Kayla finally on insulin after three years on low carb diet.

LoCarbCat

LoCarbCat

Member
Our female ten-year-old spayed Norwegian Forest Cat, Kayla was diagnosed with high blood sugar three years ago. We decided to put her on high-quality low carb, under 2% (Merrick, Tiki) food instead of insulin. She shed five pounds, got to her ideal weight, and was completely healthy and active for three years with her glucose averaging 290. Then two months ago she got a UTI. That lead to multiple rounds of ineffective antibiotics, which lead to weight loss, anemia, dehydration, DKA, and subsequent hospitalization. The sonograms also revealed a heart condition and bronchitis. She just got out of the hospital after four days of fluids, potassium, blood, etc.

She's on one unit of Glargine/Lantis two times a day. We had a Freestyle Libre installed. What we noticed when we got her home she's been eating ravenously, yet drinking and peeing normally. Also, her sugar has gradually gone up to 457 (although my AlphTrak3 says 387). When we brought her home 10 hours ago she was 253 on the Libre meter. But 457 is higher than before we used insulin! This is technically her seventh dose, but I personally did the first dose on her at home about eight hours ago and I saw no reduction in sugar. Maybe I messed up the shot? Is the meter ok? Is this normal?

We see our regular vet who we trust much more on Monday. The hospital's doctor seemed to push for all sorts of tests that didn't seem to lead anywhere. But since I have Trupanion I let them. Even though she's acting healthy, I'm still worried about these numbers. Any advice would be greatly appreciated.

All the best,

Stephen
 
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Welcome, Stephen and Kayla.

I am going to share @Bron and Sheba (GA)'s list of things you need to do to help Kayla. This is the same list that was shared with me to help my Kobe recover from DKA.
"
  • you need to give one and a half times as many calories as she normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If your kitty won’t eat the low carb food, feed her whatever she will eat as eating any food is better than not eating,
  • Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, don't feed and test again in 20 minutes and post and ask for help.
  • Test daily for ketones. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all. To test for ketones you will need to buy a bottle of ketostix from a pharmacy. Please get these asap as it is very important we know if ketones are present
  • Give antinausea medication if needed such as ondansetron or cerenia. Nausea is very common in post DKA kitties and it needs to be addresses immediately
  • Give appetite stimulant if needed after the antinausea medication
  • Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
  • Ask the vet about subQ fluids
  • Set up a spreadsheet and test the BG frequently
  • Post daily with updates and ask for help as often as needed."
 
LoCarbCat said:
But 457 is higher than before we used insulin! This is technically her seventh dose, but I personally did the first dose on her at home about eight hours ago and I saw no reduction in sugar. Maybe I messed up the shot? Is the meter ok? Is this normal?
Click to expand...

Infections can really wreak havoc on BG. The members on this forum can help you with dialing in the dose. It's great that you have the Libre and are testing at home.
 
Stephen --

You and your kitty have really been through a lot. On top of the last round of medical issues, I hate to point this out but normal blood glucose (BG) is in the 50 - 120 range. If Kayla's BG was averaging 290, she has been an unregulated diabetic for the past 3 years.

It takes about 5 - 7 days for Lantus to develop a depot and for the depot to stabilize. You may not see much of an impact of the insulin until then. It sounds like they started Lantus while she was hospitalized but it's also likely that if they were managing DKA, they were likely using a fast acting insulin in addition to Lantus. (It's often referred to as basal/bolus dosing with the bolus being the fast acting insulin.) There's a sticky note that describes the depot. It's one of the features of glargine that makes it such a good insulin for cats. You may want to review the sticky notes at the top of the board so you have a feel for the way Lantus works.

There can be other reasons that Kayla's BG spiked. Without benefit of seeing what her numbers have been looking like, I could speculate but that may be my shooting in the dark.

For right now, with a cat that's been through an ordeal and recovering from DKA, the biggest issues are making sure Kayla is eating and getting insulin. DKA results from an underlying infection/inflammation + not enough calories + not enough insulin. If you're not sure what to do at shot time, please post. You can post here (Lantus board) or on the Health board. We generally recommend that new members start out on Health.

Just so you're aware, the Libre tends to give false low readings if your cat's BG is below 100. In other words, don't panic if you get a suspiciously low reading. Use your handheld glucometer to check on the numbers. The AlphaTrack is also calibrated differently than a human meter and will read higher when compared with a human meter.

I'm also linking a post we refer to as helping us to help you. It provides information on how to set up and use our spreadsheet. The spreadsheet will allow you to view Kayla's progress and let us follow along and provide informed feedback. The post also provides information on what goes into your signature. The signature has basic information about your cat so we don't keep asking you the same questions repeatedly.

Please let us know what we can do to help.
 
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