PMPS of 70 but full dose of Caninsulin injected

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Wonderful surf indeed!
Glad you got him in quicker for checkup. I suggest continuing the spot checks. The after meal tests (1-2 hours after his meal) will tell a lot about how his body is reacting to food. Take the info with you to the vet.

Critter Mom's response is why I STILL look for advice from the pros! Their knowledge and advice is priceless!
 
StephG said:
How has he been today? Still staying around 70? Or did he eventually go up?
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I don't' know it was the night here :) . I will test him soon. But for now he seems to be OK. Yes I would like also to know if it did go up.
 
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Oh I forgot, my husband tested him yesterday :

At +26 : BG = 75 mg/dl (so exactly the same than at + 21 and after most of his meal (just difficult to say how long after the meal because I gave him in several times so I don't remember).
 
That is great! Over 24 hours with no insulin and still normal numbers!
Please update us after his appointment! I'm very curious about what the vet will have to say.
 
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@Capoo :joyful::joyful:

At + 36 : 66 mg/dl.
He just ate 6 kibbles from his usual food 3 hours before.

I couldn't test the ketones yesterday so I must succeed today.

Appointment tomorrow with aaaall the results.

One advice before I leave for work ?

Thank you again :rb_icon:

Edit : I would like to change for a mix of dry and wet food. I will wait for Friday after the appointment.
 
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Hi Sif,

I am pleased and relieved that your kitty is OK and I'm sorry the two of you had to go through such a scary experience. You did wonderfully well to keep him safe; that wasn't an easy time at all. (((Sif)))

I'm very tired at the moment and I need to get rest so I might not be able to answer all of your questions today (sorry!).

Sif said:
Yes and until yesterdaym nothing ! I have the Bayer Keto-diastrix strips: I will test him again tonight.
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Just to make sure I've got this right, my understanding is that your kitty has been tested for ketones and that the results of the tests have always been negative.

Is this correct?


Mogs
.
 
Critter Mom said:
I am pleased and relieved that your kitty is OK and I'm sorry the two of you had to go through such a scary experience. You did wonderfully well to keep him safe; that wasn't an easy time at all. (((Sif)))
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Thank you so much !

Critter Mom said:
I'm very tired at the moment and I need to get rest so I might not be able to answer all of your questions today (sorry!).
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No problem, have some rest :)

Critter Mom said:
Just to make sure I've got this right, my understanding is that your kitty has been tested for ketones and that the results of the tests have always been negative.

Is this correct?
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Yes, correct !
 
At + 49 :p : BG = 72 mg/dl (3 hours after almost all the evening meal).

Tomorrow, vet hospital, with all the BG, from the BG before the shot to now.
I will tell you.
 
@Capoo @StephG @Kris & Teasel : question : I am seriously wondering if I will go to the vet tomorrow.

Now, after all these events (they let me shot my cat with 2 IU twice a day without testing him during 3 weeks,without telling me what is a good BG for him, and without warning me about hypoglycemia except "if he has hypo, put honey on his mouth") I don't trust them anymore...

For the check up, what are they going to do ? When they said that he had diabetes (because he is big, he drinks a lot, and he had 372.6 mg/dl of sugar in the blood), they said that for this check up, I will have to bring his food and his insulin. Now, I'm afraid of the fact that he could have a big BG with the stress (my cat is so stressed when he goes to the vet that he pees on himself). And then they would give him insulin. On the contrary, still at home, he will probably keep his normal BG.

But on the other hand, it could be good to get the fructosamine test ? (I don't know if it's worth it after everything happened). And test something else to know if something else is wrong ?
 
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They want to keep him there for the day to test BG at intervals. That's why they want you to take the food and insulin with you. There's no need for this and it's an unnecessary expense. I'd also delay the fructosamine test.

If it was my cat, here's what I would do:
  • cancel the appointment tomorrow and maybe rebook a week from now to discuss your findings
  • test his BG each day at AM and PM before eating and one other time either midday or late evening
  • after a week you'll have more data to talk to the vet about, including proof that your cat probably isn't diabetic
  • keep feeding low carb canned food because it's good for weight loss if he needs that.
 
@Kris & Teasel thank you so much. I agree with everything.

We leave the country for 10 days in one week and a half.
Our neighbour (cat lover) is going to take care of our kitties but she won't be able to test the BG etc during these 10 days. It means that we have 1 week and a half to keep going on testing him at home. I hope it will be OK.

Kris & Teasel said:
maybe rebook a week from now to discuss your findings
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With my cat ?

For the wet food I will begin a slow transition tomorrow :)
 
I agree with Kris & Teasel!
The trip to the vet is probably going to spike his blood glucose either way. You can do the curve at home yourself... your spot checks look fantastic so far.
As long as you get him switched over to a low carb wet food (best for any cat really) I don't think you'll have anything to worry about when you go on your trip. Keep the spot checks going until then and you'll get a good idea of what his usual levels are.
 
I fully agree with @Kris & Teasel !

At this time, there is really no need to spent money and to stress your cat.

Usually, a cat is considered to be in remission when his BG are in the normal range for 14 consecutive days (with a human meter, it's between 50 and 80, with some spot checks less than 120).

