Wednesday's numbers are climbing.

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alexia&wednesday

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Hi,

My cat has been diabetic since 11/24/09 when she went into DKA and was found to have pancreatitis.
Her numbers were great after she left the hospital and was on 1u BID. I don't have a chart, but basically she was about 270 pre-dose, and then about 115 at nadir.
A few weeks after this stability, her numbers climbed, mostly due to a non-diabetic diet she needed to be on because she was vomiting (i think it was because she hated the diabetic dry food, and was refusing to eating wet food), and we needed to convince her to eat with the ID diet from Hills.
Anyway, when she was on that diet her numbers were about 375-400 pre-dose, but she was pretty much flat-lining through the day when I would test her BG. It seemed that her numbers NEVER decreased significantly: 375 pre-dose, then 325 or so at nadir, back to 375 at her second pre-dose.

Now, she has been off this diet for a few weeks. She is still about the same. I have increased her dose to 2u BID and her numbers still are consistently high.
Recently, I have started giving her 2.5U BID, and that has started to drop her down a little, into about 300 pre-dose. But, that is not consistent...though it is becoming more so the last 2 days.

Can someone help me: WHY are her numbers climbing, despite being on a good diet (wellness grain free, with evo dry food for snacks)?
I really don't like increasing her dose, I feel like it means she is failing, and I was hoping her DM would go into remission!
I feel really upset about this. I hate the idea that she could be diabetic for life...

Thanks!

- Alexia & Wednesday
 
Hi there,

I've seen ur cross post in health, so assuming u are using lantus - is why u posted her right?

You might want to consider setting up a spreadsheet with google documents, instructions can be found in the Tech forum.
Did u start lantus back in november as well?

I can't make any dosing suggestions, but will suggest u read the information stickies here in the lantus forum about how lantus works.
Also, feeding dry as snacks will tend to have an impact the BG levels. Please refer to the feline nutritional links here

viewtopic.php?f=14&t=115
 
Any infection in a cat's body will cause numbers to rise--Stress will cause numbers to rise...
If you are on lantus, you will need to read the stickys at the top of the lantus homepage-New to lantus, and all those articles..
You will need to do spot checks at am preshot, +1 or 2, +3, and +6 are very important and start again at pm preshot!! There is a lot to learn, but PLEASE stop changing the dose without proper guidance..We all help each other here and are a wealth of information...
If you love your cat, you will try to get this in control..Not all cats here go into remission, but many are well, healthy & have great lives...
 
Cassandra and Sasha have a lot of experience with diet and vomiting issues. I will PM her and ask her to stop by your condo. Maybe she'll have some insight.
 
Do you have a spreadsheet? If you could post some numbers in your condo that may help. As for EVO dry, it is lower carb than most dry food but it is still a no no for kitties. Go luck. You are in a good place. Read and re-read all the stickies and become familiar with the protocol here. This forum gets very good results.
 
Hi,

I don't feed her evo dry only, i give this to her as a snack, occassionally. mostly I feed her wet food.
I am a medical student, so i am prety well-versed in med dosing, etc. not that I know everything, but I am pretty confident with drug dosing and monitoring.
Plus, I have increased her with the vet's help slowly....

I will post some numbers soon.
Thanks for your help.

- a & w
 
I'm sorry you misunderstood my comment about the dry. My kitty was addicted to dry. It is a no no for diabetic cats even as a snack. It will send the BG up. It took a while but I finally got Tuffy weaned off the dry. Glad you are going to be posting numbers, that will help to see what she is doing. Have a good evening.
 
Dry food is very bad, and I can say that before I eliminated ALL dry from Shadoe's diet, I knew exactly when she got into my other cat's dry food. Shadoe's numbers went WAY up whenever she snuck a mouthful of dry food.

She is fine with absolutely no dry now and she still gets snacks.
I get packs of dehydrated chicken, beef liver, and ocean fish called Pure Snacks. Shadoe LOVES them and they are 100% the one item. Another snack that you can give is chicken pieces. I steam a boneless chicken breast then dice it into tiny cubes and freeze them for when you need to give a snack.

Just by cutting out all of the dry food has helped with Shadoe's numbers, so that's one thing you can eliminate.
 
Welcome Alexia.

There are a few points in your post I want to try to reply to. First, regarding food, I'd encourage you to take a look at the website developed by Lisa Pierson, DVM. (If the folks over in Health directed you to this, sorry for the duplication.) It is a wealth of information about feline nutrition. She discusses the pros and cons (pretty much entirely cons) of feeding dry food. Part of why we are so adamant about not giving dry food is that it typically is higher in carbohydrates than canned food, is made of products, usually vegetable matter or grain, that a cat cannot digest, and it adds to dehydration. Importantly, if dry food is contributing to raising blood glucose levels (and it only takes a very little bit to do this), it takes a considerable period of time for dry food to clear your cat's system and give you numbers that you can rely on.

I'd also encourage you to take a look at the protocol that we use here to guide our dosing decisions. The Tight Regulation Protocol indicates that if a dose needs to be raised, it is typically raised by 0.25u (or in some cases by 0.5u). From your post, it sounds like you have raised Wednesday's dose by 1.0u and then raised by 0.5u. I can understand your concern about wanting to get Wednesday's numbers into a better range. However, the reason that doses are increased in such small amounts is that it can be easy to miss what may be an ideal dose. Unfortunately, too little insulin can appear much the same as too much. With too little, you get high numbers. With too much insulin, if you don't have mid-cycle checks, there are lower numbers at nadir and all you end up seeing are the bounces into high numbers at pre-shot times. As a result, add more insulin is given to bring down the numbers and the cycle continues. Without seeing your spreadsheet and knowing what the mid-cycle numbers look like, it's hard to know what's happening. What I've outlined is one possible explanation for why Wednesday's numbers are higher than you'd like.
 
Thanks!

Is there a way to back off from the current dose, if I have in fact, gone too high by increasing too quickly?

This is so frustrating!

I will post a spreadsheet soon! Basically, she is flat lining, or she decreases by about 50 when she is at +6. She has hardly decreased her numbers the last few weeks...

- A & W
 
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