A Question About The Pancreas

[firefly]

Sue or anyone, while reading some of the posts here, I noticed in one that you stated there is a "limited time to allow the pancreas to help". What is that limited time? How do you know when the pancreas is helping....when they require less insulin? Thanks

 

[BJM]

To heal. If you support the pancreas with insulin, it may heal and recover the ability to produce insulin in some cases. With home testing, you will see gradually decreasing glucose levels requiring decreases in insulin dose until you can get 14 days off insulin.

Mel, over in Relaxed Lantus has had a number of cats go into a diet-controlled state even after long periods.

Rumpelteazer in PZI, on ProZinc, is nearly off insulin.

I'm not holding my breath on my Gracie (8 months untreated and fed crap then; now fed Friskies pates and on ProZinc.). Dusty, though, went off the juice in about 2-4 weeks, once he was on low carb canned food and Lantus.

 

[firefly]

Thank you BJM. Gracie wasn't diagnosed until the end of Nov., but it wasn't until I noticed that she started losing weight (which was a few days before her diagnosis) that I took her to the vet. Looking back (after the vet visit) the symptoms were there beginning about August, but I had two cats that used the same littler box, ate dry food from the same bowl (free feeding), and drank water from the same bowl. I had a lot going on then, and I mostly missed the symptoms. I feel terribly guilty over it, and hope I didn't waited too long that her pancreas may never help. Thank you again for your input.

 

[Sue and Oliver (GA)]

We usually say that when a bean is debating whether to start insulin (which allows the pancreas to "rest") or whether to try the pills (which we think taxes the pancreas). No one has a set date. And it is also that darn ECID. There have been cats who have been on insulin for years and go OTJ. But the general consensus seems to be, the longer and sooner you can get them and keep them under the renal threshold, the better it is for the pancreas. (there is debate about what the renal threshold is - I think generally people think 250 and under)

 

[firefly]

We usually say that when a bean is debating whether to start insulin (which allows the pancreas to "rest") or whether to try the pills (which we think taxes the pancreas). No one has a set date. And it is also that darn ECID. There have been cats who have been on insulin for years and go OTJ. But the general consensus seems to be, the longer and sooner you can get them and keep them under the renal threshold, the better it is for the pancreas. (there is debate about what the renal threshold is - I think generally people think 250 and under)

That is what you were discussing (pill or shot) when I noticed the quote I mentioned. I did notice somewhere else a while back someone (or perhaps more than one) had mentioned something to the effect that if a cat hasn't had diabetes that long there is a chance that the pancreas may start working again. I didn't know if anyone had an estimated guess as to when the pancreas may start working.

I noticed that your furbaby Oliver passed away due to heart failure (I am truly sorry for your loss). I also noticed that one or two other people (there may be more...I have read all the posts) have lost their furbabies due to heart failure, and their cats had been OTJ. Is there any correlation between being OTJ and heart failure? Thanks.

 

[BJM]

It is more common to find other endocrine disorders in diabetics. Spitzer (GA) may have had IBD.

 

[Sue and Oliver (GA)]

I think the consensus is that most diabetic cats are older - above 10 years or more - and many are elderly. And so you may get them into remission but they still have all the problems older cats have. Oliver was 16 when diagnosed and a Maine Coon. That breed seem to have a propensity to heart disease. I was so sorry to lose him, but figured he had a wonderful, happy, food filled life :mrgreen: and that this forum had given me an extra year with him.

 

[firefly]

It is more common to find other endocrine disorders in diabetics. Spitzer (GA) may have had IBD.

I apologize for being ignorant about this subject, and for all the questions....so whether or not you catch the diabetes in time for the pancreas to start working right again, there will always be some kind of damage done from the diabetes that will pop up somewhere along the way....is this correct? Is it possible for a cat to be OTJ for two years without any complications from diabetes showing up? I guess I foolishly thought that if I could get Gracie's diabetes under control, with the least amount of damage being done (fingers crossed) that it would be smooth sailing for her (except for whatever may come from old age).

