5/19/22 New Member -- Elevated BG pre dental work

[AbbottTheCat]

Hello everyone!

My name is Drew and my 13 year old male Tabby is Abbott. I have read up on the FDMB FAQs and the 5 Steps to Regulating Your Diabetic Cat and I have a basic understanding of FD and the relevant testing, dosing, etc.

Here is some history to get you up to speed:
Abbott has been a healthy older cat eating a low carb balanced diet for many years. In the last 4 months I noticed increased drinking and urination so I took him to his first vet visit since his teeth were cleaned/extractions back in 11/2020. The vet did an exam and said otherwise healthy except for high plaque build-up with no infection visible. recommended teeth cleaning. This was 5/4/2022, a few weeks ago.

The next week, on 5/9, I took Abbott in for dental evaluation and pre-dental bloodwork/urinalysis (screenshots attached below). As a sidenote- both these visits Abbott was quite stressed and vocal, long time since vet and now back to back. Scheduled teeth cleaning for later that week on 5/12.

Test results showed:

CHEM
Glucose 389mg/dL ref:64-170 mg/dL
TRIGLYCERIDE 325mg/dL ref:25-160 mg/dL
BUN 34mg/dL ref:14-36 mg/dL

URINALYSIS
pH 7.5 ref:5.5-7.0
Protein 2+
Glucose-Strip 3+ -
Ketones NEGATIVE -
Bilirubin NEGATIVE -
Occult Blood 1+

Microalbuminuria >30mg/dL ref: - mg/dL

If you'd like to have a look at full results, screenshots below.

Abbott went in for his dental on 5/12 and had 3 smaller extractions and teeth cleaning and seems to be recovering fine. He has been on 1ml/day Antirobe drops due to complete on 5/21. Surgeon noted that there was excessive gingivitis along with mucus in throat and likely an infection hence the antibiotics.

After speaking at length with Vet, we decided on a course of action over the next few weeks:
We agreed that the high BG levels may be related to stress/infection and cannot diagnose DM for certain until further testing, we decided to wait to test for Fructosamine and recheck BG until 2 weeks after course of Antirobe. That puts his next appointment on 6/6.

In the meantime I've been trying to learn as much as I can and be prepared, and that's how I found all the wonderful folks at FDMB.

Abbott is currently doing well, basically I would call it unchanged since dental, walking and jumping on tables, appetite good. Still have excessive drinking and urination.

At the moment my concerns are:
Should I be gathering supplies, insulin, home-testing equipment? Since he is over 300mg and considered unregulated? Or is it too soon to say for certain we are looking at DM until fructo test? Or maybe I should be doing home-testing and establishing a curve?

Since he does not appear to have liver damage maybe this is early stages and I shouldn't be waiting around and should be getting him on insulin asap to get out ahead of this with better chances of remission.

This is all quite new to me and I'm struggling with what to do next, any help or direction or insights would be welcome. Thanks!

 

[FrostD]

I am relieved to see your vet did not jump straight to FD. Long running infections, plus dental issues are the most common causes of elevated BG. For the record, for a non diabetic cat or cat in remission, the "stress" BG seems to top out around 180 (no source to cite there, just from what I've seen) - so at 389 theres definitely something going on. Even a fructosamine at that point would likely show elevated numbers because it essentially measures the BG over the prior two weeks - so also glad to see the vet wants to wait to run one until 2 weeks after antibiotics complete!

That said, I would have expected at least some drop in BG (and therefore clinical symptoms) after a week on the antibiotics. It's also possible it's not the right antibiotic, especially if they didn't culture anything.

I have seen more than my fair share of misdiagnoses here so I am glad to see your vet is...more thorough...than a lot we see.

If you're in the US you can certainly go out and buy a cheap ReliOn meter from WalMart..it'll cost you around $30 for the meter, some lancets, Vaseline, cotton rounds, and like 100 strips. If he's amenable to the testing, once or twice a day testing may help you see if BG is trending down the longer he's on antibiotics and during that wait for the fructosamine. If finances are tight or he's not amenable to testing then I'd just wait for fructosamine. If you do get the meter and manage to test once or twice a day then the fructosamine really won't be necessary (since you'll already know what BG is).

Tagging @Suzanne & Darcy for the lab results...did they do any regular hematology looking at the RBC, WBC, etc in his blood?

 

[FrostD]

Oh one thing I definitely would do is go out and buy some urine ketone strips, a lot of us use Ketostix. In the US you can get them over the counter from pretty much any store with a pharmacy.

