4/4 Rudy AMPS 332, +3 357, +5 385, +7 360, +9 361 PMPS 399, +1.5 387, +3 309 **Vet/Meds Update Too**
- Thread starter Jen1218
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Kris & Teasel
Member Since 2016
Looks like you're following TR with Lantus. I suggest you add that info to your signature for everyone to see. Testing for ketones? One day at a time ... 
Jen1218
Member Since 2017
Looks like you're following TR with Lantus. I suggest you add that info to your signature for everyone to see. Testing for ketones? One day at a time ...
I thought I was following TR, but he also gets dry food, so he has to be SLGS. I think until he finds the right dose, I'm doing some combination of the two. (My 2 other cats like dry, so I still feed it. Rudy only eats minimal dry. It is Young Again, so it's safe for him.)
Been getting advice from folks on here about upping his doses and when to do it. Consensus says his starting dose was too low when he switched from ProZinc to Lantus. He started at 2 units. He went up to 2.5 a few days ago and he's going up another .5 tomorrow AM.
I don't test for ketones. I would like to and I know I should, but I can't stalk the litterbox waiting for him to pee. His vet tested him a few weeks back and he was ketone-free.
Kris & Teasel
Member Since 2016
It seems like you have a good plan. Re ketones: I don't stalk Teasel but I know when he's likely to use the litterbox and seize those opportunities when they arise. Mind you, I live in a condo apartment and the litter box is in my storage room so I don't have to go looking downstairs in the basement.
Jen1218
Member Since 2017
Thanks. I'm glad my plan seems ok. Getting a lot of good advice/suggestions from members on here. For now - he's holding his own and seems like his usual happy self. I'm glad he's acting fine and that he's an agreeable patient that lets me poke at him throughout the day.
Jen1218
Member Since 2017
**Vet/Meds Update**
When Rudy first went to see her 2 months ago, she found some gingivitis/inflammation of his gums. He was given antibiotics which I gave him for about a week. I didn't think anything more of it since I got wrapped up with the diabetes diagnosis.
She asked me to send her a picture of his gums today. They're still all inflamed. Since they don't seem to be any better - she thinks this might be causing his body to not respond to the insulin as a cat without even a minor infection would.
Totally makes sense.
Rudy will start 4ml clindamycin once a day beginning tonight at dinner. For now - she wants me to hold his dose of Lantus at 2.5 to see if his number starts to move after the antibiotics kick in. I'll speak to his vet again on Friday to discuss his progress/dose increase. We'll also be scheduling a full UA for next week.
Hopefully - the antibiotics will help put him on the downward track.
When Rudy first went to see her 2 months ago, she found some gingivitis/inflammation of his gums. He was given antibiotics which I gave him for about a week. I didn't think anything more of it since I got wrapped up with the diabetes diagnosis.
She asked me to send her a picture of his gums today. They're still all inflamed. Since they don't seem to be any better - she thinks this might be causing his body to not respond to the insulin as a cat without even a minor infection would.
Totally makes sense.
Rudy will start 4ml clindamycin once a day beginning tonight at dinner. For now - she wants me to hold his dose of Lantus at 2.5 to see if his number starts to move after the antibiotics kick in. I'll speak to his vet again on Friday to discuss his progress/dose increase. We'll also be scheduling a full UA for next week.
Hopefully - the antibiotics will help put him on the downward track.
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Bobbie And Bubba
Member Since 2015
Glad that you are addressing the inflammation of the gums and the vet is right that that inflammation will impact his numbers making them higher. The only way to completely address it is to get his teeth cleaned as soon as you can because as soon as the AB is out of his system, his numbers could go up again.
Sounds like you have a good Vet to work with.
Sounds like you have a good Vet to work with.
Clindamycin is a good AB for the mouth. I'll warn you that if you are giving it as a liquid, apparently it's a little bitter. At least, that's what Neko's face told me. 
It's also a strong antibiotic, so I would recommend getting some probiotics on board first if you can. Separate the probiotics and AB by a couple of hours. I hope the med helps soon.
It's also a strong antibiotic, so I would recommend getting some probiotics on board first if you can. Separate the probiotics and AB by a couple of hours. I hope the med helps soon.
Jen1218
Member Since 2017
Clindamycin is a good AB for the mouth. I'll warn you that if you are giving it as a liquid, apparently it's a little bitter. At least, that's what Neko's face told me.
Thanks for the warning that it's bitter. I ordered a probiotic for him on Amazon. Will be here Thursday morning. Hopefully, he'll hold off on any stomach upsetment for the first 2 doses.
julie & punkin (ga)
Member Since 2011
I'm not sure that I agree with your vet about the gum inflammation being responsible for these high numbers. Infection and inflammation definitely can increase blood sugar, but to my eyes - and this is simply my opinion - the issue is that the Lantus dose was started too low. I would be asking if the inflammation only occurred after you reduced the dose?
There are many reasons cats might need more than 2u of insulin. Appropriate doses vary from a drop to more than 100u per shot - I've seen all of those here in Lantus/Lev Land. Sometimes vets haven't seen cats needing higher doses of insulin - many people euthanize cats upon a diabetes diagnosis so sometimes vets don't have a lot of experience with dosing a diabetic cat. Not saying that's your vet's situation, just mentioning it.
