Hello. Looking for advice for my boy, Dexter. I will try to post my original thread below. Please let me know if it doesn't work. I have transitioned Dexter to eating only canned friskies pates, but I am concerned that I have not doing enough to get his diabetes under control. Hopefully my spreadsheet updated. I just updated it but not sure if it saved. I'm very concerned because his numbers are so high and for the first time tonight, I got a positive indication for ketones on our blood test. Before, ketoSense said "low," but tonight it says 0.4 and as you can see, his blood sugar has been pretty high. There have been some days with really low numbers, though, so I am afraid to increase the insulin dose. I'm trying to do the "Start Low, Go Slow" technique, but I'm worried that I'm doing the wrong thing. All advice appreciated. I'm worried that even with the switch to low carb food, he is not headed in the right direction. https://www.felinediabetes.com/FDMB/threads/stalling-please-help-resolved.254326/#post-2865912
Hi, I don't think I have enough experience to give advice. Has he had DKA before? Is he eating well and getting enough calories? Is he showing any other symptoms? Here is a link about ketones https://www.felinediabetes.com/FDMB...and-diabetic-cats-a-primer-on-ketones.239971/ When my cat had DKA I found ketones testing his urine with Ketostix and anything trace and above is a concern. I don't know about ketones in the blood though. If no one else responds soon perhaps call your vet. I know it can escalate quickly. Christine
Hi. Dexter is bouncing from that low of 52. He’s on too high a dose. He earned a reduction yesterday by falling under 68. His bg of 52 was too low. If you ever get a test under 68 you need to feed and test again in 30 minutes. He could have gone into a symptomatic hypo which can be life threatening. His new dose is 1.25. You don’t go back to 1.5 unless he shows that he’s not getting enough insulin. Lantus is dosed based upon how low it takes your cat, not the amps or pmps if high. Please read the basics sticky. Has he ever been DKA? https://felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/
Hi Rena When was Dexter fully transitioned to low carb canned food? That 51 on 11/1 indicates that the dose of 1.5U is too high for him. I suspect the higher numbers you are seeing are him bouncing from going too low. With SLGS, you reduce by 0.25U every time the numbers drop below 90. Considering you saw 51 after multiple skipped doses in the last few days, I would drop his dose to 1U and see how he does on that. What is your schedule like? Will you be able to get at least 1 test every cycle sometime between +2 and +6? It would be useful to see how low he is going on the dose so that dose adjustments can be made accordingly. @tiffmaxee
@tiffmaxee we cross-posted! Rena, could you please take out the latest labs from your signature and input it in the sheet titled "Labs" in your SS? Thanks!
I will have to read through the basics again. My vet of course suggested that we up his dose because of the high numbers. It is so confusing getting conflicting advice from the vet and here, but obviously what the vet has been telling me for the past 5 years is not working. He was originally diagnosed back in 2016. His Fructosamine level back then was 606. In the meantime, he has overall done very well on dry food and pretty high doses of insulin. Like 3 to 5 units every 12 hours. For the past 5 years, his Fructosamine has been good, so I thought his diabetes was controlled well. Then, last month, when he went in for a regular checkup the Fructosamine was over 500. He had also been drinking a lot more water. The vet at first said to just increase the insulin, which I did, but after the Fructosamine lab came in, she told me to switch him to low carb food. We have been gradually transitioning from kibble to low-carb food and I just removed all dry food from the house a few days ago. He is now eating only Friskies pates and freeze dried chicken treats. Does anyone have a link for syringes that will show .25 of a unit? I have a hard time seeing 1.5. so, is the consensus I should go to one unit or 1.5? How long do you think before his blood sugar never start to go down? I just looked through all of his medical records and I don't see any indication of ketoacidosis previously. How concerned should I be about the 0.4 reading on the blood test meter? What are signs to look out for for ketoacidosis?
Lantus dosing is not based on the highs but on how low the dose takes the cat. On 1.5U, Dexter dipped to 51 which is low. Anything below 68 on a pet meter is too low. What happens when the dose is too high is the cat's body fights to stay alive. The insulin may be trying to drive the blood glucose down too low and the liver and pancreas will release stored hormones and sugars to bring it back up fast so too much insulin can actually look like it's not enough insulin! That is why we recommend getting mid-cycle tests to see how low the dose is taking the blood sugar. You could try 1U for a few days and see how he does on it. 1.5U is definitely too high. We use syringes with half unit marks to draw doses. There aren't any with 0.25U markings. You can buy ReliOn syringes from your nearest Walmart. You want the 30 unit syringes - they come with half unit markings. You can also buy syringes online at www.adwdiabetes.com. Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones
Here’s information on DKA. https://www.felinediabetes.com/FDMB...and-diabetic-cats-a-primer-on-ketones.239971/
Update: This morning he was at 321. I administered one unit. Prior to his p.m. shot, I tested his blood sugar and it was at 90 so I did not give any insulin. Should I stick to one unit? Also, I did the ketoSensetest again and it went down to 0.2 so hopefully that is good.
