Biscuits and neuropathy

[Karen & Biscuits]

Happy Saturday everyone! I hope you all had a great week! I am having issues with Biscuits - sort of new ones actually and I don't know what to make of it. About 3-4 weeks ago I started her on Methyl B-12 as many of you recommended, despite her sugar being high. It seems to be helping as she is walking slightly better and has been jumping up on things by herself in the last week. What concerns me is extreme sensitivity in her back, all along her spine from the neck to the tail and even her ribs. What is causing that? She has never been sensitive anywhere, unlike her brother Purrcey, who is not diabetic but hates his back being touched. He has always been that way but Biscuits has not. If I run my hand along her back, she licks herself or the air like crazy, she will turn around and try to bite me, which is NOT normal for her. She's never done that. It's making me wonder if she's been numb along her back and her hind legs and maybe has a feeling of pins and needles that are amplified by touch, sort of like when a hand or foot falls asleep on humans and as the nerves come back to life it's extremely sensitive for a few minutes. Am I way off base or what is this? Has anyone else had a cat with this issue?

 

[JanetNJ]

Happy Saturday everyone! I hope you all had a great week! I am having issues with Biscuits - sort of new ones actually and I don't know what to make of it. About 3-4 weeks ago I started her on Methyl B-12 as many of you recommended, despite her sugar being high. It seems to be helping as she is walking slightly better and has been jumping up on things by herself in the last week. What concerns me is extreme sensitivity in her back, all along her spine from the neck to the tail and even her ribs. What is causing that? She has never been sensitive anywhere, unlike her brother Purrcey, who is not diabetic but hates his back being touched. He has always been that way but Biscuits has not. If I run my hand along her back, she licks herself or the air like crazy, she will turn around and try to bite me, which is NOT normal for her. She's never done that. It's making me wonder if she's been numb along her back and her hind legs and maybe has a feeling of pins and needles that are amplified by touch, sort of like when a hand or foot falls asleep on humans and as the nerves come back to life it's extremely sensitive for a few minutes. Am I way off base or what is this? Has anyone else had a cat with this issue?

That could be. Or maybe some arthritis. You'll want to get those numbers in a better range to help the neuropathy resolve faster.


I was just looking at your spreadsheet. Your cat is due for an increase. Generally you don't want to hold an ineffective dose more than a week.

 

[Karen & Biscuits]

That could be. Or maybe some arthritis. You'll want to get those numbers in a better range to help the neuropathy resolve faster.


I was just looking at your spreadsheet. Your cat is due for an increase. Generally you don't want to hold an ineffective dose more than a week.

 

[Karen & Biscuits]

Hi Janet! I agree with you on the increase of Levemir. I sent the spreadsheet to my vet last week and I'm waiting on a response from her about it. The weird thing is, Biscuits glucose levels are all over the place. She can dip down into the 300's or high 200's and then back up to 500 + and it makes me scared to change the dose because I never know what is coming next. I don't know why it's so high except for pain and given the way she's acting with her back, I'm thinking her pain is a lot higher than the gabapentin is able to manage. She's on 75 mg tablet once a day and she tolerates it well but I don't think it's really working for her pain. She's just acting very strange lately and while some of it is good, in terms of her being able to move and jump a bit better, she's also not wanting to be touched the way she used to. She's become very sensitive to that and that has never been the norm for her.

 

[Wendy&Neko]

When we look at dosing Levemir, we don't look at the highs. Those are mostly from bounces or the dose being too low. We look at the nadirs, or how low the dose is taking the cat. Biscuits needs an increase. Once she starts getting closer to a better dose, and as a result gets more used to normal numbers, her levels will flatten out.

Gabapentin never did much for Neko's pain, she needed buprenorphine. I think you need to experiment to find out what works for your cat.

 

[JanetNJ]

Hi Janet! I agree with you on the increase of Levemir. I sent the spreadsheet to my vet last week and I'm waiting on a response from her about it. The weird thing is, Biscuits glucose levels are all over the place. She can dip down into the 300's or high 200's and then back up to 500 + and it makes me scared to change the dose because I never know what is coming next. I don't know why it's so high except for pain and given the way she's acting with her back, I'm thinking her pain is a lot higher than the gabapentin is able to manage. She's on 75 mg tablet once a day and she tolerates it well but I don't think it's really working for her pain. She's just acting very strange lately and while some of it is good, in terms of her being able to move and jump a bit better, she's also not wanting to be touched the way she used to. She's become very sensitive to that and that has never been the norm for her.

Even the 200's are way too high. Raising the dose at this point is what you need to do. We want to see the low numbers around 90-100.

