? Dora stuck in the 300s - am I the problem or is she?

Hi everyone -

Well, we moved and my dog is very sick, taking a lot of my focus away from Dora. We had been testing Dora and keeping her fairly steady at 1.75 units with mostly numbers that looked good at preshot, an occasionally super low number which would worry me but she would always bounce back up. Then she started going a little higher. I thought maybe it was the Friskies, so switched back to FF but the numbers would sometimes come down for a day or so and then go back up. I didn't really track her numbers during this time as things were just crazy and she was doing ok.

I have tried to patch together a spreadsheet with data from the two meters (and one one-off human reading due to a strip shortage) and some notes that I took for the past couple of weeks. I don't see that I took many readings the day before I raised her from 2.25 to 2.50 but I do remember every time we tested her she was in the 300-400 range.

The other day I pulled a syringe without half unit markings and it confused me and I only gave two units (meant to do 2.5) and she was high that evening. We were gone all day at the vet with the sick dog, so couldn't test her. We have been trying to get more tests lately and they're what I have attempted to log in the right places. I don't think she has ketones. It's hard to get her to perform so I stick the strip in right after she goes. The sugar always registers and the ketones do not. She eats well.

My plan was to keep her at the 2.5 and do a curve on Monday. If no change I want to see about getting her in to the vet. She hasn't been since she was diagnosed in April and although she seems fine, what if something else is going on? She is young and in otherwise good health, though. Am I missing with her shots? Why would this be happening? I feel like I'm letting her down, like this should not be so hard to get right :-(

I don't have a vet for her is the problem - since we have moved two hours from her last vet. She is a terrible patient who turns completely wild feral when she gets freaked out. I need a nice calm vet who can cajole her into most of the things they want to do. She tends to draw the line at blood work, though, and has required sedation for that; which is why I am always slow to take her in. She also has a hole in her heart so I am extra cautious about sedation.

Thanks everyone - happy new year.

 

Hi, just wanted to offer some supportive words. Please don't be too hard on yourself, this is such a stressful, difficult, and unpredictable condition at times and you obviously care very much for Dora and your dog. If testing regularly is too difficult for your schedule, I wonder if a freestyle libre could be an option? That way you can simply scan to get a reading instead of dealing with ear pricks and you can sync it to an app so you'd have all the readings recorded.
I wish I could give more advice on dosing but I unfortunately do not have the experience.
@Bandit's Mom I see you are also doing SLGS, any advice here or know who else can help?

 

Thanks - when she last was fluctuating the vet wanted to do a Libre. I just don’t know how she’d react to having that on her. She has a lot of sensory issues with being touched and petted and poked - I may have to do it but she’s also one of those “anything that can go wrong, will” cats so I’d rather try to test a little more if needed. But a Libre might be helpful now. Thanks again for the encouragement. She just ate some of my dog’s rice and sweet potatoes so

 

Hi Jane,

Welcome back to FDMB. I think this was your last post here:
https://www.felinediabetes.com/FDMB/threads/dora-10-11-pmps-114.236732/

Sorry to hear about your dog being sick. My civvie has been sick with bad diarrhea and I find that I am forgetting to keep track of what Bandit has eaten and when.

I guess you won't be surprised to hear me say that you need more tests to see how low Dora is going on 2.5U. Like I explained on FB, the high numbers you see could be because Dora is bouncing from low numbers that are not being caught without tests. A lot of cats go low at night and bounce in the day. Lantus dosing is based not on pre-shot values or how high the cat is going but on how low the dose is taking it.

If she is fine otherwise and its only her BGs that are high, I would get more tests/data to see if she is bouncing or if she needs more insulin. I'm not sure how much help a vet can be without BG data. A curve at the vet would only give you elevated values on account of stress. We have found home testing the best way to keep our cats safe.

A curve sounds like a good idea. Or....would it be possible for you to get a couple of tests in addition to the pre-shot tests for the next few days? It's just that if you pick a day when she is bouncing to do a curve, you will just see flat high numbers.

I am sorry that we cannot offer a ready solution, but I am sure with some tests over the next few days, we would get a better idea of why the high numbers and what to do about it. Please do not increase the dose without more data!

And do keep checking for ketones!

 

Thank you! This is a helpful reminder and encouraging, but - I’m still nervous. My reason for a vet visit would just be wellness check to be sure there’s no infection. What if her teeth have gotten worse from lack of dry food, for example?

She was over 400 this morning and then I remembered I caught her eating the dog’s leftovers which included sweet potatoes and rice. How long does it take for carbs eaten to stop affecting glucose? And she needs a new vet so it might be best for her to have a low key get acquainted visit. If her first experience includes blood work she may never go there happily again. And with covid I don’t get to see how she behaves.

Do you think I should go back to the 2.25 dosage? It seems like we are actually seeing more highs on the 2.5? Anyway we will try to get several readings over the next few days. Dora cooperates, but only to a point. How many/what intervals do you recommend at minimum?

Thanks for your patience and explanation-I know I don’t comply much of the time but it’s not Dora’s fault!

 

Dealing with two sick fur babies is a lot to handle. Don't be so hard on yourself.

Here's an interesting discussion that took place here on dry food and dental health - https://www.felinediabetes.com/FDMB/threads/01-09-chnoudi-dental-health.241235/

Like I said, it is difficult to know which dose works for her without enough data. Pick one dose (maybe lower will be safer - cannot say without data) and try and get some tests over the next week? Are you at home to be able to test her?

And feel free to ask as many questions as you want!

 

It is hard for sure, but one thing I know is that Dora has the higher likelihood of a better outcome . My dog was at death’s door but a few weeks and several thousand dollars later, he is still with us for however long. Thanks to a Facebook group for recommending a diuretic switch. The vet didn’t do it until I asked. I actually had to have him seen by a cardiologist through emergency to get it done. Anyway, he is my very best pet ever but this is really wearing me thin.

Interesting on the teeth. I admit to not taking the best care of my pets’ teeth. One of my cats had a bunch pulled and my pom had one cleaning a few years ago but his teeth are abysmal- I have been trying to brush them recently but he’d need a lot more than that to remove what he has.

Anyway - we will keep at it for a few days and maybe I’ll just take Dora for a meet n greet at the new vet.

thanks again!

 

Don't do the curve at the vet even if he/she recommends it. You will get more accurate results doing it at home. And like I said, a couple of extra tests a day would give you better data than a one cycle curve!

Good luck with the new vet!

 

Oh I would never leave her for a curve! Her last vet never even tried to suggest it. She was actually pretty good with us although I stopped calling her because we’d get into a “whisper down the line” situation where I’d leave a message and her tech would call me back with a canned response, and she wasn’t able to answer any follow up questions. In the end, I got the sense they thought I was a little crazy for testing so often and making my own decisions so I just ignored them and they stopped reaching out. On the rare occasions that I did get to speak directly to the vet, I liked her very much. It’s too bad their business model was such a gatekeeper model. The cardiologist is at the same facility and I can email and she herself calls me back. I wish I could let that other vet know how this cost her a client. Even if we had not moved away I’m not sure what I would have done next. And it’s far away but close enough that I’d drive for a great vet.

 

Hi from another fiesty/fractious cat owner Jax thinks the vet has 100 heads and we tried gaba last week for a dental consult and he did pretty good - gave me some hope! Admittedly I don't know risk for Dora's heart condition but here's an article on it to look into https://fearfreepets.com/study-gabapentin-reduces-stress-cats-veterinary-visits/

 

Thanks- it’s been suggested! I will have to first find a new vet we like and then I’ll see how it goes