Remission or Misdiagnosis?

[Buddy’s Ma]

Welp! After texting in Buddy's glucose charts from this weekend, my vet texted back telling me to stop the insulin injections (we already were down from 3U to 0.5U and his pre-shoot numbers kept dropping lower), because he's officially in remission.

From all the things I've read, this is a really quick turnaround so I'm wondering if he never was diabetic to begin with and it was all brought on by the bout of severe pancreatitis he just had? I did notice he was incredibly thirsty for a little while before the pancreatitis, and he's always had issues with spraying/inappropriate urination since I've got him (he was a rescue) so there's evidence that he may have had underlying diabetes in hindsight, but I'm questioning it with how quick this turnaround was.

Our fight now is to get him to eat on his own so we can take the esophageal tube out but the diarrhea returned once I fully switched him to a limited ingredient rabbit diet, so I'm now switching him to a limited ingredient duck diet with pumpkin to aid the transition.

He still has the Libre Sensor for 10 days so we can monitor closely as we figure out his food situation. So far the only thing he will eat on his own is his old kibble and some tuna and he even threw up that little bit this morning about 15mins after eating it. I'm not sure if this vomiting and diarrhea is linked to his remission, or food switches, or pancreas, or if it's IBD, or what...my vet thinks it's the food so that's how we're proceeding along with continuing his herbs for his pancreas and colon.

 

[Ale & Bobo & Minnie (GA)]

Omg congratulations on either because the good news is no more insulin for Buddy!!

Minnie had the tube for 2 weeks so I feel your pain. How is the daily cleaning going? It freaked me out every time

 

[Buddy’s Ma]

Omg congratulations on either because they good news is no more insulting for Buddy!!

Minnie had the tube for 2 weeks so I feel your pain. How is the daily cleaning going? It freaked me out every time

Thank you! The cleaning makes me a little queasy for sure especially when he moves. He's pushed his collar up off his head multiple times now and that freaks me out more though. Cannot wait for the day it gets removed. How's Minnie doing now?

 

[Ale & Bobo & Minnie (GA)]

Thank you! The cleaning makes me a little queasy for sure especially when he moves. He's pushed his collar up off his head multiple times now and that freaks me out more though. Cannot wait for the day it gets removed. How's Minnie doing now?

Ups and downs with her. Had to take her back to the vet because her breathing was too fast but we’re home now.

she never managed that but she did unroll the tube a few times and would drag it behind her she wouldn’t move for the cleaning but did many times when I was mid tube feeding so I’d have to trail behind her holding it like a maid of honor holds the bride’s gown ha! The tube was removed about a week ago and the wound also made me queasy because it had to stay open to heal. She groomed away the crusty part twice now but it’s healing well despite that. Did they tell you when Buddy’s will come out?

 

[Bron and Sheba (GA)]

Are you giving Buddy an antinausea medication such as cerenia to see if that helps with his eating?
Cats recovering from pancreatitis may need cerenia to help with nausea for some time.
Also if you are stopping the insulin, I would test the urine for ketones to make sure none develop its an easy test and you need to buy some Ketostix from Walmart or a pharmacy.
Can you share your BG numbers with us please?
Have you tried a probiotic for the diarrhoea? Boulardii probiotic is very good.
I doubt the vomiting and diarrhoea has much to do with remission but more to do with the pancreatitis with may not have resolved yet.

While the most important thing is to get him to eat just be aware that if he eats dry food that will put his BG up again. But ensuring he eats trumps everything.

 

[Buddy’s Ma]

Ups and downs with her. Had to take her back to the vet because her breathing was too fast but we’re home now.

she never managed that but she did unroll the tube a few times and would drag it behind her she wouldn’t move for the cleaning but did many times when I was mid tube feeding so I’d have to trail behind her holding it like a maid of honor holds the bride’s gown ha! The tube was removed about a week ago and the wound also made me queasy because it had to stay open to heal. She groomed away the crusty part twice now but it’s healing well despite that. Did they tell you when Buddy’s will come out?

