New member. Constant high reading.

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Susan and Toby

Susan and Toby

Member
Hello,
I'm glad I found this group!
My cat Toby was diagnosed 2 months ago after a trip to the ER with keto acidosis.
He was able to stabilize after spending 3 nights in the hospital. Since then he has tested with the Freestyle Libre consistently "HI"
for most of the day and evening with dips or bounces down to 250 for a couple of hours. His vet has adjusted his dose from 2 to 2.5
to now 3. Mostly the same pattern although he is dropping to under 200 for a few days the past couple of weeks. On 10/31 he bounced to 50. Since then he has not budged
from "HI" at all. Other then the fact that his coat stands out and he is losing weight,
clinically he is doing very well. Question is can a cat consistantly stay a such high numbers and be OK?
Thank you.
 
What food is he on?

If he went down to 50, which is a very low number and much lower than what he’s used to, he could now by bouncing as his body is trying to protect itself from going that low again. Here’s what we call bouncing. It's a kitty's self defence mechanism. Here is the description.

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).
 
Hi and welcome to the forum.
After having diabetic ketoacidosis (DKA) it is very important your kitty eats well all the time. How is Toby’s appetite?
What food are you feeding him?
Are you giving him snacks during the cycles as well as before the insulin doses?

Are you testing for ketones at all? It is also important after DKA that you check for ketones in the urine, as this is your early warning system to tell you if things are going well or not. We don’t want to see any ketones at all. To test for them you will need a bottle of Ketostix from Walmart or a pharmacy, and follow the directions on the bottle after collecting a urine sample from Toby.

What insulin and dose are you using?

I am going to give you a link to our spreadsheet and signature here…HELP US HELP YOU
If you could set those up and add some blood glucose data from your freestyle libre, that will allow us to help you. It does sound as if you need help with dosing. Dropping to 50 and then having high numbers is bouncing as described in post 2 by Ale. If you have any trouble setting up the spreadsheet let us know and someone will help you.
I would not increase the dose further until we can see some data. Toby may need a decrease, not an increase.

We would not want to see Toby in high numbers all this time, but being high for a while is better than being too low for a minute. We can help you get Toby back into better numbers if you can set up the SS and signature and a fill the SS with a couple of weeks data.
Bron:)

 
Ale & Bobo & Minnie (GA) said:
What food is he on?

If he went down to 50, which is a very low number and much lower than what he’s used to, he could now by bouncing as his body is trying to protect itself from going that low again. Here’s what we call bouncing. It's a kitty's self defence mechanism. Here is the description.

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).
Click to expand...
 
Thanks you for the valuable information! His BG will take a nose dive from 400 to 100 or less on occasion and then a quick bounce back to high.
Feeding him is tricky. He has always preferred kibble.
He eats dry Purina pro. I am switching him to Purina pro wet or fancy feast but he usually just licks the food with very little eating
Ale & Bobo & Minnie (GA) said:
What food is he on?

If he went down to 50, which is a very low number and much lower than what he’s used to, he could now by bouncing as his body is trying to protect itself from going that low again. Here’s what we call bouncing. It's a kitty's self defence mechanism. Here is the description.

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).
Click to expand...
 
Bron and Sheba (GA) said:
Hi and welcome to the forum.
After having diabetic ketoacidosis (DKA) it is very important your kitty eats well all the time. How is Toby’s appetite?
What food are you feeding him?
Are you giving him snacks during the cycles as well as before the insulin doses?

Are you testing for ketones at all? It is also important after DKA that you check for ketones in the urine, as this is your early warning system to tell you if things are going well or not. We don’t want to see any ketones at all. To test for them you will need a bottle of Ketostix from Walmart or a pharmacy, and follow the directions on the bottle after collecting a urine sample from Toby.

What insulin and dose are you using?

I am going to give you a link to our spreadsheet and signature here…HELP US HELP YOU
If you could set those up and add some blood glucose data from your freestyle libre, that will allow us to help you. It does sound as if you need help with dosing. Dropping to 50 and then having high numbers is bouncing as described in post 2 by Ale. If you have any trouble setting up the spreadsheet let us know and someone will help you.
I would not increase the dose further until we can see some data. Toby may need a decrease, not an increase.

We would not want to see Toby in high numbers all this time, but being high for a while is better than being too low for a minute. We can help you get Toby back into better numbers if you can set up the SS and signature and a fill the SS with a couple of weeks data.
Bron:)
Click to expand...
Hello Bron and Sheba, thank you for your response.
Regarding diet and appetite: he has always favored kibble over wet food and would only eat a few bites of
wet. I have been trying to change this and he will eat
about a half of can. He mostly licks the food. Then I give him dry after that to make sure that he has enough for insulin. He eats Purina Pro or Fancy Feast (his favorite" He was anorexic before the Mirtazapine
and now it varies. His vet does not want him to eat between doses because he is so high. If I feed him between he won't eat prior to insulin. Plus I can only leave dry food because the two other cats will eat up the wet,
His vet emphasizes to focus on clinical signs and to only test him twice a day. He is like normal.
she never mentioned checking for ketones but to bring him in to vet or ER if he shows symptoms. Will be very difficult to get his urine with multiple cats but will try.
He has graduated to 3 units of Lantus gradually from one since August 27th when he was diagnosed
because his numbers were "HI" ( using freestyle Libre)
all the time. Hasn't changed much from this but
at least some drops. I will attempt to set up SS later today.
Thanks again for reading this long reply.
 
