11/21 Luna: Return of Rocket Cat? - AMPS 208, +2 496, +3-5 HI, +6 466

For_Luna

For_Luna

Member Since 2019
Yesterday is one of the best days for BG that we've had since Luna came home. Mostly yellow and blue for the entire day and night. This morning we started out with 208 and shot up to red at +1 and HI by +3.

I thought I had a fur shot this morning because she smells like insulin and her numbers are high. She's so skinny there's not much to grab, and we can't use the neck area yet. I know I got the needle in because she squeaked and turned around and looked at me while I was giving the injection. I think I at least got a partial, but we might also be seeing old Luna with her bouncing after a good day.

I know her food is higher carb and we were off of Lantus while she was in the hospital, but has anyone else seen an increase in dosage like this with DKA or pancreatitis? There had to have been some damage done internally or maybe we're still dealing with inflammation? We're double what she was before all of this happened, and it's nowhere near as effective. Though the emergency vet that treated Luna, who is probably our new vet now, said 150-300 is where he wants her.
 
Wish I knew what to say. No experience with DKA (thank goodness) Just wanted to send support. Still thinking of you. Really hope things calm down for you soon.
 
Hi Dan,
Nothing to offer except admiration for the care you and your wife take of Luna.
But can you fix your thread title? +3-5 HI +6 46 got my adrenalin going crazy.
 
My experience has been that Ts BGs will increase due to inflammation & especially with pain. I have seen the BGs start to go up & then I will notice other symptoms (increased crouching or decreased appetite or increased lethargy) start to occur. In fact, when we attempted to decrease the Prednisolone when T was first diagnosed with diabetes, the pancreatic specialist out of TAMU & a feline specialist out of Cornell both said it was worth a try to decrease the Prednisolone but that the knee jerk reaction to discontinue steroids due to diabetes is a mistake & that by discontinuing them, we may see a worsening of his diabetes secondary to an increase in inflammation. Therefore, we were advised to reduce very slowly, keep the insulin the same & watch for any increase in BGs for 2-3 weeks at a time while he would be given a slightly lowered dose. They also let me know that they have seen many cats BGs actually improve when treated with steroids vs off of them secondary to the uncontrolled inflammation. So, yes, inflammation &/or pain will make it harder to manage BG even with insulin on board. The inflammation/pain must be controlled.

Did they do a Spec fPLI? The importance of this test cannot be overstated because if there is Pancreatitis, besides clinical symptoms, the way you you are able to monitor what is happening is by repeating the test to see if it changing—-is the specific # staying the same, going up or going down. That is the issue with just doing the in clinic SNAP test vs sending it off for a specific value. In clinic is not going to provide any specific #. So, while it is additional $ to get the Spec fPLI, it is worth it to help with monitoring a very complicated disease state.

I’m hoping Luna does not have pancreatitis—last I remember she does not?
 
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TSP said:
My experience has been that Ts BGs will increase due to inflammation & especially with pain. I have seen the BGs start to go up & then I will notice other symptoms (increased crouching or decreased appetite or increased lethargy) start to occur. In fact, when we attempted to decrease the Prednisolone when T was first diagnosed with diabetes, the pancreatic specialist out of TAMU & a feline specialist out of Cornell both said it was worth a try to decrease the Prednisolone but that the knee jerk reaction to discontinue steroids due to diabetes is a mistake & that by discontinuing them, we may see a worsening of his diabetes secondary to an increase in inflammation. Therefore, we were advised to reduce very slowly, keep the insulin the same & watch for any increase in BGs for 2-3 weeks at a time while he would be given a slightly lowered dose. They also let me know that they have seen many cats BGs actually improve when treated with steroids vs off of them secondary to the uncontrolled inflammation. So, yes, inflammation &/or pain will make it harder to manage BG even with insulin on board. The inflammation/pain must be controlled.

Did they do a Spec fPLI? The importance of this test cannot be overstated because if there is Pancreatitis, besides clinical symptoms, the way you you are able to monitor what is happening is by repeating the test to see if it changing—-is the specific # staying the same, going up or going down. That is the issue with just doing the in clinic SNAP test vs sending it off for a specific value. In clinic is not going to provide any specific #. So, while it is additional $ to get the Spec fPLI, it is worth it to help with monitoring a very complicated disease state.

I’m hoping Luna does not have pancreatitis—last I remember she does not?
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I didn't see Spec fPLI on any of her tests; just looked through 30 pages. I know we asked about a pancreatitis test at some point. They did multiple ultrasounds and radiographs and said the liver was inflamed but I believe they said the pancreas wasn't or they couldn't tell because of the inflammation around it...there was a lot of info. Basically they didn't suspect pancreatitis based on what they saw, but also didn't rule it out since it's often a trigger of DKA. So they changed her food and the supplements are supposed to help. The nutritionist explained their purpose. And the didn't give her any steroids, so that makes me further believe they really didn't think it was pancreatitis. Which is good if true, but also we still don't know what started all of this.
 
For_Luna said:
I didn't see Spec fPLI on any of her tests; just looked through 30 pages. I know we asked about a pancreatitis test at some point. They did multiple ultrasounds and radiographs and said the liver was inflamed but I believe they said the pancreas wasn't or they couldn't tell because of the inflammation around it...there was a lot of info. Basically they didn't suspect pancreatitis based on what they saw, but also didn't rule it out since it's often a trigger of DKA. So they changed her food and the supplements are supposed to help. The nutritionist explained their purpose. And the didn't give her any steroids, so that makes me further believe they really didn't think it was pancreatitis. Which is good if true, but also we still don't know what started all of this.
Click to expand...

That is great albeit still challenging when you are searching for answers. If it helps at all, know that what your vet is telling you about the range is in line with most of what the top endocrinologists studying feline diabetes are saying as well. They are finding little evidence that improving glycemic control in cats that are already reasonably controlled (clinically) has any long term benefits. This goes back to the importance of treating the cat vs a #. It sounds like overall, Luna continues to improve, which is so awesome :).
 
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Have you discussed an increased dosage with your vet? It look like based on her numbers that she may need one. Unfortunately as we see with many kitties, the dose that worked previously just doesn't work now - for various reasons, their needs change - try not to look back and focus on what was, but what she needs now to get those numbers down. Love that Libre! So nice to see all her numbers - albeit too high numbers...but nice to monitor so closely!

You guys are doing a great thing with Luna's care! :bighug::bighug:
 
Sue and Luci said:
Have you discussed an increased dosage with your vet? It look like based on her numbers that she may need one. Unfortunately as we see with many kitties, the dose that worked previously just doesn't work now - for various reasons, their needs change - try not to look back and focus on what was, but what she needs now to get those numbers down. Love that Libre! So nice to see all her numbers - albeit too high numbers...but nice to monitor so closely!

You guys are doing a great thing with Luna's care! :bighug::bighug:
Click to expand...
Yeah, we've been sending her numbers. We'll probably increase soon but he likes to hold for a few days before changing.

Yesterday's numbers were in a range he likes, though I'd like to see them a bit lower. We'll follow the vets advice as she heals, and we can think about being more aggressive later. Hopefully these larger doses won't be needed for long.

I hope we're doing everything we can for her. I thought we were doing a good job before she got sick, now it's like we're starting over and I don't know.
 
I think the Libre sensor is dying. Been getting scan errors all day, and then it started showing LO and then when it started showing numbers again, it was in the 180s and started dropping fast. We checked PMPS and +1 against our meter and it said we were in the 400s. Might be going old school tomorrow.
 
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