? 11/25 - Gen, AMPS 61, NS, [...] +7 >400 (relapse, hypo, trying to restart insulin)

eddis

Member Since 2025
(What a first post to be making in the support group forums.)

Yesterday evening we started back on a low dose - 0.5U. I was nervous, because he was hospitalized last week (after a few days of 1U every 12 hours, following relapse/rediagnosis), so I kept an eye on him for the first few hours. He started with a PMPS of around 400 (this is with a Libre, so high numbers are "out of range") and when I went to bed about four hours later it was at 244.

I had set the "low glucose" alarm at 100 but apparently I managed to sleep through it. Woke up about half an hour ago to numbers in the low 60s. The overnight graph just goes down, down, down.

He'd been sleeping in the bed with me and it was a little hard to identify symptoms one way or another, so I got up and went to feed him immediately. He's currently on a Hill's m/d wet and dry diet (the plan has been to look into changing that after we get him a little more regulated). He ate some of the dry food and stopped (not unusual; he never eats everything in a sitting, he's always been a grazer), but I checked the monitor and it was down to 57.

Yes, I know a blood test would be better. He doesn't tolerate them from me. I'm a solo cat parent and he's a rather big boy (not heavy, but big/tall), and he's shown repeatedly in the past that I can't restrain him sufficiently to get a good reading. And ratcheting up the stress is generally something I try to avoid.

I tried to give him some honey at this point, and he was having none of letting me anywhere near his mouth. (Very normal for him, unfortunately, and he is currently in need of an oral procedure which we had to delay due to relapse.) So I went and got a can of Wellness Signature Selects Shredded White Meat Chicken & Turkey Entrée in Sauce (what I had on hand from before his relapse, unfortunately; never again except in cases like this), and he ate some of that.

As symptoms go, he's moving slowly and somewhat lethargically (though he perked right up to struggle when I tried the honey). After eating he wandered down the hall and cried once; I went and found him immediately, crouched outside the door of my roommate's room, where he could hear her on the phone as she gets ready to leave for Thanksgiving. (My roommate doesn't have much to do with him, but he tends to want to know what someone's doing when he hears them talking and also objects to all closed doors.) Now I'm sitting in the living room near him (he doesn't want to come sit with me, probably because I tried to stick something in his mouth last time he did).

He's trending upwards now (higher than the screenshot at this point - 117 now), but I don't trust it - when he was hospitalized last week, he confused the doctors by plunging again after they got his numbers back up; that was well over 12 hours after he'd had his last shot (of the 1U). I'm scared; I don't want to get to that point again! My vet's office opens in an hour. Thank you thank you for any thoughts.

Screenshot_20251125-073733.png
 
In my experience the Libre is very accurate in that 100-200 range, so that's a number you can probably trust. I think you did the right thing skipping his shot this morning, though, and I'm sure you plan to get in touch with the vet when they open.

If it were me, I would keep an eye on the Libre, and if he starts to dip again, give him a little honey mixed into a food or wet treat he likes (rather than trying to force the honey alone). Better to be too high than too low.

Sorry if I missed this in your other thread--what food is Gen on, and what is his meal schedule like? Also, do you know if his relapse was caused by steroids or an infection, or was it just spontaneous?
 
Oh--another question the more experienced members might ask when they get eyes on this thread is more details about his hospitalization. I think you mentioned a fructosamine, do you know what the result of that lab was?
 
He's on Hill's m/d, a combination of wet and dry. I know it's not ideal, but it's what he was put on in 2021 when he was initially diagnosed (and I didn't have all these resources), and given that he went into remission three months later, I didn't see any reason to change it. He kept eating that until sometime in September this year, when the other doctor at my vet's office (my genuinely fantastic vet was on medical leave) suggested I feed him something else because he "wasn't diabetic." I was giving him Wellness Signature Select until a little over a week ago (11/14) when we went in for oral surgery and the initial bloodtests showed a BG of 400. (Surgery was postponed.) That's what I'm considering his re-diagnosis, especially after my vet confirmed it the same day.

