Back on the Juice :( Now to determine the right dose

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JennC & Diago

JennC & Diago

Member Since 2018
Hi All -
My kittie has been OTJ since February 2018 and normally when I test him twice a month in the AM his BG's are normally between 70 - 80. I checked him recently and got a 116 and just tested and got a 107. I know, I know these numbers are still good. But can someone check my spreadsheet to see if there is any reason for concern. I know the numbers can fluctuate but he's almost always between 70 - 80, so when I see low 100's I get worried. Thanks in advance.

Spreadsheet: https://docs.google.com/spreadsheets/d/1kHHtnSW5CYug6orP_uEuw5faqEouShCJlv6uYbVoAhM/edit?usp=sharing
 
How's his foot? Is there something else going on that would cause this? A change? Work being done at house? Unknown people visiting? Sleeping more than usual? Sniffly/sneezy? Peeing more than usual? Not feeling well will raise numbers...
 
Squeaky and KT (GA) said:
How's his foot? Is there something else going on that would cause this? A change? Work being done at house? Unknown people visiting? Sleeping more than usual? Sniffly/sneezy? Peeing more than usual? Not feeling well will raise numbers...
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His foot is doing ok, the vet said it's a pocket that fills with fluid and that I don't have to worry about it. I still keep an eye on it to see if it is getting larger. Still the same size, pea size. No other noticeable changes for him. Peeing, food and water intake appear to be normal.
 
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Added more details to the spreadsheet if I can get some eyes on it. I did notice last night he did have the small bump on his foot come back, I drained it but not much came out. I'm also working on a curve today to see how he is doing through the day. His poor ear looks bruised and his other ear doesn't give much blood. I guess I'm just trying to see what everyone's thoughts are. Should I really be concerned since the numbers are still green and blues? I just want to make sure he stays healthy, and appreciate that he hasn't been urinating outside of his litter box which he was doing before he went into remission.
 
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When in remission, Sheba’s numbers would go up (up as far as 300) if she was unwell and would come back down to normal when she was better, usually the next day once treatment started (pancreatic flares). After 2 1/2 years she fell out of remission due to ongoing unresolved diarrhoea (which eventually turned out to be a food allergy).
I would do the curve and see if his numbers go down a couple of hours after eating. This indicates that the pancreas is working.
I would also get onto any infections or inflammations straight away. Can the foot issue be resolved? Any ongoing issues with infection/ inflammation could raise the BG.
His numbers look ok except for the ones on 1 July when he had the abscesses foot. But it is good to be checking.
Also keep an eye on water intake and output. Sheba’s urine output increased several weeks before she fell out of remission.
Can you get a sample of the drainage from the foot to pathology for testing? May be some residual infection there.
Good luck
 
[QUOTE="Sheba’s urine output increased several weeks before she fell out of remission.
Good luck[/QUOTE]

This is what has me worried. We've seen an increase in urine 'clumps' in the litter box. Unfortunately the vet said the foot issue is just a pocket of fluid and I really shouldn't mess with it. I only checked it because of the past increase of BGs. I'm hoping he isn't falling out of remission. How soon after he eats should I check his BG to see how his numbers are to verify if the pancreas is working? And what number should I be looking for, under 100 or over. I wasn't sure if food brings up BGs or lowers.
 
QUOTE. This is what has me worried. We've seen an increase in urine 'clumps' in the litter box. Unfortunately the vet said the foot issue is just a pocket of fluid and I really shouldn't mess with it. I only checked it because of the past increase of BGs. I'm hoping he isn't falling out of remission. How soon after he eats should I check his BG to see how his numbers are to verify if the pancreas is working? And what number should I be looking for, under 100 or over. I wasn't sure if food brings up BGs or lowers.[/QUOTE]


I’d do a curve every two hours and note down when you feed on the ss. The BG should go down about 2 hours after food. So if his prefood number was 120 the next 2 hour BG should be under that.
I would follow up on the foot. If the pocket is in the surface, it should be able to be drained then bandaged firmly to heal to stop the pocket forming. He may need an antibiotic cover while this is done.

Can you get a urine sample to check for a uti?
 
Ok perfect. I'll have to keep him upstairs to make sure I know when he eats so we can check. The fluid pocket is on the surface but it's in a bad spot to be bandaged, it's on the inside of his ankle. I can probably get a sample of urine to run up to the vet.
 
JennC said:
Ok perfect. I'll have to keep him upstairs to make sure I know when he eats so we can check. The fluid pocket is on the surface but it's in a bad spot to be bandaged, it's on the inside of his ankle. I can probably get a sample of urine to run up to the vet.
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The ankle should be able to be bandaged.. just need to pad out the hollows and bandage firmly. The vet should be able to do that easily. I think that if it keeps filling with fluid it is an issue. I’d get a second opinion if your vet thinks it is nothing.... mainly because you have a diabetic cat and you want to do everything to try and keep him in remission.
 
I completely agree. I think I'll call around tomorrow to see if I can get him in. Thanks so much for taking a look at our spreadsheet.
 
