? Glucose in urine question

[MISSY + Simone&MICIO (GA)]

Not sure what's going on with my Missy but her the situation aggravated...Not only her BGs keep getting higher (264 yesterday) but now she also have Glucose on her urine: I tested 3 diastix strips with the same urine sample and all with same result between 1/2 and 1. How bad is it?
This is the first time I've seen this and I'm not familiar with what glucose in the urine numbers/levels, is this an emergency?
Having a phone call appointment in the morning with the IM, meanwhile can someone advise, please? I'm totally freaking out now....Missy's BGs has been around 100-130's up 'till late last month and in the last couple of weeks her numbers totally spiked up! @Bron and Sheba (GA) , @Chris & China (GA), @Suzanne & Darcy
Below, the previous link from couple of days ago.
https://felinediabetes.com/FDMB/threads/missys-tests-results-need-help-please.274912/

 

[Bron and Sheba (GA)]

The glucose test in the urine just indicates that the glucose is spilling into the urine. There is a threshold and until that threshold is reached, no glucose spills into the urine. The threshold is different in every cat but it is around 200-280.
There is no need to be concerned. Testing the BGs is giving you a better idea of where things are up to.
The higher BGs are looking like she may need insulin moving forward.
Do you think she could have an infection such as a UTI?
How are her teeth?
When you speak to the IM vet ..if he suggests insulin make sure you get either Lantus (my preference) or prozinc.

 

[MISSY + Simone&MICIO (GA)]

The glucose test in the urine just indicates that the glucose is spilling into the urine. There is a threshold and until that threshold is reached, no glucose spills into the urine. The threshold is different in every cat but it is around 200-280.
There is no need to be concerned. Testing the BGs is giving you a better idea of where things are up to.
The higher BGs are looking like she may need insulin moving forward.
Do you think she could have an infection such as a UTI?
How are her teeth?
When you speak to the IM vet ..if he suggests insulin make sure you get either Lantus (my preference) or prozinc.

I'll get her urine next time she'll pee and run another diastix plus I can use some Pretty Litter too to see if the color change may indicate issues. She doesn't look uncomfortable or straining when she pees, wouldn't that be a sign of UTI? But she keeps drinking and pee though...

Have been wondering why all of a sudden her appetite increased in the last week. On 24 February I also increased the Budesonide a tiny bit, from 0.1 to 0.15ml once daily to try to help with Panc but I wouldn't think it would increase her BGs that much...do you?
Her teeth have some tartar but there shouldn't be any gingivitis/infection, she was last checked last December by regular vet . I will ask the IM this morning if she checked her mouth also on the 20 February visit (they took Missy on the back for the visit and tests...I hate that).

As for the insulin, I relally don't think Missy will alloe me to give her shots without quickly squirming away from me or/and bite me, plus either one of us getting hurt with the needle. Only thing I can think is try to give her a shot (with some water on it) on her scruff and see her reaction....but I'll guarantee, she'll take that so wrong and that's it, won't let me do anything else anymore. Micio was soo easy in everything I had to do with him...
If insulin will be an option, I had good luck with Insulin Glargine with Micio and I still have 1 brand new pen. Lantus is soo expensive. I don't know about Prozinc. Is there any good insulin that can be give just once a day or is it best to give depot type of insulin?
Tnx

 

[MISSY + Simone&MICIO (GA)]

UPDATE: Diastix test: Ketones= none / Glucose 1 BG's (2-1/2 hours after morning meal): 223
Pretty Litter test (for what is worth): normal range color, dark yellow to green

 

[Ale & Bobo & Minnie (GA)]

No insulin should be given once a day only. So was she diagnosed with diabetes and when? Did they do a fructosamine test? If she’s diabetic, the longer without insulin the worse it is for her. Glargine is just the generic form of Lantus and it’s a good insulin

 

[MISSY + Simone&MICIO (GA)]

No insulin should be given once a day only. So was she diagnosed with diabetes and when? Did they do a fructosamine test? If she’s diabetic, the longer without insulin the worse it is for her. Glargine is just the generic form of Lantus and it’s a good insulin

I am familiar with Insulin Glargine and I know that's best but was just wondering for other options too. Missy hasn't been officially diagnosed with diabetes yet but probably getting close to. I've attached a link with the latest blood work from previous post. I'm currently and closely working with the IM doctor and agreed on try a few different things before start insulin...but we both agree on not waiting for too long neither.