I feed him a half can (they're the big ones) and a scoop of dry in the morning, and another scoop of dry at night. I take away leftovers at morning feeding time. He's a grazer, like I said ... I used to think it was from his days as a stray (I adopted him when he was about 1, he was very friendly and inviting himself into peoples' houses through their cat doors in an acquaintance's neighborhood). Food insecurity or something; he seemed to want to make sure there was always a little something left in the bowl, like it was for emergencies. I don't know if that's why, but he's almost never been one to lick the bowl clean.

(At this point, I'm planning to try switching him to a low-carb FF pate--my vet and I discussed this yesterday and she was completely on board, said most of what I was going to say before I did. But we agreed to try and get his BG a bit more stable first, since insulin and food changes can be a dicey combination.)

As for the relapse, we're not sure. I was actually worried about it over the summer when I noticed an increase in drinking/urination, but when they checked him in August, his BG was 95 and the substitute vet (argh) said he was fine and "not diabetic." She reinforced this later, which is when I started giving him the Wellness Signature Select. He was really into it (variety after four years!), and gained a little weight (which was actually kind of a relief, he was/is always flirting with being underweight).

There are a lot of variables, is the problem. At the same time as this was going on, he was diagnosed with some significant oral problems. (The substitute vet, who I will never work with again, told me she thought he had terminal jaw cancer. A week afterwards, the tests came back and showed that she was completely wrong; it was a significant bacterial infection. We can't rule out other issues but if he'd had what she said he had, he wouldn't have still been alive by then, let alone now.) I was referred to a veterinary dental specialist in September, and we scheduled surgery (which would have been at least partial extraction and a bunch of diagnostic testing into the mix) for November. I ran a GoFundMe to cover the estimate, which I very very much could not afford on my own. So that was exhausting.

I continued to notice the drinking/urination, but the sub vet had reiterated that it was okay, and I was really freaked out about/focused on the infection and making sure I could pay for treatment. I caught him peeing in the bathtub the week of the surgery and noticed that he had lost weight (the weight he'd initially put on, and about a pound of what he'd had previously, as it turned out), so when they gave me blood test news, it wasn't a complete shock. I was mostly upset about postponing the surgery. That is, until last week's hypoglycemic crisis. (Before that, I was feeling mildly optimistic/confident; he takes his shots very well, unlike literally any other form of medication, and it felt like I was in familiar territory, unlike with the teeth. But.)

So whether the relapse was on its way somehow this summer, triggered by the dietary change, related to the ongoing tooth/gum/jaw issues, or some/all of the above, it's hard to say.

God, that is a novel of a forum post. I'm sorry/thanks for your patience!
 
No need to apologize, that's very helpful info! Let us know what the vet says.

If it were me (and again, I'm not an expert, just thinking about what I've learned here/Esse's diabetes journey), I would see about switching just to a low-carb, all-wet diet and treating the infection/oral issues and see what progress that makes on his BG before going too far with the insulin. Obviously cost is going to be a factor but I worry that the insulin is just a very unpredictable bandaid for the other stuff, you know?

If your vet does want you to stick with the insulin, feeding several small meals between the AM/PM 'shot meals' can be very helpful for keeping them surfing and avoiding those big drops. I know this is tough--several of the things you've said (big grazer, "he's the least food-motivated cat I've ever met," "from his days as a stray...inviting himself into peoples' houses", etc.) are also true of Esse, so switching him to scheduled meals was and is a bit of a struggle for us. But worth trying if you're able to. I can share more about the schedule that works for us if you're interested.
 
Well, apparently my vet won't be in the office until 1PM today, but everyone over there gets the urgency and will try to get the info to her sooner/make sure she calls me as soon as she gets in. (The office manager has a diabetic cat and checked to make sure I have dry food out in the meantime in case, which I do.)