 

[Sue and Oliver (GA)]

There have been cats here who have lived for years OTJ and cats who have lived for years on insulin. It's just like with people - it's all in the genes and everyone reacts differently to disease.

 

[IttyBit]

Totally speaking in human terms here but I know a lot about the endocrine system. I assume cats are similar if not the same within the organs. Now our dietary needs are very different but organ wise I'd assume they're the same. But the body really will exhaust all other avenues to try to fix itself. Within the endocrine system if 1 gets worn down due to illness it'll start to pull on the others to pick up the slack. The longer it goes untreated the more it'll wear on the other organs effected. It's kinda like a 3 legged dog (the endocrine system thyroid/adrenals/ovaries or gonads) take away 1 leg & then only 2 legs are doing the work that 3 legs should be doing. This will wear them out much quicker but they will pick up the slack for awhile in hopes the 3rd leg can heal while on "break". But the longer it goes like this the harder it is to come back from. And if too far it will never come back meaning supplement for life. Also going so long w/o treatment the endocrine system will start pulling on vitamin/mineral stores. Eventually it'll make it impossible for the body to maintain healthy levels. Long term effects of vitamin/mineral deficiencies wreak havoc on other vital non endocrine organs like the heart ect. It's a viscous cycle. It's like a string of dominos 1 goes down & it starts pulling all the others down with it. So the sooner it's dx'd & properly treated the better chance you have.

Now each body is different as for how long this is, it's just as individual as fingerprints. It depends on a lot of things like vitamin/mineral stores, body weight, other health conditions ect. So it's impossible to put a time on how long you have to possibly heal it. I will say I personally had an untreated adrenal condition for over a decade. It then affected my thyroid & then eventually my ovaries. I had a full body crash after 15yrs of being untreated, I was literally on my death bed. It took me a 1 1/2yr of treatment to heal it up but I was able to go off all meds for it. But it took a ton of testing to figure out what all I needed to supplement & what all was affected in the process. Now I'd imagine they don't do this at all with cats of dmaking sure it didn't effect other things while untreated. knowing their food lacks most of the proper nutrients needed to aid the process so it prolly takes them much longer to come back from or heal. I could be totally off the ball here but it makes sense to me knowing what I know about the human endocrine system.

 

[firefly]

There have been cats here who have lived for years OTJ and cats who have lived for years on insulin. It's just like with people - it's all in the genes and everyone reacts differently to disease.

Sue, I was writing my post when you responded about Oliver.

I have another cat named Ebony who is my lap kitty. Gracie is my husband's (well she favors him more than me), but I feed her, and take care of her. Ebony has three slip discs that pinch a nerve, and sometimes she has trouble walking for a minute, or two because of the pinch nerve. The vet has already told me there is nothing I can do about it (other than pain meds if she should ever need it again) I know at some point I will have to put her to sleep (she is almost 10 yrs. old too). It will break my heart to have to do so, but I know it's coming. For some reason that I can't explain, it's different with Gracie and her diabetes. I feel that if Gracie has to go, let it be about old age, and not about diabetes that is treatable. I probably make no sense here. One interesting development from Gracie being sick, for some reason she has become very affectionate with me, and I am the one who pricks her ear, and gives her the shot. Thank you all for helping me to understand this diabetes better.

 

[Sue and Oliver (GA)]

One of the lovely "side effects" of diabetes is that it seems to bring the caretaker and the cat closer together. Although we know it is partly due to the treats the kitty gets used to with regularity , we also suspect the cat starts to feel better and associates the care he/she is getting from their bean to that and responds. Yes, they have to put up with some pokes daily, but they get lots of extra attention and treats. Many beans report that their cats start to remind them when the shot or poke is due and go to the place where that happens and complain until the bean arrives. (with treats of course)

There are absolutely no dumb questions on this forum unless you count the ones people wonder about and don't ask. We all learn every day from each question that is asked and each answer that is given - that is the magic of this place.