If he is actually diabetic, the infection plus no insulin gives you the perfect storm for ketones and DKA. DKA is life threatening and very expensive to treat - some reading for you here. Keeping an eye on urine ketones allows you to be much more proactive and hopefully intervene before a hospital stay is required.

 

[Diane Tyler's Mom GA]

The Relion Premier Classic Meter is 9 dollars and the test strips are 17.88 for 100 strips
You can but any brand lancets get 26 or 28 guage
All from Walmart
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

Test strips
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

Lancets 26 gauge. 6.99 for 100
https://www.walmart.com/ip/O-well-Blood-Glucose-Lancets-100-Count-26-Gauge/587659467

Lancets 28 gauge 6.25 for 100
https://www.walmart.com/ip/TRUEplus...V4pJbCh0HlQBSEAQYBiABEgIs-_D_BwE&gclsrc=aw.ds


The smaller the gauge size will make the eats bleed better

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up

Here is a video one of our members did
VIDEO: How to test your cat's blood sugar

You don't have to anything to the Relion Meter such as setting it to a certain number for cats which Janet is using (Pet Meter) The Relion you just stick in the test strip

 

[AbbottTheCat]

I am relieved to see your vet did not jump straight to FD. Long running infections, plus dental issues are the most common causes of elevated BG. For the record, for a non diabetic cat or cat in remission, the "stress" BG seems to top out around 180 (no source to cite there, just from what I've seen) - so at 389 theres definitely something going on. Even a fructosamine at that point would likely show elevated numbers because it essentially measures the BG over the prior two weeks - so also glad to see the vet wants to wait to run one until 2 weeks after antibiotics complete!

That said, I would have expected at least some drop in BG (and therefore clinical symptoms) after a week on the antibiotics. It's also possible it's not the right antibiotic, especially if they didn't culture anything.

I have seen more than my fair share of misdiagnoses here so I am glad to see your vet is...more thorough...than a lot we see.

If you're in the US you can certainly go out and buy a cheap ReliOn meter from WalMart..it'll cost you around $30 for the meter, some lancets, Vaseline, cotton rounds, and like 100 strips. If he's amenable to the testing, once or twice a day testing may help you see if BG is trending down the longer he's on antibiotics and during that wait for the fructosamine. If finances are tight or he's not amenable to testing then I'd just wait for fructosamine. If you do get the meter and manage to test once or twice a day then the fructosamine really won't be necessary (since you'll already know what BG is).

Tagging @Suzanne & Darcy for the lab results...did they do any regular hematology looking at the RBC, WBC, etc in his blood?

Thanks! It was actually my idea to wait on Fructo test, and "That said, I would have expected at least some drop in BG (and therefore clinical symptoms) after a week on the antibiotics"...
He hasn't been tested yet since being on antibiotics.

And I will get some Ketostix.

 

[AbbottTheCat]

The Relion Premier Classic Meter is 9 dollars and the test strips are 17.88 for 100 strips
You can but any brand lancets get 26 or 28 guage
All from Walmart
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

Test strips
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

Lancets 26 gauge. 6.99 for 100
https://www.walmart.com/ip/O-well-Blood-Glucose-Lancets-100-Count-26-Gauge/587659467

Lancets 28 gauge 6.25 for 100
https://www.walmart.com/ip/TRUEplus...V4pJbCh0HlQBSEAQYBiABEgIs-_D_BwE&gclsrc=aw.ds


The smaller the gauge size will make the eats bleed better

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up

Here is a video one of our members did
VIDEO: How to test your cat's blood sugar

You don't have to anything to the Relion Meter such as setting it to a certain number for cats which Janet is using (Pet Meter) The Relion you just stick in the test strip

I had seen a few videos on this but your write up with the exploded view is much more detailed, thanks for that.

 

[AbbottTheCat]

And FrostD, in answer to your question about if they ran RBC, WBC, etc if its not in those screenshots they didnt run it.

 

[AbbottTheCat]

@FrostD Do you think they should have?

 

[FrostD]

Thanks! It was actually my idea to wait on Fructo test, and "That said, I would have expected at least some drop in BG (and therefore clinical symptoms) after a week on the antibiotics"...
He hasn't been tested yet since being on antibiotics.

And I will get some Ketostix.