Given that you're going to transition him to LC wet food, his BG will continue to decrease (anti jinx).

I would continue to test until your departure, and if all the BG continue to be in the normal range, just give a call to the vet before leaving. I suppose that all the clinical signs of diabetes have vanished too, right?
 
@
Capoo said:
I suppose that all the clinical signs of diabetes have vanished too, right?
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That's the point : I think that he drinks and pee a lot (and maybe more than when he got insulin ?). At least more than Diego. That's the only thing.

He still wants to eat a lot but for me that could be a behavior problem. The same for water : maybe the fact to fill himself as I don't give him food. I don't know how to explain...

Ketones still negative yesterday evening.

@Kris & Teasel : I corrected the BG that they found at the hospital a week
and a half ago.
 
Sif said:
That's the point : I think that he drinks and pee a lot (and maybe more than when he got insulin ?). At least more than Diego. That's the only thing.
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That can be due to something else than diabetes, and that need to be checked.

Is it possible that you keep your vet appointment, and just do a complete blood work, but without the BG curve at the vet, just to see what can cause these symptoms?
 
I don'the know and I don't know if they are going to understand me...

Do you have an idea about the other explanations possible ?
 
That can be due to renal problems, and a lot of other things. That's why it would be better to check with a complete blood work.
 
Capoo said:
That can be due to renal problems, and a lot of other things. That's why it would be better to check with a complete blood work.
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By the way he didn't loose weight... the vet thought that he lost weight because of the diabetes but it was because we put him on the diet...
 
And if you don't trust the diagnosis of your vet, you can post the results here : there are some people experienced in the reading and interpretation of blood work.
 
Capoo said:
And if you don't trust the diagnosis of your vet, you can post the results here : there are some people experienced in the reading and interpretation of blood work.
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:)
For that I will have to ask them the blood analysis. Here we don't have the patient's file. Everything is on a computer under our identity number.
 
And that would also be interesting to have a urine analysis. Would it be possible for you to collect a urine sample?
 
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I'm not sure that my cat drinks more than 300 ml per day. He just drinks more than the other one... that's difficult to say as they are two drinking in the same bowl.
 
@Capoo I don't trust them about the fact that they won't do BG tests. I'might afraid that they could give him insulin because of a high BG due to the stress... and I'm afraid that my cat start again a kind of diabetes because of the huge stress.

Edit : which quantity of water drinks a cat of 7-8 kg ?
 
Capoo said:
Are there other vets around you?

Anyway, you can stay with your cat at the vet (a complete blood work doesn't require a lot of time), and say NO if you see them doing something that you don't want: you're their client.
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So you were thinking to just do blood tests and not let him all the day at the vet like it was planned ?

OK I just saw the rest of your reply !
 
If I remember well, a cat eating dry food should drink around 40 ml per kg, that means in your case around 280 ml per day.
How many times per day does he pee?
 
2 times per day is perfectly normal!

What makes you feel that your cat is peeing / drinking more than usual?
 
Capoo said:
2 times per day is perfectly normal!

What makes you feel that your cat is peeing / drinking more than usual?
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Compared to the other one. But maybe that's more than 2
And now that I'm thinking of it, it is maybe more because I find more than 2 balls of pee in the litter. I don't know. He started to do that when he got bigger.

Aurélien called the vet : we can come this morning just for a blood test. I will ask for a complete one.
 
*** LONG POST ALERT ***

Hi Sif,

I've only skimmed through the latest posts but my current understanding is this:

* Epi is overweight and his food portions need to be controlled or he will eat more. Current vet recommended high carb dry food for weight loss.

* Current vet diagnosed feline diabetes after Epi was presented with symptoms of excessive drinking and peeing. (Polydipsa/polyuria, aka PU/PD)

* Current vet did not do a urine test to check for presence of glucose at time of diagnosis.

* Current vet did a spot check of blood glucose at time of diagnosis.

* Current vet did not order a fructosamine test and thus diabetes diagnosis was based on blood glucose spot check and possible PU/PD.

The following comments are based on the assumption that the information above is a correct picture of events up to and including the time of initial feline diabetes diagnosis.

The vet SHOULD have immediately checked for presence of urine in glucose (a crude diagnostic measure indicative of existence of significant hyperglycaemia - over the renal threshold - in the home setting and therefore not influenced by vet/travel stress.) As a standard diagnostic measure the vet should have performed a fructosamine test to determine whether BG had been at diabetic levels over the previous fortnight.

A single BG spot check is NOT sufficient information upon which to base a diagnosis of FD. Without urine and fructosamine testing at time of diagnosis if your vet then went on to prescribe insulin then the vet made a serious, potentially life-threatening treatment recommendation.

Blood glucose levels may be influenced by a non-FD disease process in the body (e.g. infection).

PU/PD can be a symptom of several conditions, so your vet was wrong not to order further tests upon which to base a differential diagnosis including comprehensive blood and urine testing, and possibly advanced diagnostic procedures, e.g. ultrasound. The blood and urine tests would also have given an indication of whether any other problems existed, e.g. inflammation or infection. (I cannot see any mention of your vet having ordered any blood tests so I am assuming that none were carried out.)