Buddy does that too! Usually only one or two times before giving up and just flopping over on his side and napping while I feed him and rub his belly. Sometimes I wonder if he's starting to like being pampered. I'm glad Minnie's doing ok, I still have such OCD about every little thing. So grateful my vet's clinic has a number I can text then I don't feel so bad about calling and interrupting their day all the time.

Buddy's can't come out until he's been eating on his own for 2 weeks unfortunately. I had no idea they leave the wound open, that's going to freak the F out of me...

Are you giving Buddy an antinausea medication such as cerenia to see if that helps with his eating?
Cats recovering from pancreatitis may need cerenia to help with nausea for some time.
Also if you are stopping the insulin, I would test the urine for ketones to make sure none develop its an easy test and you need to buy some Ketostix from Walmart or a pharmacy.
Can you share your BG numbers with us please?
Have you tried a probiotic for the diarrhoea? Boulardii probiotic is very good.
I doubt the vomiting and diarrhoea has much to do with remission but more to do with the pancreatitis with may not have resolved yet.

While the most important thing is to get him to eat just be aware that if he eats dry food that will put his BG up again. But ensuring he eats trumps everything.

Bud's gone through 4 rounds of Cerenia (with breaks in between because it isn't supposed to be given for longer than 4 days in a row), he doesn't seem to be nauseous or in pain anymore but I've had to keep his feedings regulated to give him insulin so he was always feeling full. I haven't given his regular nighttime feeding tonight since the insulin has been cut and he's already eating more/seeking out food. Yay!

He was also on the Visbiome probiotic but we stopped it two weeks ago because the diarrhea had started and we were pretty sure it was because he was rebuilding his gut flora so the probiotic was too much. Maybe I'll sprinkle in a little bit though since he did go through a round of metronidazole.

I have the Diastix that I test with everyday to make sure there are no ketones or glucose in his urine and will definitely be keeping that up! So so so glad he has the Libre sensor so I can continue monitoring his glucose closely too.

At his last vet check, they said it looks like his pancreas is doing better based on the blood work but I think it's still recovering a bit too. He's on Chinese herbs San Ren Tang to help both his pancreas and colon and I saw a huge improvement in BG after we started him on those. All the ER vets had mentioned that they were unsure if he was actually diabetic or if he had an onset of diabetes due to his pancreas being so inflamed and not producing enough insulin as a result, my gut was the latter.

BG numbers started at 19mmol/L when he first came home from the hospital about a month ago, and we are now sitting at a stable 7/8 regardless of what he eats/how much he eats. I gave him the 0.5U this morning when he was at a stable 7 all night, and he almost dropped past 3. I regretted it so much because my gut was telling me he was in remission, but I didn't want to skip a dose and regret it. Of course I had to hear it from the vet to trust that I was right, yet again.

So annoying because I've gotten very good at trusting my gut in most other cases but I get so fearful when it comes to my babies.

 

[Bron and Sheba (GA)]

Can you set up a spreadsheet so we can see the numbers please
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
As far as I am aware it is fine to give cerenia daily now without breaks.

 

[Buddy’s Ma]

Can you set up a spreadsheet so we can see the numbers please
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
As far as I am aware it is fine to give cerenia daily now without breaks.

Because I have the Libre app where I can add notes and it charts his BG numbers directly, I didn’t set up a spreadsheet and won’t be setting one up now that he’s in remission. I can share his charts though if you’re interested! He’s been at a stable 7 all night with one dip down to 6 without any insulin

 

[Ale & Bobo & Minnie (GA)]

Buddy does that too! Usually only one or two times before giving up and just flopping over on his side and napping while I feed him and rub his belly. Sometimes I wonder if he's starting to like being pampered. I'm glad Minnie's doing ok, I still have such OCD about every little thing. So grateful my vet's clinic has a number I can text then I don't feel so bad about calling and interrupting their day all the time.

