Sudden jumps in BG readings? - Need Help

Hello all,

Today is approx Day #10 for Pearl on Lantus (newly diagnosed diabetic on 12/21, 4 days in hospital some of which was on IV insulin).

Until today, her readings have been pretty stable/predictable. Then, all of a sudden today they JUMPED. Now they are in the 400s (which of course scares me b/c she is prone to the high numbers, she was diagnosed at 500 with stumbling, not eating and drinking, significant dehydration - this is why she was hospitalized on 12/21). Nothing has changed diet-wise or stress in the house since she returned from the hospital on 12/25.

Is this normal? What could this be from? Is it normal for things to change like this with Lantus? She is on 1 unit twice daily. Tomorrow is her first curve.

What do I do if her sugars get really high in the middle of the night?

Her BG chart link is in signature. My vet asked me to try to NOT take as many readings for now (as you will see) since Pearl is prone to internalizing stress and getting a lot of anxiety.

Thank you!
Margaret and Pearl

 

Hi Margaret

There could be a couple of things:
-Sometimes a dose goes ‘stale’ meaning that a dose that use to bring nice numbers doesn’t anymore
- If a cat goes low, sometimes they will ‘bounce’ (jump into high numbers). By not getting any pm tests you are missing half of your data. Pearl may have gone quite low during the night and now bouncing. Most cats do go lower during the night. It’s best to get at least a test before going to bed.
-I can’t see what kind of food Pearl is eating. High carb food or getting into ‘contraband’ can send numbers soaring. Could she have gotten into something she wasn’t suppose to?

Another thing you will want to be checking regularly is ketones. Did she have ketones when she was admitted to the hospital previously?

You can help reduce stress when testing by giving her a treat prior, during and after a test. I use freeze dried chicken treats and crumble them up.

You are doing a great job getting the spreadsheet set up, doing testing at home and giving shots. Hopefully Pearl will start associating test time with treats and it won’t be a big deal. When Freckles was first diagnosed, it took 3 employees plus the vet to try and get a blood droplet for testing and they still couldn’t do it so they had to sedate her. It only took a few days at home for her to come running to the bathroom (testing room) and jump up on the counter to get her test treat. No big deal anymore.

 

Hi Judy,

Thanks for your message and for the tip about "bouncing", that is new for me, and thank you for bringing that issue with no PM tests to my awareness. What causes the cat to go low? Is it possible not enough food, that's why they go low?

Pearl is eating the Wellness Core Turkey and Duck (5% carbs) - one 5.5 oz can daily - and gets some Fussie Cat Tuna and Anchovies for snack (0 carbs). The only contraband she may have gotten into this morning was 1 pebble of my other cat's Royal Canin HP (I keep the HP with me in the bed so I am aware of who is there and eating - Pearl doesn't really like my other cat, so she stays out of the bed, whereas my other cat stays IN the bed).

I didn't know about checking ketones regularly. She did not have ketones when admitted to hospital on 12/21. She was primarily admitted due to approx 8% dehydration and quite low potassium numbers (I am very skilled at home caring for seniors - but not diabetes -, but my vet told me even with all my experience I wouldn't be able to correct the hydration and potassium deficit at home at that point). She also has complications of chronic pancreatitis, IBD, and a bout with focal peritonitis (terrifying) in October, so she needed to get an ultrasound also to see what else was on board. Thankfully, this was only a diabetes issue, but that means the dehyration, stumbling, not eating/drinking, low potassium were from the diabetes. I personally think she was close to the ketones (from looking at symptoms of keto acidosis).

I will go get the ketone strips. I know to wad up some plastic and put in litter box where she pees to try to catch a few drops. I somehow felt that since she was getting so good at being regulated on the Lantus (prior to today ugh), that we were coming down and she would never need the ketone strips. It's like I viewed this as a linear journey (i know, laughable).

I need to find some treats Pearl likes. She is not really a treat cat. So far it's just the Fussie Cat fish (which I really don't want her to have due to the IBD, but I haven't found a substitute yet). Thanks for this tip.

Oh good grief - I laughed at Freckles' story! Pearl is pretty mild, she lets me take the blood droplet and I always try to sing her a song afterwards about getting some breakfast so then she knows to go into the kitchen to eat. But I need to get more "treaty" type things so it's not always a meal.

 

Cats can go low from: too high dosage of insulin; not eating and have already been given the insulin; given the insulin injection but then vomited; when the caregiver gives a furshot or partial furshot (so not all of the insulin made it into the cat) and the caregiver gives a second shot - NEVER do this because you cannot tell how much insulin went into the cat; sometimes the pancreas starts working better and secretes more “natural” insulin; sometimes another household member gives the shot without telling anyone and the kitty gets a double dose; and sometimes they go low... well just because they are a cat and can!

Another way to catch a urine sample is to use a soup ladle under the butt to catch the stream when kitty is in the litter box. Freckles always gives me the look of “Umm excuse me, but this is my private time!” Lol

Pearl is still showing a bit too high of numbers to be considered regulated. Ideally she would be in the “green zone” consistently.

Since Pearl has a few other health issues, I’m going to tag some more experienced people who have lived the feline diabetes dance + other health concerns with their fur baby. They will likely be able to offer some observations/advice to help you and Pearl out. You’ll want to add any and all health conditions to your signature line so you don’t have to keep telling everyone.

You are doing a great job in helping Ms Pearl. She’s lucky to have such a good mom!!


@Bron and Sheba (GA)
@Wendy&Neko
@Marje and Gracie
@Sienne and Gabby (GA)
@Sandy and Black Kitty

 

@Judy and Freckles, Margaret has a thread on the lantus forum on the same topic and has had several responses. Maybe one of the moderators will combine the threads.

 

Linking that thread here with a request to @Wendy&Neko to merge them. Thanks!
https://www.felinediabetes.com/FDMB/threads/sudden-jumps-in-bg-readings-need-help.240968/

 

Thanks for tagging all those folks for me. This morning Pearl's numbers were abnormally high for her (again) - low/mid 400s. Last night she got down to mid-200s. With such a wide spread, (first of all I have no idea what is going on - no contraband foods etc), is it plausible these wide swings can be from improper dose of Lantus? I mean, I know my vet wants to increase dose at this point, but I am nervous because her low numbers aren't atrocious, but the high ones are. Thanks for your advice!