11/25 Biddy - high BG

Hi there! I hope you’re doing well. Traveling at all over this weekend? Do you get days off this week from the vet?

As for Biddy, I spent quite a bit of time last night pondering his spreadsheet. If you think there’s nothing new going on with his health then the only other thing I can think of is that this dose has gone stale for him and to increase by .25. That does happen sometimes. Hopefully we can bump him out of the higher numbers and maybe even take his dose back down over time.
 
I noticed the trend beginning around the first of November but becoming more pronounced recently. Has he been recently checked over at your vet? Appetite still good? Bowels? He seems stable on his meds? No new proteins introduced?
 
Just a short trip to visit my fiancé's family tomorrow. They live about an hour from us. We are both lucky enough to have tomorrow and Friday off. Any big holiday plans for you?

Biddy hasn't been seen by his vet for a couple months but has an appointment next Thursday for an exam and bloodwork. His appetite is great, his stools are solid, and he seems to be thriving! He's been eating the Farmina Digestion formula (lamb and quail) since September and tolerated the transition far better than I could have hoped for.

I am feeling a bit frustrated with our vet (my boss) because after I gave her his last glucose curve, she mentioned that she believes he is going into remission! She told me to text her if his preshot is under 150 and she will likely lower his dose by HALF. I feel conflicted because I do not want to go against her directions but I thought that was absolutely bananas and I have lost quite a bit of trust in her...
 
Wow. That’s amazing. Remission! Biddy is far from remission (as you and I both know.) Gosh I wonder how high Biddy’s BG would go with a dose cut to 3 units! I am kind of speechless.
 
When was the last curve you showed the vet? I see some beautiful numbers on November 4, but that was with the help of 6 units of insulin.
 
Yes, November 4th was the curve I showed her. I was very pleased with his numbers that day but I was shocked when I heard the word remission! Yikes!
 
Hello. I hope you had a good Thanksgiving.

It’s disappointing to see that his numbers haven’t moved much. It’s all good news with the bloodwork though — so we should be happy with that.

If Biddy were my cat, I would continue to increase until I reached a breakthrough dose. I can’t think of anything else except that cats’ insulin requirements can change over time. You said his appetite is good and stools are normal. And his arthritis? How is that?
 
His appetite is great and stools have never looked better! We’ve been doing Solensia the past few months with great results. He’s getting around much better.
 
Hello. I have been thinking about Biddy’s numbers. Sorry for the delay. I was trying to remember if we had ever talked about having him tested for Acromegaly or Insulin Autoantibodies? It’s probably just the Triaditis and the high Pred dose, but it seems like it would be worth checking.

Now that Biddy is at a higher dose, dose increases and dose reductions can be made in .5 increments. Think of it as a proportion or percentage of the dose. Actually if you think of it — a .25 unit increase when a cat is at a dose of 1 unit is a 25 percent increase. For a cat on 6 units, an increase of .5 units would be less than ten percent. When a cat gets to 10 units then the increases and reductions are usually done in approximately ten percent increments from there on. The only time you might do smaller increases and reductions if of you are really close to an ideal dose and then you fine tune the dose.

His numbers aren’t too bad and he still sees some blue. I wonder if it’s the ebb and flow of his inflammation?

Does he lick the Animax ointment off? Just wondering how you manage that.
 
On that high Pred dose, how do you keep Biddy from catching bugs when he goes to the vet? I have cats who are at the vet a lot and they always seem to catch something. They get upper respiratory infections and bring them home and next thing you know it runs through most of the household. A few of the cats are delicate and a URI can be the end for them (particularly for my FIV+ boy and for my girl with the severe rhinitis— she got a URI recently and stopped eating. I had to fully syringe feed her three times a day for five days.). I guess Biddy has a pretty good immune system despite the Pred! What a blessing! Our latest bug going through the cat household involves diarrhea. Fun fun fun!
 
Oh boy! Luckily we have not had any issues catching any illness at our clinic thus far!
We have not tested for acromegaly or insulin autoantibodies (his vet is happy with his bg). I had a shirt on him while he was getting Animax otherwise he definitely would lick it off.
 
Have you ever tried taking him off the Flagyl? That’s not a recommendation! I am just wondering. I have read about Metronidazole toxicity and also about studies showing long term changes to the gut microbiome with Metro. But some cats really need it, including one of mine who had to take heart medications that gave her diarrhea. She had to be on it long term.
 
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We have tried and it did not go well. His stools are so good now I’m afraid to change anything but might be worth another try.
 
Lane&Biddy said:
We have tried and it did not go well. His stools are so good now I’m afraid to change anything but might be worth another try.
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I probably would not rock the boat. You do such an excellent job with him. I bet there were times you thought you would never have him this healthy and stable with the GI stuff.
 
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