My instinct is to talk to her about pausing insulin and trying the dietary changes now. One upside about his lack of food-motivation is that Gen is also not super picky? I anticipate that he won't be resistant about a change in wet food. He'll be upset about it if I take away the dry food, though. As for the infection/oral issues, the problem is that per the dental specialist, high BG means it's unsafe to operate/use anesthesia. That's why they didn't go ahead with the surgery. I will ask my doctor about other interventions. (Gen has been uniformly resistant to any form of oral medication I've ever tried with him, so I will admit that I'm anxious about that, but.)

Sure, I'd like to hear about your schedule! Unfortunately I work full-time and am only allowed one remote work day per week, which might complicate things some? (My boss has been very understanding about me needing to be remote the last few days, thankfully, but it's rapidly becoming an issue.)

Gen's BG is at 258 now ... hopefully he's not going to plunge again. He's moving slowly and with care, though that could in part be the harness which he still seems to feel awkward about wearing.
 
(The office manager has a diabetic cat...
This is reassuring to me, seems like you have an advocate (sort of) in that office.

He'll be upset about it if I take away the dry food, though.
This page has some tips for you: Tips for Transitioning Dry Food Addicts to Canned Food. You could also look into switching his current dry food to a dry food that's low carb, like Dr. Elsey's or Young Again Zero.

As for the infection/oral issues, the problem is that per the dental specialist, high BG means it's unsafe to operate/use anesthesia.
This one is tough, because sometimes the risk is worth it if the issue is the cause. Several of our members have gone through this with veterinary dental work. The AVMA and AAHA have guidance for vets on using anesthesia on diabetic patients. Esse's BG was not regulated when he had his last dental extractions but after conferring with the vet we decided it was worth it.

Sure, I'd like to hear about your schedule!
We do 1/2 can wet food for his big meals, and 1/4 can for snacks at +1.5, +3, and +6 during the day. We use an auto-feeder (PetLibro Polar but there are cheaper options) for those midcycle snacks. Since Gen is a bit like Esse, you might find you have to "train" him to use an auto-feeder, but you can try it on days that you're home to start, maybe?

He's moving slowly and with care, though that could in part be the harness which he still seems to feel awkward about wearing.
The Libre FB group calls this "going on strike," lol. Should be temporary!
 
This is reassuring to me, seems like you have an advocate (sort of) in that office.
To be fair, I think my vet has had a diabetic cat herself, and I know she does active research. (Also I don't think the office manager saw any problem with the surgical glue - but he also doesn't use a CGM himself.) I sent her the Libre FB group's guide to using it with pets last night at her request, because she hadn't heard the thing about surgical glue. (She does seem to be pretty cautious about prescribing CGMs, which may be part of why! But she knows how bad it was when I was trying to manually monitor Gen at home, and a few other folks she sees are in a similar position.)

This page has some tips for you: Tips for Transitioning Dry Food Addicts to Canned Food. You could also look into switching his current dry food to a dry food that's low carb, like Dr. Elsey's or Young Again Zero.
Yeah, I saw that, and I actually brought it up with my vet. Her feeling is that wet food is best but eating, and eating relatively healthily, is the most important, which I'm inclined to agree with. Since he's always had both (and I don't anticipate difficulty with switching wet foods), weaning him off the dry altogether is somewhere in the middle of my priority list, but I guess we'll see.

This one is tough, because sometimes the risk is worth it if the issue is the cause. Several of our members have gone through this with veterinary dental work. The AVMA and AAHA have guidance for vets on using anesthesia on diabetic patients. Esse's BG was not regulated when he had his last dental extractions but after conferring with the vet we decided it was worth it.
Thank you, that's good to know. I mean, I'm pretty risk-averse (I can't stress how intensely I love this cat, my first cat after many many years of practically pining for one, who has lived with me for over a decade and gotten me through some of the hardest times in my life, including an early COVID quarantine period of more than six months when I didn't see a single human loved one in person, just roommates). But that said, it'll be one of the things we discuss for sure, especially if there are intermediary measures that might help (like antibiotics, especially if they can be administered by the vet's office with professional expertise and more than one person involved).

