"new" diagnosis, blood glucose not lowering

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BirdiesMom

BirdiesMom

Member Since 2018
Birdie diagnosed 7/3. Free-feeding moderate calorie Royal Canin SO for urinary crystals at that time. Glucose curve run 7/5 and glucose went from 550 down to 140 after 9 hrs. with 2 units vetsulin. Being at clinic, she was not eating during curve. Since then have hardly gotten glucose less than 400, mostly 450ish. We are up to 4 units, 2x a day. Feeding at time of shot, although she is getting where she does not want to eat then. Royal Canin people recommend keeping her on moderate calorie SO food and controlling glucose with insulin. She has had urinary crystal problem about 3 1/2 years and had seemed controlled but right now that is not controlled either and her bladder has lots of crystals. If can ever get glucose controlled she has to have a surgery for it. She is 14.
I am frustrated. (1) Does her initial free-feeding (before diagnosis) and then not eating during glucose curve make that much difference compared to eating at time of shot? (2) What are some ways to get her to eat more at time of shot? Initially she ate well; I was mixing some canned SO food into the dry food. Am still doing this but she does not eat well at start--wants to go back to free feed behavior. (3) should I try another vial of the vetsulin to make sure this one is OK? I do not know if it was this vial used in curve. They say same lot number used then. Expires 10/2018, but my vet says it tends to last much longer than expiration. (4) when should I push to try different type insulin? OH, all glucose tests done at vet office
 
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Hi Birdies Mom and welcome to the board. I understand your frustration and worry. It is a recommendation that you start home testing. We all learned how and it became and is just a part of life. Home testing lets you know just how the insulin is working for Birdie, and it can help prevent a hypoglycemic event (blood sugar too low) which is dangerous and can be fatal. There is information here on the board about home testing, and many videos online also. Link to Home Testing information
Shooting blind (giving insulin without testing first to see if it's safe) is never a good idea. Our vet didn't recommend that we test before shooting either, or even regularly. We learned better. The best diet for a sugar cat is a low carbohydrate wet diet. I am not knowledgeable about Birdie's urinary crystals issue, but I know others will chime in. I do know an unregulated diabetic kitty is not able to process and use food properly, and therefore is hungry, so we usually feed more, smaller meals. Many of us use timeed feeders to help with that. Please start reading some of the other information on the board, there is great info in the FAQ's forum, and also specific information about insulin you are using in the Vetsulin forum (stickies at the top of the forum)
 
What type of crystals is she having?

Here's some very good information about urinary issues and crystals https://catinfo.org/feline-urinary-tract-diseases/

When he ate when he was at the vet'ss office and how much he ate can influence the test results the vet got on top of the stress of being at the vet, so I also think that for you to really know how is he doing and if the dose is the correct one the best (if not the only) way to do it is to test at home, and also is the only way to make sure he's safe and does not go to low which can be fatal, with people when using insulin they have to always test before getting the shoot
 
I have ordered a test meter. Thanks. I can't remember the name of the crystals, but it is the ones they get when their urine is too acidic. (pH too low). I am going to the vet with her this afternoon as I am worried about whether her pancreas may be bothering her. No great reason to suspect this except she did vomit a few nights ago. I had a cat years ago with chronic pancreatitis, and he also did not want to eat. I am just going to be sure...unfortunately my regular vet is not there periodically as his wife had a bad auto accident. I think it always helps to have the continuity of seeing the same one.
 
she definitely has crystals, by the way...I was trying to figure out which of my cats was peeing out of the litter box and when they looked at her urine they did not even need the microscope...and they have done x-ray on her bladder. It is awful looking--so much white due to the crystals. and she has a UTI now...I had to leave a little over a week ago to help my parents and I had to lock her in the bathroom so the people coming to give her shots could do so. Not sure but what some stress--either of me being gone or her being locked in bathroom, contributed to the infection (yes, they saw white cells)
 
Yes calcium oxalate crystals are more apt to be formed in an acidic environment and usually those are not going to dissolve with diet and with a cat prone to urinary problems stress usually makes it worse or can cause a flare even if there are no crystals involved because stress can cause the bladder walls to get irritated and start the whole ordeal.
 
OK. Birdie started not eating well late last week; some, but just not good. I could get her to eat some canned, but not as much as I thought she should, and she has never been picky about dry, so refusing it was not a good sign. Finally M morning refused to eat. The canned food pleases my vet, although he never said anything about it beforehand. She was still on antibiotic and M they switched to another thinking her first one might be upsetting her stomach. Her amylase was also slightly elevated, although no other signs of pancreas inflammation in her bloodwork. Some bloodwork signs of anemia, although no clinical signs. After vet visit, she ate the canned food pretty reasonably, so I have kept her on that. I got my meter in and worked up courage this morning to use it. I used it first on my other cat as he is more forgiving of messing with him. Got a 99 on alphatrac 2. So, with confidence bolstered, I did Birdie. Got a 33!!! tested another two times and got 42 and 32, so quick contact with my vet. She would eat well, so we gave her more food and I tested her again tonight, got 192 two hours before insulin shot due. We are narrowing in on getting a decent glucose level!! Before--at vet--she was never below 300. So, if she eats well at insulin time tonight (since she already ate most of a day's food, we are not sure what will happen), I am to decrease her insulin one unit. Otherwise, I am to call him. Thank goodness for a vet who takes home phone calls. Poor Birdie's ears have been punctured a lot today as I had to try several times to get enough blood for the 192 reading plus three readings this morning (gonna set the lancet one setting deeper). Am going to try to do a "curve" tomorrow as I think she gets nadir sooner than vet is thinking, and she goes back M to be tested about the infection again, so I can discuss this with him.
 
He is hopeful she will eventually go down some more on insulin. I am also hopeful she will drop the glipizide pill as she dislikes it more than the shot. My impression is the oral pills often don't do a lot and I am hopeful it is the canned food that has helped her.
 
Birdie is off the antibiotic! and the glipizide at least for now. Directed to try two units insulin 2x day! But she has lost more weight...am to try to encourage her to eat more.
 
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