at first. It is all about collecting data and figuring out how the insulin works in your cat.

What will help you is to get some more mid cycle numbers. (Your +4 and +6 numbers today are helpful.) If you just work off preshot numbers, you may be missing the picture because you don't know how low the insulin takes him in the middle of the cycle. Because we have no numbers from the cycle before your lower amps of 198, I would guess he went down low overnight. Today's higher numbers can be bounce or rebound from a low number. His liver sees a low number he is not used to and releases glucose. Here is an explanation: http://petdiabetes.wikia.com/wiki/Somogyi_rebound

I am guessing that is what happened. If it is, then it would mean that your 1.5 dose could be too much. I would continue your testing today and see what happens with the whole cycle.

Some things that may help: We have a good document with info on PZI: viewtopic.php?f=24&t=32799 We have a PZI support group. It is a small friendly group with people who use or have experience with your insulin: viewforum.php?f=24 You could come over, introduce yourself and Sumo and get advice on dosing. I would suggest doing that before you dose tonight.

So rechecking at a 2 hour interval is ok?

Not only is checking at 2 hour intervals okay....it is what we call a curve, it is what a vet does when they have a diabetic cat in for all day testing...You can also run a mini curve which is checking every 3 hour for one 12 hour cycle.

If you look at Musette's spreadsheet you will see how often I test her. And before you ask, her ears are just as pretty as the first day I adopted her. Now granted she is on Lantus, so I'm no help when it comes to dosing with PZI, but testing...I do a bunch of it.

Mel, Maxwell, Musette & The Fur Gang

Yes. That will be helpful.

There is no chance he got into some dry food today? That is another possibility for sudden high numbers. Or it could be an inverse curve, with the highest numbers in the middle which is sometimes caused by too much insulin. (You see why we need data to figure out what is going on.)

Thanks Sue for the link to "the somogyi effect" It makes sense. I was stupid to increase his dose. I dropped off Sumo's BS numbers to his vet a few days ago and asked him to advise me on dosage adjustment, but I have not heard back. I guess thats when I felt I had to do something. Well this is a good learning lesson. I will get into your PZI board. Thanks, Mary

There are no stupid decisions here. :mrgreen: The data may yet say you need to increase or maybe increase by a smaller amount. It is logical to think high numbers need more insulin. Sometimes they do, sometimes they don't. This stuff is HARD! And you have to learn everything so fast!

BTW, are you also testing for ketones? With the numbers you are have been getting, it would be wise. Here is some info: http://petdiabetes.wikia.com/wiki/Ketoacidosis