JennC said:
I completely agree. I think I'll call around tomorrow to see if I can get him in. Thanks so much for taking a look at our spreadsheet.
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I’m glad you are following up with the foot (and the urine sample). I was so frustrated when Sheba had the chronic diarrhoea because I knew it was causing problems and nothing seemed to help no matter what the vet and I tried. It wasn’t until some time after she fell out of remission that I found it was a food allergy and the diarrhoea stopped as soon as the food was changed but by then it was too late.
So it is good to be vigilant and follow up any possible issues.
It may all be nothing!
Please keep us posted
 
Oh no, that's terrible. I know some cats go back into remission but not always. Here's hoping this will pass and we will be in the clear. How old was your kitty when she was diagnosed? My boy will be 14 early next year
 
JennC said:
Oh no, that's terrible. I know some cats go back into remission but not always. Here's hoping this will pass and we will be in the clear. How old was your kitty when she was diagnosed? My boy will be 14 early next year
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She was 9 when she was first diagnosed. Went into remission in 3 to 4 months and was great for 2 1/2 years. She used to get pancreatic flares after she became diabetic which did not help matters.
 
Bron and Sheba said:
She was 9 when she was first diagnosed. Went into remission in 3 to 4 months and was great for 2 1/2 years. She used to get pancreatic flares after she became diabetic which did not help matters.
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I'm so sorry to hear that; that must have been very challenging. I just took his BG and he was at 91 and hadn't eaten in 3 hours. He did eat a little after I took it, so I'll test him again in 2 hours. I've been lucky with him, only testing twice a month and how easy it is to forget the important stuff like how to check how his pancreas is working, etc.
 
Yeah he has food anytime he likes, we keep dry down during the day and wet food at night. I'm going to clean litter boxes soon to see how much urine there is.
 
13 pee spots in the boxes which is less than the last few days and he was 103 this morning. I'm going to keep watching him and check him today after he eats a bit larger of a meal.
 
Let us know how you get on at the vet. Good catch finding the urine in the floor with blood in it.
What type of dry food are you using? Is it low carb variety?
 
The vet confirmed blood in the urine. He gave antibiotics and an anti inflammatory infection. I'm going to give him a few days before I check his bg. And then I'll probably test twice a week through January. He's eating Dr. Elseys clean protein and FF chicken pate. We recently started letting him upstairs while we've been at work, I'm wondering if that change caused him stress. He was only downstairs during our work day and night because of the inappropriate urination. :(
 
The vet gave a covenia and azimycin injection yesterday at the office. We had 20 pee spots today and one being on the basement floor. I decided to take his BG this morning at +2 and it was 209. :'( I really hope it's just the meds and infection causing this. It does say at his invoice he was prescribed a cortisone which will increase thirst and urination. Praying he feels better in a few days, I just feel so bad for him.
 
JennC said:
The vet gave a covenia and azimycin injection yesterday at the office. We had 20 pee spots today and one being on the basement floor. I decided to take his BG this morning at +2 and it was 209. :'( I really hope it's just the meds and infection causing this. It does say at his invoice he was prescribed a cortisone which will increase thirst and urination. Praying he feels better in a few days, I just feel so bad for him.
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I am really surprised to see that the vet gave a cortisone injection to Diago. That will raise the BG.
Cortisone injections are responsible for some cats becoming diabetic in the first place. Did he ask you if you were happy for him to give the cortisone injection? Did he say why he was giving it?
 
I thought that's what I remembered. I know the one he gave is short acting. He's had it before but it has never raised the BG this much, although I wonder if it's a combo of medicine and infection at this point. He said he was giving him an anti-inflammatory, it wasn't until I seen the invoice that I noticed it was a cortisone. I honestly don't know how much he really knows about diabetes in animals. It seems he really knows just the very basics and nothing past it. I'm hoping he feels better in the next few days, I should be able to tell based on how many pee spots there are in the box.
 
JennC said:
I thought that's what I remembered. I know the one he gave is short acting. He's had it before but it has never raised the BG this much, although I wonder if it's a combo of medicine and infection at this point. He said he was giving him an anti-inflammatory, it wasn't until I seen the invoice that I noticed it was a cortisone. I honestly don't know how much he really knows about diabetes in animals. It seems he really knows just the very basics and nothing past it. I'm hoping he feels better in the next few days, I should be able to tell based on how many pee spots there are in the box.
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How frustrating for you. I hope the BSL comes down quickly. I won’t let any of my cats have a cortisone injection unless it is a matter of a life and death issue. He should have asked your permission to give the cortisone though considering Diago is a diabetic.
 
I'm really disheartened, I think we might have lost remission. He had a 285 this morning PS and 304 this evening PS. I called the vet and they said the anti-inflammatory can raise BG and that if we were under 300 not to worry but then I checked tonight and got the 305. He has been drinking more water today and yesterday and peed on the basement floor today. Should I get insulin and give him some in the morning if he is high again.
 
JennC said:
I'm really disheartened, I think we might have lost remission. He had a 285 this morning PS and 304 this evening PS. I called the vet and they said the anti-inflammatory can raise BG and that if we were under 300 not to worry but then I checked tonight and got the 305. He has been drinking more water today and yesterday and peed on the basement floor today. Should I get insulin and give him some in the morning if he is high again.
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Yes I think you probably should start back on insulin to support the pancreas. What rotten luck. I’d be furious with the vet.
I’ll just tag @Chris & China to see what she thinks.
 