Re: testing - yes I know. I would have expected clinical signs to improve. If the antibiotics were working they should have been lowering BG closer to normal range and the PU/PD should have improved if not resolved. Unless there's another issue at play, but one thing at a time.

I would have liked to see the hematology if they suspected infection. Suzanne knows much better than I do, but my understanding is that unless it is an infection in bladder/urinary tract there likely would not be WBCs etc in urine. So you would need to look at the actual blood for that stuff to confirm infection.

 

[AbbottTheCat]

Ok, I see what you mean. At his next app on 6/6 we are planning on bloodwork and urinalysis and fructosamine add-on.
It sounds like I need to verify that the chem panel checks WBC to confirm or rule out infection before a proper diagnosis is made.
Although at 389 something is up. Maybe getting at home testing equipment and getting a good curve is the best course of action right now? Although if infection is present BG could be high but not necessarily FD?

Everything I've heard so far mentions elevated levels due to stress-related BG should top out at 180 but I'm not sure about infection related BG...

 

[FrostD]

Ok, I see what you mean. At his next app on 6/6 we are planning on bloodwork and urinalysis and fructosamine add-on.
It sounds like I need to verify that the chem panel checks WBC to confirm or rule out infection before a proper diagnosis is made.
Although at 389 something is up. Maybe getting at home testing equipment and getting a good curve is the best course of action right now? Although if infection is present BG could be high but not necessarily FD?

Everything I've heard so far mentions elevated levels due to stress-related BG should top out at 180 but I'm not sure about infection related BG...

So a curve won't tell you much - the purpose of a curve is to see how the insulin behaves in a particular cat. Since he's not on insulin, all you will probably see is high numbers that maybe come down a little bit a few hours after eating. Not worth all the ear pokes. If you want to test, I would just do once or twice a day, time doesn't really matter.

Yes typically hematology is done with the chem panels and urinalysis which is why I had asked.

If infection is present yes it could be that and not actually FD. Unfortunately only time will tell, so just watch the ketones.

Speaking for my own cat - he's been in remission for awhile (completely non-diabetic numbers under 100, not the garbage some vets tend to call remission). When he got an infection while in remission, he spiked to around 300 but I caught and treated the infection very quickly. Within 3 days of antibiotic he was down to low 100s, normalized by 2 weeks after (you can see my spreadsheet from November 22, 2021)

 

[AbbottTheCat]

Thanks, very insightful and makes sense. So can Suzanne chime in and give me some direction for what we need to test for at the vet regarding possible infection? Abbott had gingivitis and bacterial infection during dental so it’s possible this caused the high BG but I’d like to test appropriately. The surgeon just told me the Antirobe drops would clear up the infection by day 10 and he’s at day 7. I can always move up the appointment to get in sooner as well.

I read your link on ketones. Sounds like some meters test for both ketones and BG. The Precision Xtra is available overnight on Amazon. Is this a good meter for a beginner and what should I know about it, as in what strips to get with it, settings etc? Maybe the other 3 ketone/bg meters are better? I can pick up lancets at Walmart.

Also can you share more details about your cat’s infection and how it was diagnosed, treated?

 

[FrostD]

I'll tag her again, sometimes the tags don't work or they get lost in the mix - @Suzanne & Darcy can you peek at lab work please?

There are a handful of meters that do both BG and ketones, some just so one or the other. The strips for the dual meters tend to be more expensive, and sometimes they also require larger blood drops (ketone strips by default always require a decent amount of blood). I use a RwliOn from Walmart as my every day meter because it's dirt cheap to use, I have a NovaMax Plus that I use for ketones (it also serves as a backup BG meter but I have yet to use it for BG). I'd you think blood testing ketones will be easier than urine go for it, but I personally would not make the big investments until you have a confirmed diagnosis.

They do not know what his infection was (except that it was not urinary), and to be honest we didn't really have time to narrow it down because his fever was 105+. 1-2 days earlier he got lethargic and wouldn't eat, I assumed pancreatitis at first because hes had that twice now. Then the fever sprang up and got him to ER. They prescribed Veraflox in case it was respiratory, and metronidazole in case it was a GI thing. Whatever it was, one of the two did the trick.

 

[Suzanne & Darcy]

And FrostD, in answer to your question about if they ran RBC, WBC, etc if its not in those screenshots they didnt run it.

I definitely wish they bad run a hematology panel so we could see those results! I would at least want to know if his white count was elevated. Antirobe is the antibiotic of choice for oral bacteria, yes.