 

[Karen & Biscuits]

When we look at dosing Levemir, we don't look at the highs. Those are mostly from bounces or the dose being too low. We look at the nadirs, or how low the dose is taking the cat. Biscuits needs an increase. Once she starts getting closer to a better dose, and as a result gets more used to normal numbers, her levels will flatten out.

Gabapentin never did much for Neko's pain, she needed buprenorphine. I think you need to experiment to find out what works for your cat.

I think you're right about the gabapentin, she's just not herself anymore and I'm getting more and more worried that I'm going to lose her if we can't get this glucose stuff sorted out. I know the neuropathy may straighten out on its own if we can get her sugar down to normal levels but my fear is that she's suffering organ damage, maybe slight right now but with her numbers so high it has to be causing issues with other parts of her body too. I will ask the vet about buprenorphine and see what she thinks. Is that available in pill form? I think I recall seeing that after a spay or neuter with my ferals and strays as a 3 day pain shot, but I could be mistaken, it just sounds familiar. I'm just frustrated because I was so hoping that the Levemir would change things for her and it seems like we're still in the same rut. I will up her dose in the morning to 3 units and see how she does with that. Got to start somewhere right?

 

[Karen & Biscuits]

Even the 200's are way too high. Raising the dose at this point is what you need to do. We want to see the low numbers around 90-100.

I totally agree, as I said to Wendy, I am frustrated with this because I thought the Levemir would change things quickly for her and in the first 3-4 days it sort of did bring her levels down but just not far enough. I've tried to be patient by giving her body time to adjust to a new insulin and give it a chance to regulate her sugar but so far she's all over the place, mostly way too high. I am going to up her dose to 3 units in the morning and see what happens. Thank you!

 

[Wendy&Neko]

Buprenorphine is a liquid. You squirt it on the gums or inner cheek and it is absorbed there. Dosing is based on ca5 weight but quite a range, so you may have to tinker with it based on the cat’s reaction to it. I got it compounded into a chicken flavoured liquid. It is considered a restricted drug, so some vets are more reluctant to prescribe it.

 

[JanetNJ]

I totally agree, as I said to Wendy, I am frustrated with this because I thought the Levemir would change things quickly for her and in the first 3-4 days it sort of did bring her levels down but just not far enough. I've tried to be patient by giving her body time to adjust to a new insulin and give it a chance to regulate her sugar but so far she's all over the place, mostly way too high. I am going to up her dose to 3 units in the morning and see what happens. Thank you!

3 units is a good call. I think there is some insulin resistance going on. You may find you need to do several increases at this point until you find the breakthrough dose and then it will start coming down.

 

[Karen & Biscuits]

3 units is a good call. I think there is some insulin resistance going on. You may find you need to do several increases at this point until you find the breakthrough dose and then it will start coming down.

Biscuits sugar is all over the place. Late last night when I did her shot, her sugar was at 155, that's the lowest it has been in months. I have no idea what happened. I was worried about giving her too much insulin last night because I can't stay up and watch her all night so I just did 2 units and waited until about 2 am. She was fine and acting normal, no sign of her sugar going too low. I tested it again just before I went to bed, and it was up to 233! What's up with that? She had not eaten anything since her shot and me taking the reading a second time. I found that to be very odd. This morning it was back up to 551 and that was after she ate breakfast, which was 1/3 of a can of Weruva Cats in the Kitchen, which doesn't usually mess with her sugar at all. I gave her 3 units and it came down a bit but it's just making me nuts because I have no idea why her sugar is bouncing around like this. I'm just confused with what is going on. Any suggestions?

 

[JanetNJ]

Biscuits sugar is all over the place. Late last night when I did her shot, her sugar was at 155, that's the lowest it has been in months. I have no idea what happened. I was worried about giving her too much insulin last night because I can't stay up and watch her all night so I just did 2 units and waited until about 2 am. She was fine and acting normal, no sign of her sugar going too low. I tested it again just before I went to bed, and it was up to 233! What's up with that? She had not eaten anything since her shot and me taking the reading a second time. I found that to be very odd. This morning it was back up to 551 and that was after she ate breakfast, which was 1/3 of a can of Weruva Cats in the Kitchen, which doesn't usually mess with her sugar at all. I gave her 3 units and it came down a bit but it's just making me nuts because I have no idea why her sugar is bouncing around like this. I'm just confused with what is going on. Any suggestions?

Hooray for a blue number! My guess is she had a late peek. The high number in the morning was a bounce because even though 153 isn't hypo, her body isn't used to those low numbers. Once she's more used to them her liver hopefully won't panic and the bouncing will subside.

If you get a preshot under 200 it's a good idea to stall withought feeding for up to an hour and retest to see if the number is going up.