We do 1/2 can wet food for his big meals, and 1/4 can for snacks at +1.5, +3, and +6 during the day. We use an auto-feeder (PetLibro Polar but there are cheaper options) for those midcycle snacks. Since Gen is a bit like Esse, you might find you have to "train" him to use an auto-feeder, but you can try it on days that you're home to start, maybe?
How did you "train" Esse on the autofeeder? I'm definitely open to this - actually stumbled on the recommendation in another thread this morning.

The Libre FB group calls this "going on strike," lol. Should be temporary!
I found it pretty funny last night, to be honest. Today it's less so because it's been a little harder to be sure whether it's all that, or hypo too.

Certainly not hypo now, though ... in spite of my fears of a repeat performance with a second plunge (like last week), he's shot right back up again. (I hate it. Though I'll certainly take it over another crisis.)

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How did you "train" Esse on the autofeeder?
Putting higher value food/treats in it for the first week or so, and walking him over to it whenever it went off. I'll be honest, we're still working on it, but he has always been very averse to eating alone. He knows what the machine does and what the noise means, though--when he's hungry he goes over and looks at it expectantly, and sometimes when he hears the ding-ding noise he comes to get my boyfriend (whose office is closer) to accompany him and watch him eat.

in spite of my fears of a repeat performance with a second plunge (like last week), he's shot right back up again.
Definitely better high than low!!
 
... and my vet is sick. Well, that's really all we need. The receptionist (a sweet person who understands how upset I am and is being kind but realistic with me) doesn't expect her to be able to be in touch until Friday, given the holiday.

Gen's BG seems to be hitting a plateau around 370, which is a little lower than the >400 it's been consistent at for days (when not plunging into hypo).

Tentatively, I'm thinking of getting myself some FF Classic Puree and starting him on it tonight and tomorrow morning, and depending on how that goes and where the numbers are, maybe trying 0.25U after breakfast tomorrow? (I think morning is better since I won't risk sleeping through warning signs.)

Advice/thoughts would be greatly appreciated. ❤️

Thank goodness the dean of the college where I work decided to give us all day tomorrow off.
 
@Lauren & Esse Thank you - I didn't want to tag people since I'm new/they don't know me, it seems rude given those things, and I'm not really sure who I should ask anyway, though I've been trying to get a feel for the community. I really appreciate all your help, including with that. ❤️ Talking to you today has really helped to keep me grounded.
 
(So much for that plateau, we're back to the Libre reading HI again. Damn it.)
Probably to be expected, unfortunately. Who knows how long it's been since Gen had BG under 100. Are you familiar with the concept of "bouncing" from your last go-round with diabetes?
 
Probably to be expected, unfortunately. Who knows how long it's been since Gen had BG under 100. Are you familiar with the concept of "bouncing" from your last go-round with diabetes?
Unfortunately not, though I've seen it used here and have been meaning to review whatever info is available so I have a better understanding of what exactly it means (it seems somewhat self-explanatory but not entirely). Four years ago, my attempts at home BG monitoring were disastrous (I promise, I didn't just give up, and the decision to stop was carefully considered, discussed and in my case, agonized over). We made due with frequent testing at the vet and a lot of back-and-forth reporting about behavior/symptoms. We definitely did not do the kind of careful monitoring that is recommended and which I'm able to do now. (I'm so grateful for the stupid Libre. I mean, in the circumstances I would try to do the manual if I didn't have it but I feel like this is much better for him as well as for me right now.) We were extremely fortunate that everything went very smoothly and that he went into remission so quickly.

(I'm dealing with a suddenly rather unreasonable boss on the side now, so if I'm less responsive, that's why.)
 