However, I understand wanting to take your vet's advice. I would watch carefully to see if you get lower blood sugar within 48 hours or so. Or ask the vet how long it should take for the antibiotic to take effect and the blood sugar to lower in response. The problem with waiting too long is that high blood sugar does do damage in the body, so you don't want to wait too long to see if one strategy is going to work before simply increasing the dose. How long is too long? I don't know - it probably varies depending upon the cat's body. These are things to be aware of.
Punkin developed C. Diff from getting clindamycin, so it's really good that you're going to give Rudy a probiotic! He got it for a dental infection after teeth were pulled. Clindamycin works on anaerobic bacteria, the kind that live in no-oxygen environments like gum pockets or intestines and is very effective. It can cause diarrhea if you haven't countered it with good bacteria, so be on watch for that. This is a really great link about giving probiotics to cats: http://www.ibdkitties.net/probiotics/ I give them to 2 of my 3 every day. I've seen the suggestion to give the antibiotic, then 2-4 hours later give the probiotic. You don't want to give the probiotic first because then the antiobiotic will kill the probiotics.
Another thing to get on hand in case you need it - Sacromyces Boulardii. It's a beneficial yeast that will prevent diarrhea from the C. Diff and actually can overcome a C. Diff infection. I didn't know about it back when Punkin got sick, but one of my daughters has Lyme disease and has been taking constant multiple antibiotics at the same time for over 2 years now. She had one round of C. Diff more than a year ago and then we discovered S. Boulardii - which has prevented her from having that again. It's mentioned in the link above. You can buy it at a local natural food type store - it's common. You can also give it as a preventative instead or with the probiotics. There are directions in the link.
There are many reasons cats might need more than 2u of insulin. Appropriate doses vary from a drop to more than 100u per shot - I've seen all of those here in Lantus/Lev Land. Sometimes vets haven't seen cats needing higher doses of insulin - many people euthanize cats upon a diabetes diagnosis so sometimes vets don't have a lot of experience with dosing a diabetic cat. Not saying that's your vet's situation, just mentioning it.
However, I understand wanting to take your vet's advice. I would watch carefully to see if you get lower blood sugar within 48 hours or so. Or ask the vet how long it should take for the antibiotic to take effect and the blood sugar to lower in response. The problem with waiting too long is that high blood sugar does do damage in the body, so you don't want to wait too long to see if one strategy is going to work before simply increasing the dose. How long is too long? I don't know - it probably varies depending upon the cat's body. These are things to be aware of.
Punkin developed C. Diff from getting clindamycin, so it's really good that you're going to give Rudy a probiotic! He got it for a dental infection after teeth were pulled. Clindamycin works on anaerobic bacteria, the kind that live in no-oxygen environments like gum pockets or intestines and is very effective. It can cause diarrhea if you haven't countered it with good bacteria, so be on watch for that. This is a really great link about giving probiotics to cats: http://www.ibdkitties.net/probiotics/ I give them to 2 of my 3 every day. I've seen the suggestion to give the antibiotic, then 2-4 hours later give the probiotic. You don't want to give the probiotic first because then the antiobiotic will kill the probiotics.
Another thing to get on hand in case you need it - Sacromyces Boulardii. It's a beneficial yeast that will prevent diarrhea from the C. Diff and actually can overcome a C. Diff infection. I didn't know about it back when Punkin got sick, but one of my daughters has Lyme disease and has been taking constant multiple antibiotics at the same time for over 2 years now. She had one round of C. Diff more than a year ago and then we discovered S. Boulardii - which has prevented her from having that again. It's mentioned in the link above. You can buy it at a local natural food type store - it's common. You can also give it as a preventative instead or with the probiotics. There are directions in the link.
Bobbie And Bubba
Member Since 2015
I agree with that statement and I think that the dose being too low to start is a separtate entity from the inflammation. It is more like the dose being too low to start AND in the presence of plaque and tarter around the teeth and needing a teeth cleaning. The too low of a dose would not cause inflammation. Plaque and/ or tartar around the teeth would cause the inflammation.
Jen1218
Member Since 2017
I have a call scheduled with his vet for Friday to discuss his bg readings after a few doses of the abx and upping his insulin at that point.
I'll be the one to ultimately make the decision to up his dose or not. If he's still steadily in the 300s - he will be moving to 3 units regardless of what his vet says. I'm willing to let it ride for a few days to see if there is any difference.
Jen1218
Member Since 2017
The inflamed gums existed prior to his diabetes diagnosis. He got an abx for a week or so. Then we got involved in diabetesland, so I didn't give his gums another thought. His vet asked for a photo of his gums today. When she saw they were still inflamed - she prescribed the clindamycin.
Bobbie And Bubba
Member Since 2015
Yes, glad the vet revisited the gum inflammation. And with this discussion, I am going to go brush Bubba's teeth as inflammation and tooth decay took him out of remission the 1st time. 
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