 

[Suzanne & Darcy]

Thanks, very insightful and makes sense. So can Suzanne chime in and give me some direction for what we need to test for at the vet regarding possible infection? Abbott had gingivitis and bacterial infection during dental so it’s possible this caused the high BG but I’d like to test appropriately. The surgeon just told me the Antirobe drops would clear up the infection by day 10 and he’s at day 7. I can always move up the appointment to get in sooner as well.

I read your link on ketones. Sounds like some meters test for both ketones and BG. The Precision Xtra is available overnight on Amazon. Is this a good meter for a beginner and what should I know about it, as in what strips to get with it, settings etc? Maybe the other 3 ketone/bg meters are better? I can pick up lancets at Walmart.

Also can you share more details about your cat’s infection and how it was diagnosed, treated?

On his next visit, ask them to do a Complete Blood Count (CBC) the Chemistry panel and I would even repeat the Urinalysis. All you have here is the chemistry panel. It would have been good to see if his WBC was elevated, although I have seen cats with “infection “ that is responsive to antibiotics that did not. So we won’t really have a pre- and post-antibiotic comparison on the hematology (CBC) - to see if it made a difference. Sometimes only certain of the white cells will be elevated and the type that’s elevated can give a clue as to what is going on. The primary reason that I would repeat the urinalysis is that he has protein in his urine and I would like to see if he still does. Has your vet mentioned doing a Urine Protein Creatinine Ratio test? It’s usually called a UPC test. It helps to determine if kidneys are damaged (and if that is the cause of the protein.)

 

[Suzanne & Darcy]

Hello everyone!

My name is Drew and my 13 year old male Tabby is Abbott. I have read up on the FDMB FAQs and the 5 Steps to Regulating Your Diabetic Cat and I have a basic understanding of FD and the relevant testing, dosing, etc.

Here is some history to get you up to speed:
Abbott has been a healthy older cat eating a low carb balanced diet for many years. In the last 4 months I noticed increased drinking and urination so I took him to his first vet visit since his teeth were cleaned/extractions back in 11/2020. The vet did an exam and said otherwise healthy except for high plaque build-up with no infection visible. recommended teeth cleaning. This was 5/4/2022, a few weeks ago.

The next week, on 5/9, I took Abbott in for dental evaluation and pre-dental bloodwork/urinalysis (screenshots attached below). As a sidenote- both these visits Abbott was quite stressed and vocal, long time since vet and now back to back. Scheduled teeth cleaning for later that week on 5/12.

Test results showed:

CHEM
Glucose 389mg/dL ref:64-170 mg/dL
TRIGLYCERIDE 325mg/dL ref:25-160 mg/dL
BUN 34mg/dL ref:14-36 mg/dL

URINALYSIS
pH 7.5 ref:5.5-7.0
Protein 2+
Glucose-Strip 3+ -
Ketones NEGATIVE -
Bilirubin NEGATIVE -
Occult Blood 1+

Microalbuminuria >30mg/dL ref: - mg/dL

If you'd like to have a look at full results, screenshots below.

Abbott went in for his dental on 5/12 and had 3 smaller extractions and teeth cleaning and seems to be recovering fine. He has been on 1ml/day Antirobe drops due to complete on 5/21. Surgeon noted that there was excessive gingivitis along with mucus in throat and likely an infection hence the antibiotics.

After speaking at length with Vet, we decided on a course of action over the next few weeks:
We agreed that the high BG levels may be related to stress/infection and cannot diagnose DM for certain until further testing, we decided to wait to test for Fructosamine and recheck BG until 2 weeks after course of Antirobe. That puts his next appointment on 6/6.

In the meantime I've been trying to learn as much as I can and be prepared, and that's how I found all the wonderful folks at FDMB.

Abbott is currently doing well, basically I would call it unchanged since dental, walking and jumping on tables, appetite good. Still have excessive drinking and urination.

At the moment my concerns are:
Should I be gathering supplies, insulin, home-testing equipment? Since he is over 300mg and considered unregulated? Or is it too soon to say for certain we are looking at DM until fructo test? Or maybe I should be doing home-testing and establishing a curve?

Since he does not appear to have liver damage maybe this is early stages and I shouldn't be waiting around and should be getting him on insulin asap to get out ahead of this with better chances of remission.

This is all quite new to me and I'm struggling with what to do next, any help or direction or insights would be welcome. Thanks!