Sorry you are going through this. With past DKA, I disagree about better to be high than low. When low you can feed hc and/ or honey or karo. You don’t want DKA again. It’s good the Libre seems to be tolerated as no testing could be disastrous with the wild swings as he gets used to normal bg again. I would get a meter to double checks low bg as that’s when the Libre can be reading a lot lower. The low 60’s on a human meter is not a rush to honey if he will eat some mc or hc food. Since right now you are following SLGS, I would reduce the dose to .25. It’s going to take 5-7 days for the depot to build and you don’t want the bg under 90.
 
Thank you, Elise!! Appreciate the more experienced eyes and correction.

I'm so grateful for the stupid Libre
You're preaching to the Libre choir. Our first couple months of treatment were extremely stressful because Esse just wouldn't tolerate it. It really helped us get him (somewhat) regulated more quickly. We thankfully are able to double-check low numbers on the handheld meter now but we would never be able to test more than two or three times a day without it.

Anyway, bouncing -- "Bouncing, as we use the term in the FDMB, is the increase in the BG due to a fast drop of the BG (this does not have to be a fast drop from high to low numbers) or a drop to a lower BG than the cat’s body is accustomed. This also does not have to be a drop to a hypoglycemic BG. Many cats will bounce, initially, when the BG drops, for example, from 300 to 150 over the course of a cycle. The cat’s body has become accustomed to higher BGs and the BG of 150, in this example, causes the liver to release counterregulatory hormones and glucagon to raise the BG back to what it deems a “safer” BG." This page has more info. Bounces can take up to 6 cycles/3 days to clear. So if you see Gen go up high soon after a "lower" number, or if a cycle just goes up up up instead of being a more typical U-shape with a nadir, that's often why.
 
Sorry you are going through this. With past DKA, I disagree about better to be high than low. When low you can feed hc and/ or honey or karo. You don’t want DKA again. It’s good the Libre seems to be tolerated as no testing could be disastrous with the wild swings as he gets used to normal bg again. I would get a meter to double checks low bg as that’s when the Libre can be reading a lot lower. The low 60’s on a human meter is not a rush to honey if he will eat some mc or hc food. Since right now you are following SLGS, I would reduce the dose to .25. It’s going to take 5-7 days for the depot to build and you don’t want the bg under 90.
Thank you so much for your thoughts. I do actually own a meter - I have two, in fact, a human one and an AlphaTrax.. They're both more than four years old at this point, though; is that okay? I'm sure I have test strips - should I get new ones? All of this said, I'm unlikely to do manual testing if I can possibly avoid it. Since I have nobody to help me restrain him and have been physically incapable of doing so in the past when he's really determined, meaning that it simply may not be possible, in addition to my strong desire not to add to his stress in the circumstances.

I'll note that my vet did a ketone blood test on Friday and he was clear then. I don't know how quickly something like that is likely to change (additional info very welcome) so I'm certainly not relying on it. That said, it may be worth mentioning that there was considerable evidence that he was diabetic for quite a long time before the DKA and diagnosis in 2021. I had no clue what to look for and there were significant life factors that made me less attentive than I wish I had been. So things are very different now in several ways.

Trust me, I would never willingly go back to no testing. If the sensor fails or falls off, I will be installing a new one; I have all the resource info on how to do it and a prescription (I'll run to the pharmacy after work hours or tomorrow morning). We were incredibly lucky last time around. He never went hypo, not once, unless it's possible that he was totally asymptomatic and came out of it without help. I had a list of symptoms and karo on hand, I was ready and very attentive (given how upset I was about everything I'd missed before).

I'm still inclined to wait until morning for another (reduced) dose because I can't risk sleeping through a hypo and apparently the low glucose alarm isn't enough to wake me up (I will see what I can do to boost it, but I am a heavy morning sleeper, especially when I've been losing a lot of sleep/struggling to fall asleep as badly as I have been in all this.)
 
