? 16 October - Sam - +9 355 - need advice, please

[Djamila]

Previous

What's up with these numbers?!?! Clinical signs are all good: he's eating, peeing, pooping, playing, appears to be feeling better than he did a week ago, but these numbers!!! He's never ever had a 355 before, and his only other pinks were soon after diagnosis #2 (Feb '17) or on an AT2 at the vet after his dental.

I think I should take him to the vet, but I need to give the vet a bit more direction than just "bad numbers" or the vet is just going to shrug and say, "well, he has diabetes." Sam had a dental, x-rays and two extractions in August, along with senior blood panel which all came back great.

What are possible causes of a sudden change like this in a cat who seems to be just fine?

 

[Kris & Teasel]

Previous

What's up with these numbers?!?! Clinical signs are all good: he's eating, peeing, pooping, playing, appears to be feeling better than he did a week ago, but these numbers!!! He's never ever had a 355 before, and his only other pinks were soon after diagnosis #2 (Feb '17) or on an AT2 at the vet after his dental.

I think I should take him to the vet, but I need to give the vet a bit more direction than just "bad numbers" or the vet is just going to shrug and say, "well, he has diabetes." Sam had a dental, x-rays and two extractions in August, along with senior blood panel which all came back great.

What are possible causes of a sudden change like this in a cat who seems to be just fine?

An observer who has no information but is looking only at the SS would say this behaviour correlates with starting him on Lev and it seems to have made him into a bouncy cat. I know this might not be very helpful, Djamila, but I find this technique useful - ie., what story does the SS tell without knowing anything more about the cat? Describe what you see on the SS.

 

[Doodles & Karen]

He's had 3 different doses in 6 cycles which can cause wonky numbers. Since you didn't let the depot fill on the .5u or the .75u and now you're upto 1u.....makes me wonder. Too much insulin can also cause high numbers.

 

[Kris & Teasel]

My experience so far with Lev (since 23 Sept) is that it behaves very differently from Lantus in my cat. The depot doesn't seem to be as strong in its effect and there's a strong resemblance to the action of an in and out insulin.

 

[Doodles & Karen]

very differently from Lantus in my cat

ECID for sure. You also have a customized dosing method.

Regardless, in Sam's case with just switching...it can take 6 cycles for the Lantus depot to drain and 6 cycles for the Levemir depot to fill. Lantus and Lev are different insulins and it's likely there is some wonkiness going on.

 

[Djamila]

Karen, I understand your point, and that it's not protocol to do quick increase, even if the starting dose was wrong.

But his numbers had started climbing in the cycles before the switch, so while the switch and dose change might have exacerbated it, something was already causing a steady rise. He had been under 120 for weeks, and then around 10/03, he all of a sudden starting giving higher PS numbers, they wobbled around for a bit, and have since been on a steady climb.

So I'm really wondering what health issues might cause an apparently healthy, regulated cat to start climbing again?

 

[Wendy&Neko]

You have to learn patience. I saw no justification for the increase to 1.0 units, but now that you are there, hold it. This could be New Dose Wonkiness, or "high before the low". As Karen said, wait for the depot to build, six cycles, then decide what to do,with the dose. Sam has to learn how to work Levemir, it's a new hormone in his system.

Besides dental, many health issues can cause insulin resistance. Get him to the vet for a checkup if you are worried. How long since the last blood panel?

 

[Doodles & Karen]

what health issues

Doodles was a well regulated cat in Jan. 2016. On January 31st a light switch went off and lost all regulation. 1.5 months of BW, AB's for no real reason since all his labs were normal but his numbers said something different. We ended up at the cardiologist and sure enough he had advanced HCM and CHF.....along with that he became insulin resistant with IAA of 78%.

 

[Djamila]

Wendy, I don't even know what to say. "Get him to the vet for a checkup if you are worried. How long since the last blood panel?" Did you even bother to read my post before jumping in with that scolding? I already said I am planning to take him in. And that his panel was in August.

 

[Wendy&Neko]

Sorry, not meant to be a scolding. I am dealing with some family matters and time on board is short so some answers typed quickly, I had a cat with many issues that caused insulin resistance. As Karen said, they can come up quickly. Cats are great at hiding things. Things as simple as constipation or more complicated like pain from arthritis or other conditions can also cause numbers to rise. You don't say if he's had a urinalysis recently -URI or other infection can also cause numbers to go up. If it were me, I would wait until the depot is full to see where Sam goes on this dose. Then decide on a course of action,

Throwing out other ideas, where did you get the Lev from? Any chance it's less than fresh?