View attachment 64290 View attachment 64291 View attachment 64292

These blood values are pointing toward possible kidney damage or disease. His creatinine is good, which is encouraging. BUN is still within normal limits, although on the higher side. But even some dehydration can elevate BUN. Some of his blood values may return to normal if you can get his glucose under control. His USG is a little low, which also points toward compromised kidneys as does the protein (but this would need checkin out and not just a single test). His urine pH is too high, - too alkaline- which can allow for the formation of crystals in the urinary tract, which you don’t want, obviously. Did the vet mention that?

 

[AbbottTheCat]

Hi and nice to meet you! Thanks for your post. It’s not lost on me how knowledgeable you are about all this and that is most welcome! Me, not so much but I’m learning. I had to put down one of my cats last year but that was heart disease which I know more than I care to know about that.

No we did not talk about UPC or urine PH.

We spoke on the phone mainly about the BG levels but I specifically mentioned CKD and she said she was not worried about that. This Dr is brand new to me, I had to change from my vet of over 5 years to a lower-cost vet because the estimate for chem panel and urinalysis was $400+. My new vet has astronomically cheaper testing but I’m still not quite sure it’s a great fit otherwise, sounds like we missed a few things! I asked about ckd and she did not seem concerned, She is, however, interested in keeping costs down for me.

So a CBC, Chem panel, and urinalysis? Which Chem panel?

So if turns out to be CKD or damage could this be causing high BG? And what would you think next steps to treating might be, I’m not adverse to herbal or holistic just fyi. By getting his glucose under control I assume you mean insulin. Sorry if I’m way off base here still getting my brain glucose under control

 

[Suzanne & Darcy]

She is, however, interested in keeping costs down for me

Hi there, Drew! I'm glad you are here (well, I am sorry that you need to be, but hope we can help.

Cost savings... I was thinking that this is why she did not run the CBC... that had crossed my mind. I wish she had though, if an infection was suspected/possible (based on the dental surgeon's comments.) Most vets/labs will run a complete blood count and chemistry panel in one go. The IDEXX lab has something called the Total Health Plus Basic, which at my vet is $98.00 and that's bloodwork sent out to the lab (usually results are back the next morning) and it includes a T4 as well (thyroid). Now, if your vet is just running the labs, in house, they can still do the CBC and that's all pretty standard, and you want a full chemistry panel. You usually get more bang for your buck when you send the blood out to the labs. Do you now which lab your vet uses? It's probably either IDEXX of ANTECH and they have similar panels. That is super expensive (over 400) for the testing that the other vet was going to charge. Wow.

As for kidney disease... I'm not saying that he has Chronic Kidney Disease at this point... but there are markers that are pointing in that direction (in particular the USG, which is low, and possibly the protein in the urine. Now, if he had a urinary tract infection the numbers could be skewed. I also could have seen whether his bloodwork showed dehydration if the CBC had been run -- there are a couple of things you can look at. But honestly, from what I have seen, when cats are first diagnosed as diabetic, a lot of their bloodwork is "off." I'm getting ready to go out for the evening, but will be back later if you have more questions. I usually check in before bed and I'll be around some tomorrow morning, too.

 

[AbbottTheCat]

Oh one thing I definitely would do is go out and buy some urine ketone strips, a lot of us use Ketostix. In the US you can get them over the counter from pretty much any store with a pharmacy.

If he is actually diabetic, the infection plus no insulin gives you the perfect storm for ketones and DKA. DKA is life threatening and very expensive to treat - some reading for you here. Keeping an eye on urine ketones allows you to be much more proactive and hopefully intervene before a hospital stay is required.

Keeping an eye on urine ketones allows you to be much more proactive and hopefully intervene before a hospital stay is required---

@FrostD Going to get CVS ketone strips tonight, can you elaborate on this? Couldnt find anything in the help articles on how to intervene before hospital stay> More specifically, what should I have on hand in case I get a postive test?

 

[Suzanne & Darcy]

Well, keeping Abbott hydrated would be important. Also, if he actually has a significant level of ketones then you might really want to start him on some insulin. Infection/inflammation plus not enough insulin and ketones make cats in danger of diabetic ketoacidosis. It doesn’t necessarily mean that, if he has ketones in his urine, that he will have DKA, just that, if he has also got an infection, and he’s not getting any insulin and has high BG, there’s a good chance of it. Some cats are prone to ketones- mine was. Some are not (even with high BG.). I would not worry unless he isn’t eating well, possibly is vomiting a lot and is lethargic. Home treatment includes fluids or putting water to their food, making sure they do eat and giving them insulin.