 

[Suzanne & Darcy]

Hello Simone. I was not on the Board at all yesterday but am reading through this post today. What happened with the IM vet? What advice did she have? Did you all discuss the Bexacat? Anything else new? I would suspect an infection too, except as I recall the recent blood work didn't show any indications of an infection and neither did the urinalysis. How is she eating? If not eating much then it still could be the pancreatitis raising numbers because of pain?

 

[MISSY + Simone&MICIO (GA)]

Hello Simone. I was not on the Board at all yesterday but am reading through this post today. What happened with the IM vet? What advice did she have? Did you all discuss the Bexacat? Anything else new? I would suspect an infection too, except as I recall the recent blood work didn't show any indications of an infection and neither did the urinalysis. How is she eating? If not eating much then it still could be the pancreatitis raising numbers because of pain?

Hi! Talked to the IM yesterday and she thinks Missy may be in the middle of a panc flare up, doesn't think infections but definitely inflammation. She wanted me to decrease Budesonide back to 0.1ml and start her on Denamarin which, supposedly, can help with pancreatitis (I've used that for Micio for several years for his high ALT but had no idea it can be useful for other issues)....I already started Missy on it today, we'll see if she'll tollerate and how she does on it. I was giving her Milk Thistle already but I guess I will stop that since Denamarin is a more complete supplement, is that correct?
Dr. doesn't want to start her on insulin yet as she wants to try this first; she's also aware of the situation and the fact that it will be very hard to give her shots.
We discuss Bexacat but we both agreed tha Missy is not a good candidate for it. I did read the link you sent me (thank you) and the IM confirm my fears but...if shots don't work we need to find a way to treat her.
IM wants me to closely monitor Missy with BG's along with testing her urine for ketones and glucose and also her weight. Doctor doesn't "believe" in Bupe that much, instead she suggested Gabapentin (don't know about that though...). Missy started eating more and on her own as soon as I bumped up the Budesonide back on 24 February but also her BGs went crazy high, that's why she wants to see what happens by lowering a timy bit the dose again...we have to try in order to find out what's going on with her.
She still eat "ok", I make sure she doesn't skip a meal but her stools are a continuous up and down and, the presence of either reddish mucus or/and bright fresh blood , is definitely an indication of inflammation/irritation on her GI...
I've been giving her S. Boulardii now and Gut Soothe but with caution cause then we may be facing constipation and so on....a continuous monitoring and tinkering, it's like walking on eggshells but I really hope we can find her balance again soon.

I'm seeing a lot of similarities like I had with Micio when he first was diagnosed with diabetes...their attitude, behavior, coat...a lot changes when they are sick

 

[Suzanne & Darcy]

Yes. I was thinking of a pancreatitis flare up. I sorry about reducing his Budesonide dose, but I agree that you have to try. I do like Denamarin and have had reductions in ALT with using Denamarin. But how will you get it into her since it is a pill?

 

[MISSY + Simone&MICIO (GA)]

Yes. I was thinking of a pancreatitis flare up. I sorry about reducing his Budesonide dose, but I agree that you have to try. I do like Denamarin and have had reductions in ALT with using Denamarin. But how will you get it into her since it is a pill?

Here's the weird part about Missy...I can brush her teeth, I can pill her with no problems, she let me test her ears for BGs most times and I can still trim her nails a bit but she doesn't want me to brush her , touch her sides or feet/hands pick her up, clean her butt when she gets dirty sometimes nor give her shots even with the thinnest needle.
With Denamarin I'll have to push the pill on her throat with my finger for now cause it doesn't fit on my pill gun, I coat it with some coconut oil to make sure she doesn't taste it and goes down smootly... I'll look into different ones. I give her Denamarin in the afternoon, about 3 hours after lunch,3 hours before dinner and hopefully she'll keep it down...with Micio, I was giviing it to him early in the morning, he tollerated it for first 2 years then he started rejecting it so hopefully Missy will do better on it.Her ALT slightly elevated but still ok, we're hoping it will help the Pancreas though.

 

[Bron and Sheba (GA)]

I have to pill Clover every day and she can be difficult. I remain calm and talk to her and pick her up and lie her on her back on my knee, holding her scruff with one hand and open her mouth with the other hand and pop the pull into the back of her throat. Works 9 times out of 10 and the 10th time is difficult.

 

[MISSY + Simone&MICIO (GA)]

I have to pill Clover every day and she can be difficult. I remain calm and talk to her and pick her up and lie her on her back on my knee, holding her scruff with one hand and open her mouth with the other hand and pop the pull into the back of her throat. Works 9 times out of 10 and the 10th time is difficult.

Amazing how every single cat differs from another....it would be virtually impossible for me to have Missy lie on her back, she'll shred my soul