 

[firefly]

IttyBit,

Your explanation makes perfect sense to me....thank you so much! These are my first cats, so I really haven't had much experience with sick cats (other than Ebony's back and leg problem from time to time).

Sue, I had suspected it was the treats all along. :smile: She has now allowed me to test her BG by myself (yipee!!!) After we are finished with her BG, she jumps from my lap, heads toward the kitchen (for a little bit of food), and stops in the door way to looks back at me, and waits until I start walking toward the kitchen before she moves on. Thank you for the kind words with regards to dumb questions. This place is truly magically in more ways then one.

 

[Deb & Wink]

Welcome to the Vampire Club!

The reason we prefer insulin shots over pills is because the shots of insulin give the pancreas time to rest and heal and create more beta cells to produce insulin. The pills, such as Glipizide, make the pancreas work harder, not giving it time to rest and heal. The first 6 months are usually the best 'window' for achieving remission in a diabetic cat, but it can take longer or not happen at all.

 

[firefly]

Welcome to the Vampire Club!

The reason we prefer insulin shots over pills is because the shots of insulin give the pancreas time to rest and heal and create more beta cells to produce insulin. The pills, such as Glipizide, make the pancreas work harder, not giving it time to rest and heal. The first 6 months are usually the best 'window' for achieving remission in a diabetic cat, but it can take longer or not happen at all.

I do feel like a vampire! I am sure Gracie thinks so too. :smile: Thank you for the information Deb....much appreciated.

 

[KPassa]

Because Mikey is so rare being diagnosed at 6 months old, I've done extensive research on this. I'll try to sum up some of what I've learned, so bear with me if I make any mistakes or any gross over-generalizations. ;-)

With cats, in the veterinary world, there's Type 1 and Type 2. These are in no way comparable to Type 1 and Type 2 diabetes in humans. All it means is if the cat is permanently on insulin (Type 1) or if the cat eventually achieves remission or has a very low dose because the pancreas seems to be working, at least partially (Type 2). Other than that, there isn't really any further research or distinguishing characteristics of different types of diabetes in felines.

In reality, there's more like 2 1/2 types of feline diabetes. I'll be using the human terminology so it's easier to understand.

• Type 1a - extremely rare/non-existent, most likely because the cat dies before diagnosis or never makes it past the first few weeks of life. (Mikey is pretty much an original.) Young age at diagnosis and no other co-morbid or pre-existing problems that could cause it.
• Type 1b (or even 2b/2c) - Diabetes caused by a specific hyperglycemia-inducing problem, such as Cushing, Acromegaly, IAA, or EPI. This can hit cats of all ages. Usually identified by cats requiring an extremely high dose (more than 5u BID, even on wet, low carb food). Remission depends on the underlying cause. Mikey might in fact have one of these conditions, but he's never shown any symptoms and has never gone over 3u so I've never had him tested for any of these.
• Type 2a - One of the most common types diagnosed in usually older cats (over around 9 years of age). Usually caused by a genetic pre-disposition being exacerbated by a long-term diet high in carbs (not good for the more carb-sensitive obligate carnivores that they are). High chance of remission if caught and treated early (within the first 6 months). After that time-frame, remission is still possible but might take longer or not happen at all.
• Type 2b - Usually "transient" depending on the cause. Another common type diagnosed in kitties, usually over the age of 5. This one is an externally-induced type of diabetes, meaning something else is causing pancreatic damage or elevating BGs. This can be anything from infections, dental issues, CRF, IBD, steroids, stress, pancreatitis, or other co-morbid conditions. Chances of remission depend on the underlying factor and the damage done to the pancreas (which isn't currently measurable so there's no way to know for sure). Some cats even fall in and out of remission (I.e. Only when steroids are needed or whenever they have dental problems).

There are no real tests available (except for the high dose conditions) to tell you which type your cat has, but usually, you'll be able to tell if you know your cat's age and history.