Anyway, bouncing -- "Bouncing, as we use the term in the FDMB, is the increase in the BG due to a fast drop of the BG (this does not have to be a fast drop from high to low numbers) or a drop to a lower BG than the cat’s body is accustomed. This also does not have to be a drop to a hypoglycemic BG. Many cats will bounce, initially, when the BG drops, for example, from 300 to 150 over the course of a cycle. The cat’s body has become accustomed to higher BGs and the BG of 150, in this example, causes the liver to release counterregulatory hormones and glucagon to raise the BG back to what it deems a “safer” BG." This page has more info. Bounces can take up to 6 cycles/3 days to clear. So if you see Gen go up high soon after a "lower" number, or if a cycle just goes up up up instead of being a more typical U-shape with a nadir, that's often why.
Ohhh, that makes sense, thank you!

I'm going to do more searching around and reading resources later but, of course, I'm now trying to get more work done and my boss is breathing down my neck (figuratively, thank god). Not finding the juggling easy at all. (Have I mentioned that I have ADHD? Switching back and forth between types of tasks is something I'm not great at in the best of times. Sorry for whining, just, this is really hard. I remain incredibly grateful to folks here.)
 
I have two, in fact, a human one and an AlphaTrax.. They're both more than four years old at this point, though; is that okay? I'm sure I have test strips - should I get new ones?
They probably still work (may need a new battery) but the strips are likely expired. They should have a date on the packaging. Since you're using a Libre for your spreadsheet it'll be easier and cheaper to use the human meter and just get new strips, that way both meters (should you happen to use the handheld one) will be using the same range of numbers.

While you're at the pharmacy or online getting the test strips, pick up some Ketostix for testing his urine for ketones. They're little dipstick tests, I think my tube of them was less than ten bucks. I use a ladle (cat-exclusive, lol) to catch some of his stream while he's in the litter box, but if he won't let you do that, there are other strategies you can use to get a sample. (Just dumping these here to make them easy to find, no need to review right away: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters, Tips to catch and test a urine sample)

Not finding the juggling easy at all.
You are doing amazing!! This is a lot to take in, even having some experience before. Gen is lucky to have you.
 
Hello and welcome.

I second Lauren's recommendation to try to get him on an all low carb diet, preferably wet or raw food, and deal with the oral problems. The two most common causes of not being able to regulate a cat are high carb food, m/d wet and dry are medium and high carb, and infection/inflammation in the mouth that needs a dental. After you've done a transition to low carb food and taken care of his mouth, he may not need insulin. Please do any food transition slowly.

Getting some test strips for you old meter is a good idea, and compare what the Libre is saying vs the blood glucose meter. Generally, the Libre shows quite a bit lower than a human meter and we do recommend people double check LIbre lows. That Libre 61 could have been much higher. But since you didn't have that data, you did the right thing to assume it could have been right.

The recommendation on a ketones test is also solid, ketones can go from trace to high in less than a day. There is a great video from Catinfo.org on getting a urine sample.
 
Thank you so much for your thoughts. I do actually own a meter - I have two, in fact, a human one and an AlphaTrax.. They're both more than four years old at this point, though; is that okay? I'm sure I have test strips - should I get new ones? All of this said, I'm unlikely to do manual testing if I can possibly avoid it. Since I have nobody to help me restrain him and have been physically incapable of doing so in the past when he's really determined, meaning that it simply may not be possible, in addition to my strong desire not to add to his stress in the circumstances.

I'll note that my vet did a ketone blood test on Friday and he was clear then. I don't know how quickly something like that is likely to change (additional info very welcome) so I'm certainly not relying on it. That said, it may be worth mentioning that there was considerable evidence that he was diabetic for quite a long time before the DKA and diagnosis in 2021. I had no clue what to look for and there were significant life factors that made me less attentive than I wish I had been. So things are very different now in several ways.