 

[Suzanne & Darcy]

Have you managed to get a ketone reading? I bought the NovaMax Plus blood ketone meter and, like Melissa, I used it for measuring blood ketones only (not for glucose). The strips cost me about $1.80 each, but after my boy was in the ER for a week, it was worth it. He did continue to have high ketones for quite a while, but finally they began to drop as his insulin dose was increased. Even before his BG came down into much better ranges, his ketones came down. It did take a long time though.

 

[AbbottTheCat]

No, I have not yet. I picked up the strips at CVS last night and have not caught him in the act yet. I did however find a CBC from the same appointment as the other tests in my first post! I must have missed it, as it was in a separate email. I am attaching the CBC here. I've also discovered what I believe to be an enlarged thyroid gland next to his throat. The size of a grape. And sneezing going on...

 

[AbbottTheCat]

No, I have not yet. I picked up the strips at CVS last night and have not caught him in the act yet. I did however find a CBC from the same appointment as the other tests in my first post! I must have missed it, as it was in a separate email. I am attaching the CBC here. I've also discovered what I believe to be an enlarged thyroid gland next to his throat. The size of a grape. And sneezing going on...

...could also be enlarged lymph node. Still determining that, not sure about location.

 

[Suzanne & Darcy]

No, I have not yet. I picked up the strips at CVS last night and have not caught him in the act yet. I did however find a CBC from the same appointment as the other tests in my first post! I must have missed it, as it was in a separate email. I am attaching the CBC here. I've also discovered what I believe to be an enlarged thyroid gland next to his throat. The size of a grape. And sneezing going on...

Whatever it is, it sounds like it needs checking out! Sooner rather than later.

 

[Suzanne & Darcy]

Well, that platelet count is ridiculous so the sample must have been clumped (that happens a lot). Overall white count is WNL as you see, so there’s no evidence of infection from that test. Even though the percentage of monocytes and eosinophils are mildly elevated, the absolute counts are WNL so that whole CBC doesn’t look bad.

 

[Larry and Kitties]

QUOTE="Suzanne & Darcy, post: 2952783, member: 30260"]Well, that platelet count is ridiculous so the sample must have been clumped (that happens a lot).[/QUOTE]
Why do you say ridiculous? The reports says the count was 197x10³/ml while normal is 200-500x10³/ml

 

[Suzanne & Darcy]

I must be seeing something different on my screen 19710. Perhaps the numbers are all run together on my phone screen and the spaces aren’t there. Also it’s in Red which is the normal lab way of indicating high values.

 

[Larry and Kitties]

I must be seeing something different on my screen 19710. Perhaps the numbers are all run together on my phone screen and the spaces aren’t there. Also it’s in Red which is the normal lab way of indicating high values.

Your phone presentation is likely the cause of confusion since the superscript 3 after then 10 may not show. In addition, there should have been a space between 7 and 1

 

[AbbottTheCat]

Good to know about the CBC, his last dose of Antirobe is tonight so any gingivitis related bacteria should be zapped by now.

I was not able to get an earlier appt than my 6/6 follow up to check out the thyroid. This vet is crazy busy. I have a suspicion the goiter is new because I find it hard to believe that 3 exams by 3 different doctors within 5/10 and 5/13 would have missed it! There was a note from the 5/10 visit that mentioned mildly symmetricaly enlarged submandibular lymph nodes but thyroid ok with physical exam. It’s possible I’m mistaking the goiter for enlarged right side submandibular lymph node, they are fairly close in location and I’m not a vet lol.

Im wondering if it warrants a trip to ER or a call to other vets to try and get him in sooner. His breathing is fine although he’s always been a wheezy boy, I counted his breaths and they checked out. He’s purring and preening and woke me up this morning playing with his moms hair tye so that a good sign he’s feeling ok. I’m definitely adding the T4 test to 6/6 appt. Any thoughts?

 

[AbbottTheCat]

…appetite is good also. Still drinking a lot, haven’t got ketones checked yet. Should have got a meter…

 

[FrostD]

Ive never dealt with lymph nodes so perhaps just call vet and mention it, see what their advice is.

If it's thyroid, 6/6 isn't that far off and you'd likely be seeing some other symptoms - though with my cat PU/PD was the only symptom and his T4 was ridiculously high.