If you need help with the SS just ask and we will get someone to help you. Also the signature is important and that s easy….even I can do that :joyful:
Please do test for ketones at home. It is your early warning system that all is not well and it will save you a lot of money and Toby’s health. Ketones can be managed if caught early. By the time Toby is showing symptoms they will be high and we don’t want that. If testing the urine is a problem, you can get a blood ketone meter that tests for ketones the same way that you test for blood glucose. NovoMax Plus and Abbott Precision Xtra are two ketone meters.
Just feeding twice a day is an old way of treating diabetic cats. Feeding a couple of snacks during the first half of the cycles is better for the cat. Not feeding him because his blood glucose is high is not a good way forward. He needs food. You can’t stop a cat eating because the vet wants the BGs to be lower. That is not fair on the cat and not a good way to manage the diabetes. The way forward it to adjust the insulin dose to Toby’s needs
Are you still giving the appetite stimulant? Maybe he is nauseated? Have you ever given him an antinausea medication such as ondansetron or cerenia?
If he is dropping to 100 or less, and then goes up high, that means he is bouncing from the lower numbers that he is no longer used to. That doesn’t mean he needs more insulin. It means he has to get used to being in the lower numbers again. And that takes time.
Here is information on bouncing
  • 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).
Have you thought about trying one of the low carb dry foods? Here is information about low carb dry in post 4. I would continue to try and introduce wet food as well if you can.
I’m looking forward to seeing the SS
 
Hello Bron & Sheba
I will be receiving the NovoMax plus tomorrow.
What do I do if there are ketones Vet or ER ASAP?
Regarding food- his vet wants to start him on Hills Diabetic diet. Doubt if he’ll eat it.
Is this not recommended? She will be consulting an internist. I guess it is very unusual
to run over 400 consistently. He is not responding to insulin. Hopefully there will be a treatment plan that will work. I have been struggling with creating a spreadsheet.
I made one in September for a Facebook group and never followed up with it.
Was hoping to be able to start a new one for you and was unable to do so.
I need help with this. Thanks Wendy&Neko for the food link.
I am very grateful for all of your help.
 
No, the Hills diabetic food is not recommended. The majority of the vet "prescription" foods are either too high in carbs for a diabetic, or poor quality ingredients. Especially their dry foods. Try one of the lower carb foods Bron linked for you if you can't get him to eat wet.

Some low level of ketones is OK. Above 2 you should be concerned. More information here: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

Tagging @Bandit's Mom who can help you get a new spreadsheet going.
 
Susan Pressman said:
I have been struggling with creating a spreadsheet.
I made one in September for a Facebook group and never followed up with it.
Was hoping to be able to start a new one for you and was unable to do so.
Click to expand...
Hello Susan & Toby! Welcome to FDMB! :)
I can help set up your spreadsheet and signature. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.


Almost all dry food is extremely high in carbohydrate, and should be the first thing you get rid of. If Toby is a kibble addict, there are low carb options in dry food as well – Young Again, Dr. Elsey’s Cleanprotein and Wysong Epigen 90. You could start with a switch to one of these low carb kibble options and slowly work on transitioning him to a low carb wet food.
 
Last edited:
Susan Pressman said:
guess it is very unusual
to run over 400 consistently. He is not responding to insulin.
Click to expand...
Hi Susan
I can’t comment on Toby’s diabetes but you’re in good hands with everyone already helping…I’m just a new person also. I do have one thing to check though, not sure if you know but Toby wasn’t /isn’t anemic (low hemoglobin/hematocrit/rbc), correct? I ask because that can make a pet meter like the AT3 give higher numbers than they really are

the AT has a feature that can be turned on pretty easily that will notify you if the blood sample you are testing is anemic. If you’d like me to explain how to do that I can.

I hope Tony’s numbers improve soon (and that you can check his ketones) but I’m glad he’s acting ok.
 
Bron and Sheba (GA) said:
Hi and welcome to the forum.
After having diabetic ketoacidosis (DKA) it is very important your kitty eats well all the time. How is Toby’s appetite?
What food are you feeding him?
Are you giving him snacks during the cycles as well as before the insulin doses?

Are you testing for ketones at all? It is also important after DKA that you check for ketones in the urine, as this is your early warning system to tell you if things are going well or not. We don’t want to see any ketones at all. To test for them you will need a bottle of Ketostix from Walmart or a pharmacy, and follow the directions on the bottle after collecting a urine sample from Toby.

What insulin and dose are you using?

I am going to give you a link to our spreadsheet and signature here…HELP US HELP YOU
If you could set those up and add some blood glucose data from your freestyle libre, that will allow us to help you. It does sound as if you need help with dosing. Dropping to 50 and then having high numbers is bouncing as described in post 2 by Ale. If you have any trouble setting up the spreadsheet let us know and someone will help you.
I would not increase the dose further until we can see some data. Toby may need a decrease, not an increase.

We would not want to see Toby in high numbers all this time, but being high for a while is better than being too low for a minute. We can help you get Toby back into better numbers if you can set up the SS and signature and a fill the SS with a couple of weeks data.
Bron:)
Click to expand...
 
Toby's ketone reading tonight was 2.3.
I used the NovaMax Plus blood ketone monitor.
It is reported to be accurate.
He is eating very well, is not hiding and is alert.
Should I be concerned? Does this reading suggest that he needs to see the vet? I don't know if a regular vet can treat this or does he need to go to the ER?
 
Susan Pressman said:
Toby's ketone reading tonight was 2.3.
I used the NovaMax Plus blood ketone monitor.
It is reported to be accurate.
He is eating very well, is not hiding and is alert.
Should I be concerned? Does this reading suggest that he needs to see the vet? I don't know if a regular vet can treat this or does he need to go to the ER?
Click to expand...
Hi Susan, hopefully someone with more experience will respond soon. That does seem a little elevated, but it’s good that he’s eating and acting well. You could throw a post in the Lantus forum maybe more people would see it.
 
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