Yeah I am so aggravated this happened. Prior to that injection he was only low 100's and now 304! I gave him 0.5 to see how it looks in the morning. When he went into remission it was literally one day he no longer needed it. I'm crossing my fingers for such luck again.
 
JennC said:
Yeah I am so aggravated this happened. Prior to that injection he was only low 100's and now 304! I gave him 0.5 to see how it looks in the morning. When he went into remission it was literally one day he no longer needed it. I'm crossing my fingers for such luck again.
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Make sure you get a few tests in overnight to see how low it takes him
 
He was 385 last night ps and 312 amps. This morning he's at 296 PS. I've started him on .5u just to see how he is reacting to it. Today is day 3 of that dose. The vet still thinks he come back to remission next week, I don't think so. :(
 
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+2 = 134
+4 = 143
+6 = 212
+8 = 275

Based on this curve, should I attempt to increase the dose to 0.75? Or is it to early to tell yet. I did do 0.75u last night since his PMPS was 385. Looks like we might be headed that way again today.
@Chris & China @Bron and Sheba
 
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JennC said:
+2 = 134
+4 = 143
+6 = 212
+8 = 275

Based on this curve, should I attempt to increase the dose to 0.75? Or is it to early to tell yet. I did do 0.75u last night since his PMPS was 385. Looks like we might be headed that way again today.
@Chris & China @Bron and Sheba
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It is better to stick to the same dose for at least 6 cycles to let the depot fill and the dose stabilise. I know it is tempting to go up sooner when you see higher BSLs but I would not. What I would do though is test for ketones. Do you have a bottle of Ketostix?
 
That makes absolute sense. I was thinking if he would get 0.75 it would bring his numbers lower and we wouldn't see the high 300's potentially. I'm trying so hard to make sure he is feeling ok and want his UTI to heal. I don't have a bottle of those, what is ketones again? Being in remission for 10 months, I have completely forgotten some of the basics. :(
 
Ketones can develop in FD kitties. Not all kitties get them but the recipe for DKA, which is an illness that can develop if ketones are present, is = not enough food, not enough insulin and an infection or inflammation. So it is a good idea to check that ketones are not developing while your kitty has higher than normal numbers and an infection, because ketones can then be treated early if they develop. To test get a bottle of Ketostix and follow directions on the bottle to test the urine. It’s a simple test and a valuable one. Don’t get stressed about it. It’s just a good precaution to take and one we recommend.
 
That's right! I'll pick some up at the store tomorrow. Just tested PS and he was 300 which is nice considering he was 385 last night PS. The 300 after he ate a some of his food.
 
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JennC said:
That's right! I'll pick some up at the store tomorrow. Just tested PS and he was 300 which is nice considering he was 385 last night PS. The 300 after he ate a some of his food.
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Do you remember that the preshot test should be taken before food and no food for the 2 hours before the test so the BSL is not food influenced.
 
Bron and Sheba said:
Do you remember that the preshot test should be taken before food and no food for the 2 hours before the test so the BSL is not food influenced.
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Oh dang it. I'm doing this all wrong. Ok, I'll make sure we get it right tomorrow. I was hoping having a lower number meant his pancreas might be working a little.
 
@Bron and Sheba, thank you for recommending we stay at the 0.5 dose. Yesterday, I did a curve and at +3 he was 101. Today, at +3 he was 67! Tonight at his pmps, he was 163 so I'm not doing an injection tonight. Slowly each day his numbers have come down.
 
JennC said:
@Bron and Sheba, thank you for recommending we stay at the 0.5 dose. Yesterday, I did a curve and at +3 he was 101. Today, at +3 he was 67! Tonight at his pmps, he was 163 so I'm not doing an injection tonight. Slowly each day his numbers have come down.
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I’m so pleased he is responding to the insulin. You could have given insulin with the 163 if you had plenty of strips and higher carb food available and could monitor the bsl. Next time you get a lower number, stall, don’t feed and post and ask for support.
ETA Jenn was correct not to give the insulin. My comments on going ahead were incorrect
 
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Bron and Sheba said:
I’m so pleased he is responding to the insulin. You could have given insulin with the 163 if you had plenty of strips and higher carb food available and could monitor the bsl. Next time you get a lower number, stall, don’t feed and post and ask for support.
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I didn't want to attempt given the 240 this morning and when I gave the 0.5 dose he came all the way down to 67. Given that drop, if I would have given the dose, he may have dropped to extremely dangerous levels overnight.
 
Yeah, I didn't want to switch in case he did go back into remission. If he is going to stay on insulin long term I will switch to something less harsh.
 
JennC said:
Yeah, I didn't want to switch in case he did go back into remission. If he is going to stay on insulin long term I will switch to something less harsh.
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Ok. Then you were correct in not giving insulin with the 163. I’m sorry I gave you the wrong advice.
I am going to tag a couple of people who use these types of insulin. I am unfamiliar with them.
@Rachel @Kris & Teasel
 
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