 

[Suzanne & Darcy]

We haven’t set you up with a spreadsheet yet? You could record BG numbers there even though he’s not on insulin- a lot of people do that.

I’m uncomfortable with waiting, if something new that’s the size of a grape is on his neck — but that’s just me. As you say, he was examined 3 times by 3 different vets and they never mentioned it.

 

[AbbottTheCat]

Yes I will start a spreadsheet. As far as getting him in earlier there are no appts, can’t even get the vet to just call after multiple messages. She may be out of town. The other doctors there are booked out.

Tomorrow morning I am calling other vets to see if I can get him in, I know from experience the two ER facilities here will not accept pets who aren’t in immediate need of treatment because of the high volume. Perks of living in a big city I guess. I will keep everyone posted, thanks!

 

[Suzanne & Darcy]

Yes I will start a spreadsheet. As far as getting him in earlier there are no appts, can’t even get the vet to just call after multiple messages. She may be out of town. The other doctors there are booked out.

Tomorrow morning I am calling other vets to see if I can get him in, I know from experience the two ER facilities here will not accept pets who aren’t in immediate need of treatment because of the high volume. Perks of living in a big city I guess. I will keep everyone posted, thanks!

Maybe it will go away

 

[AbbottTheCat]

Really? Is that a thing? That would be great and one less thing to worry about besides maybe DM and kidneys.

 

[Suzanne & Darcy]

Really? Is that a thing? That would be great and one less thing to worry about besides maybe DM and kidneys.

I am just being hopeful that since you have to wait, something positive could happen in the interim. It seems likely that it could happen only if there was an infection and it cleared up.

 

[Suzanne & Darcy]

Or if it’s viral. That could clear. I’m just hoping. But keep those appointments!

 

[AbbottTheCat]

Lol, I’m with you Suzanne! I’d love for something positive to happen too. He had his last dose of Antirobe last night so any dental bacteria should be cleared up. I bought some dental wipes with ingredients that look pretty clean and DM friendly not like all the other ones loaded with stuff like flavorings and mint oil of all things.

they are called Maxi guard dental wipes, you all should check them out. They were hard to find. Haven’t used them yet but tonight will be first time, wanted to wait until Antirobe was done.MAXIGUARD Dental Cleansing Wipes for Animals https://www.amazon.com/dp/B08DG796BW/ref=cm_sw_r_cp_api_i_QRE13RWPRCZ9X8R9CR67?_encoding=UTF8&psc=1

 

[AbbottTheCat]

Also spent half the evening researching what kind of water to give cats. I switched to bottled spring water delivery service about 4 months ago and it seems like that’s when the excessive urination started but could just be a coincidence.

as you can imagine there’s a lot of conflicting advice out there, distilled good and bad, spring water too many solids and minerals, filtered tap water too much chlorine, and on and on…

mall I can really say with certainty is that cats need water PH balanced to about 6.2 to 6.4, I am using my pool ph tester and spring is too low and tap too high, so I broke out the big ss pet fountain and am doing a 50/50 mix. Lol. I really think he did better on filtered water but I don’t know. Anything for our fur babies right?

 

[AbbottTheCat]

@Suzanne & Darcy @FrostD

UPDATE:

Ok so I've had the lab work back for a week but was waiting on the results of a Urine culture to see if he had an infection causing high BG. The Culture was NEGATIVE and the other lab work I've attached to this post. @Suzanne & Darcy I would love to hear your take on latest lab work which was quite similar to previous, urine protein still present.
The new prev not tested add-ons:
FRUCTOSAMINE: 405umol/L ref range:143-373 umol/L
T4 - checks out at 1.5mg

The vet basically shrugged off the lump, not thyroid, not lymph node, likely salivary gland.
""Swelling - r/o salivary gland, inflammation, less likely abscess or lymph node""

Since the vet does not suspect infection she feels comfy diagnosing as FD, said if there was an infection we would likely be seeing more signs from bloodwork/urine. I am still not completely convinced but I am going ahead with FD treatment, if ANYONE has any suspicions that this is not FD speak now or forever hold your peace.
FULL labs attached---

In the last few weeks I took the opportunity to gather all the the testing supplies.
Got a good test on my first try just today! -- kudos to all the awesome help articles on the boards, think Abbott is a good bleeder, didn't require any ear warming or milking, the drop pooled right up immediately. I will continue to practice. Couldn't have done it w/o all the help.
Relion Prime Classic, I didnt do any setup, calibrating or anything. First test = 300mg

**I am not sure which meter my vet uses but both of their tests came back in the high 380's, how does the Relion compare and do we have a chart listing well regulated/poorly regulated values based on human Relion meter? What's my ref range here?