The vet should also have assessed your cat's behaviours and carried out a comprehensive physical examination to identify other clinical signs to aid differential diagnosis (e.g: pot-bellied appearance; unexplained and unexpected weight loss; poor coat condition, etc.).

Here is an article by a world-leading feline endocrinologist, Dr. Mark Peterson, listing conditions in felines commonly associated with PU/PD:

http://www.endocrinevet.info/2011/01/diagnostic-approach-to-pupd-urine.html

From the above article:

Cats
  • Chronic renal failure
  • Diabetes mellitus
  • Hyperthyroidism
  • Hypercalcaemia
  • Pyelonephritis
  • Hypokalaemia
  • Acromegaly
  • Postobstructive diuresis
  • Hyperadrenocorticism
  • Hypoadrenocorticism
  • Diabetes insipidus

This second article provides a good overview of what you should expect in terms of assessment and diagnostic best practice from a competent vet:

https://petdoctormom.wordpress.com/2011/03/01/polyuria-and-polydipsia/


Sif said:
So you were thinking to just do blood tests ...
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Yes. I recommend doing this at another - more competent - vets. Also urine testing.

... not let him all the day at the vet like it was planned ?
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It appears that now your cat is running in normal BG ranges. If a glucose curve is needed you can do this at home with your own home BG testing kit. Apart from sparing yourself unnecessary vet bills the data you gather at home will not be influenced by vet/travel stress and will therefore give a more accurate picture of Epi's day-to-day blood glucose levels in his normal unstressed home environment.

I would not take my cat back to this current vet for diagnostics, and most certainly not for any advice on diabetes. Knowledge of FD appears to be extremely limited, and response to a possible serious hypo event was pitifully inadequate to the point of putting the cat's life at risk. Food advice appears to be based on promotional literature from major pet food companies and not on scientific principles.

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Has there been any change in water consumption and pee volume:

- While Epi was receiving insulin.

- Since you have stopped giving insulin.

I recommend you monitor water consumption for the next while to help you assess whether there is actually any excessive water consumption. (Measure the amount you put out for both cats each day, then measure how much is left after 24 hours. It's easier to do this if you use ONE big bowl which can contain enough water for both cats for 24 hours. It may be necessary to confine both cats to the house during the monitoring period so you can exclude access to alternate water sources outside the home. You will also need to record how much wet food is given to the cats so that you can add the moisture from this into your calculations.)

Also if your cat runs in normal BG numbers for 14 days (as Sophie advises above) then Epi is either a diabetic in remission - or he may not be diabetic at all (further diagnostics recommended).


Mogs
.
 
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Sif said:
@Kris & Teasel thank you so much. I agree with everything.

We leave the country for 10 days in one week and a half.
Our neighbour (cat lover) is going to take care of our kitties but she won't be able to test the BG etc during these 10 days. It means that we have 1 week and a half to keep going on testing him at home. I hope it will be OK.


With my cat ?

For the wet food I will begin a slow transition tomorrow :)
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Sif, my advice to you is to be really CLEAR with whoever will look after your cat that they don't overfeed him and really make that transition to wet LOW carb food as soon as possible. Otherwise you risk getting your beloved puss into diabetic state again with all stress it brings.
Good luck.
Marlena
 
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Hi again everybody ! And thank you.

@Critter Mom : the picture is correct except that they did test the urine at the time of the diagnosis, so it had sugar in the urine. What does that mean for you ?

This morning I had to show my precious BG. From the one before the shot (first that I succeeded) to the one this morning. With also all the details about the conditions (food or not, honey etc) and the name of the glucometer (they have the same).

She took the time to look at it alone. Then she came and said . "It was a type 3, temporary diabetes. He doesn't need insulin anymore, the BG is good. Keep going on the diabetic food (hum... she doesn't know that I kept the old one with less carb than hers, and just dropped the quantity of 3 gr) and test him once a week".

Then I talked about the polyura-polydispsia, and I asked for a complete blood test to check if it could be from somewhere else. She agreed. I also asl for the fructosamine even if it could be skewed by the last week... but I wanted to it while my cat endured the stress to come here (he was in the car at this moment). She asked for all the tests matching with the symptoms of polyura-polydispsia.

She will send me the results by mail. For the fructosamin, it takes 3 weeks, goes abroad etc,

NOW : monitoring + transition to wet low carb food. Check the water, ok.
Then we will see for another vet, yes.
That's the problem here, there is no school to become a vet, they have to go abroad to study. Now, imagine the docs that we have here... that's terrible.

Marlena said:
Sif, my advice to you is to be really CLEAR with whoever will look after your cat that they don't overfeed him and really make that transition to wet LOW carb food as soon as possible. Otherwise you risk getting your beloved puss into diabetic state again with all stress it brings.
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Yes, I was afraid of that... that's also why I didn't want to let him all the day in this hell. And I had to argue to avoid it this morning :mad: Thank you to my glucometer and all the BG that I collected.....

Again thank you for helping me, this is precious.
Please ask me if I'm not clear, my English sucks.
 
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