Trust me, I would never willingly go back to no testing. If the sensor fails or falls off, I will be installing a new one; I have all the resource info on how to do it and a prescription (I'll run to the pharmacy after work hours or tomorrow morning). We were incredibly lucky last time around. He never went hypo, not once, unless it's possible that he was totally asymptomatic and came out of it without help. I had a list of symptoms and karo on hand, I was ready and very attentive (given how upset I was about everything I'd missed before).

I'm still inclined to wait until morning for another (reduced) dose because I can't risk sleeping through a hypo and apparently the low glucose alarm isn't enough to wake me up (I will see what I can do to boost it, but I am a heavy morning sleeper, especially when I've been losing a lot of sleep/struggling to fall asleep as badly as I have been in all this.)
Test strips do expire so yours are almost certainly no good. If the meter works and you are able to get test strips then either is fine to use. I’d go with the human one as the libre is a human meter. The AT being a pet meter will read higher than most meters and just confuse you. I’d just want a working one in case you get a super low reading.
 
Thank you, folks!! ❤️ Just to close the loop for the timebeing (and write this out for my own sake, and for someone to jump in if they see some major flaw): my current plan is to start him on a lower-carb wet food (I'm keeping the dry food accompaniment for now, though phasing it out will happen will happen), probably in combination with his current wet food at first, give him a 0.25 shot of insulin in the morning, and watch him carefully (both his BG and being with him in person).

I'll either zip down to the CVS around the corner before the shot, or I'll head there a bit later, with the low glucose alarm on my phone set relatively high so if he trends downwards I can hurry back. I'll pick up the additional sensor, new strips for my reader, and also strips for urine-testing for ketones.

I appreciate the emphasis on the importance and accuracy of manual BG readings, and I am going to make sure I have everything I need for them. That said, I'm just going to reiterate that I'm being realistic based on quite a lot of experience both with the specific process, and with any number of partial analogs, when I say that I have little to no hope of accomplishing a successful meter reading with him in the next couple of days unless he's physically impaired enough that I'll also be taking him straight to the ER. I'm really hoping to prevent that, and to take the time needed to give us the best chance of success in the future. But I will have it all ready, and I'm grateful for the advice about how best to go about that!

Also I am definitely going to discuss dental work with my vet. It was the "substitute" vet who referred me to the dental specialist, who in turn were not willing to proceed with his BG so high. She wasn't willing to try it because she thought it was beyond her skill level. I haven't actually checked with my real vet about it at all, being so focused on the diabetes. Maybe she'll be able to take it on herself, or help me work with the specialist to find a scenario where they will do it. If anyone has a handy link to information about a specific case or cases or a study or something about the link between dental issues and regulation problems, that would be amazing? I'll be back and up for looking for such things myself tomorrow.

I am so grateful for this place and for all of you. Thank you again! ❤️

Oh, and I broke my usual no-Amazon rule because that was the fastest way I could get Gen a shirt, any shirt. It's pretty boring since I went for cheap and easy this time, but he's already moving better than he was in the harness, and that's a relief just to watch.

PXL_20251126_022933841.jpg
 
Quick google finds references to dentals and the diabetic cat: Discovering the reasons underlying difficult-to-control diabetes in cats | dvm360 says
If an insulin-resistant cat has severe periodontal disease, it may be advantageous to address this problem. Chronic infection in the mouth may trigger the release of counter-regulatory hormones such as cortisol, with resultant persistent hyperglycemia.
Our experience at FDMB is that needing a dental is one of the top reasons a cat in remissions falls out of remission.
 
I appreciate the emphasis on the importance and accuracy of manual BG readings, and I am going to make sure I have everything I need for them ... I'm just going to reiterate ...
Maybe add "| Libre 3+ (doesn't tolerate routine manual testing) |" somewhere in your signature to save yourself having to explain frequently. You are definitely not the only member here with that trait!

...a shirt, any shirt.
He looks so handsome!!!
 
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