The only thing I have not got is the insulin.
Based on the info here, I would like to use the Solostar pen because it seems easier and less easily contaminated.
Problem is I can only get a 5 pack locally and I'd rather just start with one pen.
I am hesitant to ship to my house, here in TX we have had six 100+ days in a row.
I just don't feel confident in the cold packs doing the job, and def don't want to ship from Marks in Canada.

**Has anyone had any quality issues shipping Solostar pens from Walmart PetRX? They have single pens for good price.
**CVS can't break up the 5 pack pen boxes, anyone have a lead on somewhere else I could get a single pen locally and avoid the cold pack ship and use the SingleCare coupons?

Maybe I should post those questions in another subforum, not really sure which cause I'm new here!
Sorry for long post just catching everyone up, any input welcome, thanks.

 

[Suzanne & Darcy]

Hi Drew! It is looking like FD now for sure with that fructosamine number. I will be happy to check out the attachments.

 

[AbbottTheCat]

Yes, I think so. I am still just clueless about the urine protein and all the excessive urination as to how it relates to the FD and if I should be focusing on Kidney Disease as well, vet does not seem worried about it...

 

[FrostD]

Definitely looks more like FD.

I had to call a few local pharmacies before finding one that would sell a single pen. Be sure to ask about the generics as well as they are much cheaper. Some will accept the GoodRx coupons for a pet, some will not. Seems people have had the most luck just not mentioning it's for a pet, but that's up to you are your moral compass lol

As for regulated, etc you'll find a bit of different definitions depending on where you look. This is what we use - https://www.felinediabetes.com/FDMB/threads/what-is-regulation.214777/

Your vet likely uses a pet meter like an AplhaTrak. They tend to read higher overall. At higher numbers it can be quite a bit higher (I've seen 350 on ReliOn and 500+ on AlphaTrak), but in lower numbers the difference isn't as large. Truthfully it doesn't matter - high is high, and when it gets to the lower range where it matters, our dosing methods account for the difference between meters.

 

[Suzanne & Darcy]

Be sure to check small, privately owned independent pharmacies. I had a local one that was able to get me a whole vial of Lantus for $99 using a coupon. They were very helpful. They knew it was for a cat as well!

 

[Suzanne & Darcy]

I can’t see updated labs.

 

[AbbottTheCat]

It's a pdf, should i attach pics instead?

 

[AbbottTheCat]

@Suzanne & Darcy Lab Pics attached

 

[AbbottTheCat]

Definitely looks more like FD.

I had to call a few local pharmacies before finding one that would sell a single pen. Be sure to ask about the generics as well as they are much cheaper. Some will accept the GoodRx coupons for a pet, some will not. Seems people have had the most luck just not mentioning it's for a pet, but that's up to you are your moral compass lol

As for regulated, etc you'll find a bit of different definitions depending on where you look. This is what we use - https://www.felinediabetes.com/FDMB/threads/what-is-regulation.214777/

Your vet likely uses a pet meter like an AplhaTrak. They tend to read higher overall. At higher numbers it can be quite a bit higher (I've seen 350 on ReliOn and 500+ on AlphaTrak), but in lower numbers the difference isn't as large. Truthfully it doesn't matter - high is high, and when it gets to the lower range where it matters, our dosing methods account for the difference between meters.

Thanks! I ended up finding a Walgreens that would fill a single pen RX, $80 with SingleCare coupon.

 

[Suzanne & Darcy]

Labs are similar to last time, yes. I would work on getting his diabetes under better regulation and then see if some of those labs (including the protein in the urine) don’t improve.

 

[AbbottTheCat]

Labs are similar to last time, yes. I would work on getting his diabetes under better regulation and then see if some of those labs (including the protein in the urine) don’t improve.

Thanks I’m gonna give it my best shot, no pun intended. See I didn’t realize the protein could improve with regulation, good to know.

Anyone have any tips when first getting started with the testing and shots and dose? That’s the only thing I haven’t researched yet, next few days.
Also looking to find a good system with the logging and spreadsheet, maybe live link to iPhone or something to make the logging easy after testing? Do most members test for say a week and then upload to pc with data cable?