? No longer in remission?

[Kiera]

I’m not sure if my cat needs to go back on insulin or not. I was hoping to get some advice.

After only a month and a hypo scare, my cat went into remission. We stopped insulin. That was in September.

He was doing great and I hate to admit it, but I wasn’t testing his BG since stopping. I was only monitoring his behavior, water consumption, etc. I was also testing urine (always negative for glucose and ketones).

Then, about a month ago, his water consumption began to increase significantly. A lot of days he drinks 14-16 oz. He’s peeing a lot as well.

I have been spot checking his BG for the past few weeks, and although I haven’t used the spreadsheet since September, his numbers have ranged from 120-170 regardless of when I test.

I just got a reading a few minutes ago and his number was 157. I don’t believe he has had food in a couple hours or more.

Do I need to start insulin again? Or is this number still safe? I know it’s not ideal. But is it bad?
I was hoping it was low enough to not restart insulin. But he shouldn’t be drinking so much water. It likely means something is wrong or that he needs insulin. Right?

Not sure if it’s related, but he has suffered from sinus issues most of his life (he’s a senior now). This month the poor guy has had watery eyes, stuffy nose, sneezing and snot. I’ve been to the vet in the past many times for this but we’ve never found a solution. The vet believes it’s feline herpes (keep in mind, I discovered my vet is not to be trusted so this may not even be true).

His sinus problems come and go. This time I’m concerned that his symptoms seem to be lasting much longer than usual. Basically this entire month so far. And no improvement. I just wanted to mention it in case it matters or could be impacting his increased water consumption or BG numbers. I will probably need to take him to the vet. I just need to find a new one. He gets so frantic and stressed whenever he has to leave the house so I’ve been avoiding it. He tends to get worse after vet visits. Likely from stress.

Anyway, what do you guys think?

 

[Bron and Sheba (GA)]

Hi Kiera, would you be able to get some BG tests in for a few days so we can see what is happening?
If you can test before feeding then get a BG 3 hours later to see if it has gone down, that would be helpful.
It is possible if Bailey has a flare up of his sinus issues, the BGs might have gone up because of that and may settle if the problem can be resolved.
Are you still feeding only a low carb diet?
I would try and get a few days of tests in at different times of the day and post again. I would not start insulin again just yet until we can see some data.

 

[Sienne and Gabby (GA)]

I'd also suggest a vet visit. Any source of infection or inflammation can cause BG levels to rise. It may be your cat's sinus issues are the cause of the higher numbers. Dental issues are also a frequent cause of cats coming out of remission.

 

[Kiera]

Hi Kiera, would you be able to get some BG tests in for a few days so we can see what is happening?
If you can test before feeding then get a BG 3 hours later to see if it has gone down, that would be helpful.
It is possible if Bailey has a flare up of his sinus issues, the BGs might have gone up because of that and may settle if the problem can be resolved.
Are you still feeding only a low carb diet?
I would try and get a few days of tests in at different times of the day and post again. I would not start insulin again just yet until we can see some data.

Ok, I can get more tests. It might be the food too. My other cat has IBD and always vomits after wet food. It causes other issues too. He is on dry food for sensitive stomach. It took me awhile to find, but I finally found one he can keep down. Lately, I have been catching Bailey eating it when I’m not paying attention. It is so frustrating!

They each want the others food that they can’t have. It’s a full time job keeping them at their own bowls. But I have a real job. So I’m struggling with it. I don’t even know what to do anymore. Neither will eat immediately when I put food down (unless it’s dry food for the diabetic and wet for the cat with IBD— the food they can’t have— almost like they do it just to spite me).

 

[Kiera]

I'd also suggest a vet visit. Any source of infection or inflammation can cause BG levels to rise. It may be your cat's sinus issues are the cause of the higher numbers. Dental issues are also a frequent cause of cats coming out of remission.

I will do some research and find a new vet. Do you think the sinuses could explain the heavy water consumption or is that because of his BG? He’s at 149 right now but it’s the first test today. I didn’t see these messages sooner. I just got home so I’m not sure when he ate last.

Would this number on its own mean insulin is needed again? It’s nowhere near where it was when first diagnosed. It seems good in comparison but I don’t know what the number actually means.

 

[tiffmaxee]

Hi Kiera. Sorry to see you back. I hope a vet visit explains what’s going on and then a quick fix. Please start adding all test to your spreadsheet.

 

[Sienne and Gabby (GA)]

Vets really vary in what they consider "normal" numbers. I've seen some vets feel comfortable with a diabetic cat in the 300s. Go figure! We consider normal BG range from 50 - 120, preferably below 100 if using a human meter. Vets are more generous, especially if the cat is on insulin because they are not available 24/7 and most of their clients don't home test. The last normal range on one of my kitties' labs was 72 - 175 on a serum chemistry analyzer (it would be similar to test results using an AlphaTrack or other pet meter).

If Bailey is showing other symptoms, like increased water intake and greater urine output (polydipsia and polyuria/PD and PU) along with higher BG, it may be that your kitty is symptomatic. However, keep in mind that when a cat goes into remission, it doesn't mean the diabetes is cured. While diet will help to control the numbers, any source of stress such as illness (inflammation or infection) can cause numbers to go back into diabetic range. Some cats need to go back on insulin and will go back into remission. Unfortunately, that's not true for all kitties.

As for the food situation, you might want to think of a microchip feeder. There's a flap that opens in response to your cat's microchip and only for that cat. If the kitty walks away, the flap closes. If your cat isn't chipped, I think they send a tag you can put on a cat's collar. The down side is that the feeders are pricey.