Buddy's can't come out until he's been eating on his own for 2 weeks unfortunately. I had no idea they leave the wound open, that's going to freak the F out of me...



Bud's gone through 4 rounds of Cerenia (with breaks in between because it isn't supposed to be given for longer than 4 days in a row), he doesn't seem to be nauseous or in pain anymore but I've had to keep his feedings regulated to give him insulin so he was always feeling full. I haven't given his regular nighttime feeding tonight since the insulin has been cut and he's already eating more/seeking out food. Yay!

He was also on the Visbiome probiotic but we stopped it two weeks ago because the diarrhea had started and we were pretty sure it was because he was rebuilding his gut flora so the probiotic was too much. Maybe I'll sprinkle in a little bit though since he did go through a round of metronidazole.

I have the Diastix that I test with everyday to make sure there are no ketones or glucose in his urine and will definitely be keeping that up! So so so glad he has the Libre sensor so I can continue monitoring his glucose closely too.

At his last vet check, they said it looks like his pancreas is doing better based on the blood work but I think it's still recovering a bit too. He's on Chinese herbs San Ren Tang to help both his pancreas and colon and I saw a huge improvement in BG after we started him on those. All the ER vets had mentioned that they were unsure if he was actually diabetic or if he had an onset of diabetes due to his pancreas being so inflamed and not producing enough insulin as a result, my gut was the latter.

BG numbers started at 19mmol/L when he first came home from the hospital about a month ago, and we are now sitting at a stable 7/8 regardless of what he eats/how much he eats. I gave him the 0.5U this morning when he was at a stable 7 all night, and he almost dropped past 3. I regretted it so much because my gut was telling me he was in remission, but I didn't want to skip a dose and regret it. Of course I had to hear it from the vet to trust that I was right, yet again.

So annoying because I've gotten very good at trusting my gut in most other cases but I get so fearful when it comes to my babies.

You get used to it I ended up making a bib for Minnie so it was still open but protected if she rolled over anything. Check it out

minnie is also on Visbiome but I only give her 1/3 once a day how much were you giving him? And I mix it with S Boulardii which is specific for stool regulation and I use 1/4 capsule of that one.

since you’ve tried Cerenia, I wonder if it’s worth trying ondansetron. Some cats like Minnie respond better to it than Cerenia

 

[Ale & Bobo & Minnie (GA)]

And it’s been a week only and the wound is already pretty much closed up

 

[jt and trouble (GA)]

And it’s been a week only and the wound is already pretty much closed up

Oh wow great! Our kitties are walking miracles!

 

[Buddy’s Ma]

He’s going back on Cerenia and another round of Metronidazole tonight. His vet suggested against Ondenestron because of the side effects it can have, one being vomiting which we’re really wanting to eliminate since vomiting could dislodge the tube

I’m trying to attach screenshots of his BG chart but it’s asking me for a link. Anyone know how to add images without a link?

 

[Ale & Bobo & Minnie (GA)]

He’s going back on Cerenia and another round of Metronidazole tonight. His vet suggested against Ondenestron because of the side effects it can have, one being vomiting which we’re really wanting to eliminate since vomiting could dislodge the tube

I’m trying to attach screenshots of his BG chart but it’s asking me for a link. Anyone know how to add images without a link?

Cerenia used to do that to Minnie that’s why I switched to ondansetron but yes maybe wait till after the tube is removed. The pro of it is you can give it daily no need to stop and restart Minnie is also on metocloperamide now. Maybe ask about that one too...

 

[Buddy’s Ma]

So far so good on the Cerenia and no poops I've seen yet which hopefully means the Metro is working!

 

[Ale & Bobo & Minnie (GA)]

So far so good on the Cerenia and no poops I've seen yet which hopefully means the Metro is working!

Metro does work great YAY!!!