? acceptable remission BG numbers

Status
Not open for further replies.
I dug up some AT OTJ SSs for you to peruse and compare. One isn't Lantus, but the insulin shouldn't matter, the OTJ numbers will be the same. I forgot about @Jess and Marky Mark or rather, I didn't realize she used AT, Mark was another AT OTJ cat since I've been here. Mark went OTJ in November and Jess is still testing occasionally and recording, so you get some decent longer term OTJ numbers to check out. A lot of people go OTJ and stop using their SSs, unfortunately for the rest of us who like to see the data.

https://docs.google.com/spreadsheet...lQa-YFzIF1qeIcpRBKwE8SehaI/edit#gid=361360320

https://docs.google.com/spreadsheets/d/1oMVd_9ohJbKWbV50Rmi635ct_252ubzzy1ERO5t72cc/pubhtml

https://docs.google.com/spreadsheets/d/1bl-WMP3h8k5uql9FIT4xgxUXSo0SO4smxP47UVadlSA/pub?output=html
 
There's a difference between a symptomatic hypo and a "low number"....the vast majority of what you see here are just "low numbers" that are fairly easily dealt with by feeding a little high carb food

The word "hypo" gets thrown around here too much IMHO
I do know that. Not ignorant.
 

I've been around here 10 years now and although there have been a couple cases of accidental overdosing, usually by someone other than the primary care giver, I can't recall anyone following TR having their cat go into a symptomatic hypo.

Why tempt fate?

Ive seen more than that - at least four and I've only been here four years.
 
I dug up some AT OTJ SSs for you to peruse and compare. One isn't Lantus, but the insulin shouldn't matter, the OTJ numbers will be the same. I forgot about @Jess and Marky Mark or rather, I didn't realize she used AT, Mark was another AT OTJ cat since I've been here. Mark went OTJ in November and Jess is still testing occasionally and recording, so you get some decent longer term OTJ numbers to check out. A lot of people go OTJ and stop using their SSs, unfortunately for the rest of us who like to see the data.

https://docs.google.com/spreadsheet...lQa-YFzIF1qeIcpRBKwE8SehaI/edit#gid=361360320

https://docs.google.com/spreadsheets/d/1oMVd_9ohJbKWbV50Rmi635ct_252ubzzy1ERO5t72cc/pubhtml

https://docs.google.com/spreadsheets/d/1bl-WMP3h8k5uql9FIT4xgxUXSo0SO4smxP47UVadlSA/pub?output=html
I think Rufus numbers look very comparable to Franky's, up until 2 days ago.
 
I dug up some AT OTJ SSs for you to peruse and compare. One isn't Lantus, but the insulin shouldn't matter, the OTJ numbers will be the same. I forgot about @Jess and Marky Mark or rather, I didn't realize she used AT, Mark was another AT OTJ cat since I've been here. Mark went OTJ in November and Jess is still testing occasionally and recording, so you get some decent longer term OTJ numbers to check out. A lot of people go OTJ and stop using their SSs, unfortunately for the rest of us who like to see the data.

https://docs.google.com/spreadsheet...lQa-YFzIF1qeIcpRBKwE8SehaI/edit#gid=361360320

https://docs.google.com/spreadsheets/d/1oMVd_9ohJbKWbV50Rmi635ct_252ubzzy1ERO5t72cc/pubhtml

https://docs.google.com/spreadsheets/d/1bl-WMP3h8k5uql9FIT4xgxUXSo0SO4smxP47UVadlSA/pub?output=html
And very comparable to Maggie. When she started back on the insulin she was in constant yellow, where Rufus hits yellow and drops down. I am not saying I accept these yellow numbers but at least he's going back down.

Now I'm laying in bed, and have looked at the cam footage. He's eaten kibble at 1am, 3am, and 5am. It's 630 now. At 7 ill see if he'll eat some wet and then test him. Theoretically he should be high again/still from eating all that kibble. If not, then it could be the atopica.
 
So AMBG is 146 today. Not the best, but I'll take it as he has been eating medium carb dry kibble every 2 hours for the last 6 hours.
 
Have you tried Young Again 50/22 dry? It's not as low carb as the zero but better than regular dry. My cats clearly preferred it to the zero.

Why does your vet not want Rufus on steroids? I know the disadvantages - side effects including elevated blood sugars - but it's effective for food allergies, IBD, and lymphoma (which I'm hoping Rufus doesn't have) and it's an appetite stimulant. You of course wouldn't give it at the same time as Atopica since they're both immune suppressants. It would be bad for his diabetes but that's easier to control than his other issues IMO.
 
Atopica is the safer option vs. steroids and controls similar things. Using Atopica long term is significantly safer than steroids but like anything, not all situations are the same. I'm in a weird position with Mulan right now because she has severe allergies so she's on atopica however it's not fully controlling her itching. I also have her on weekly allergy injections. She was just diagnosed with mild to moderate asthma so we are possibly looking at MAYBE adding in a low dose of prednisolone as well - we will see. Trying a z pack type antibiotic course first to see if the asthma might be bacterial related. It's so tough. Rufus has multiple things going on as well, I really feel for you Sean - it's not easy balancing all of these symptoms!
 
Have you tried Young Again 50/22 dry? It's not as low carb as the zero but better than regular dry. My cats clearly preferred it to the zero.

Why does your vet not want Rufus on steroids? I know the disadvantages - side effects including elevated blood sugars - but it's effective for food allergies, IBD, and lymphoma (which I'm hoping Rufus doesn't have) and it's an appetite stimulant. You of course wouldn't give it at the same time as Atopica since they're both immune suppressants. It would be bad for his diabetes but that's easier to control than his other issues IMO.
Neither regular vet or IM want him on steroids. I said I would rather have Rufus on insulin and have the other issues taken care of, and they both think i'm nuts. The hardest part for me is do I go ahead and get the biopsy done? IM vet doesn't think we are there yet and should continue with Atopica, and if that doesn't work try something else. She said there are a few things to try before we talk about steroids. Rufus was on prednisone before, but it really didn't help with his appetite. That is what we originally went in for back in August. BUT in the meantime he had bad teeth, pancreatits, stomach issues, and developed diabetes so maybe that is why the pred didnt help with appetite? As far as YA 50/22, I have not tried it. I was trying to keep him on a novel diet but that isn't working either. So, I'll call them today and request a sample of that. I did mix the YA zero LID 50/50 with the other dry food he was eating and he was eating that. So that theoretically would take it down to 15% carbs.
 
Atopica is the safer option vs. steroids and controls similar things. Using Atopica long term is significantly safer than steroids but like anything, not all situations are the same. I'm in a weird position with Mulan right now because she has severe allergies so she's on atopica however it's not fully controlling her itching. I also have her on weekly allergy injections. She was just diagnosed with mild to moderate asthma so we are possibly looking at MAYBE adding in a low dose of prednisolone as well - we will see. Trying a z pack type antibiotic course first to see if the asthma might be bacterial related. It's so tough. Rufus has multiple things going on as well, I really feel for you Sean - it's not easy balancing all of these symptoms!
Thanks Nicole. The pred when Rufus was on it actually worked very well for the itching and the gnawing. He was on a pretty low dose too. Unfortunetly the pred, pancreatits, overweight, male, older, and fixed, made him develop diabetes. I think that's the reason they dont want him back on the pred.
 
Please don't put on steroids. Seriously elevated BG. Steroids took Silver out of remission. Bad idea for diabetics.
 
Yes, bad as pred is, effectively treating other serious issues trumps diabetes. The reason I mentioned going back on Pred was in case the Atopica really is causing a lot of stomach issues.

Is Rufus on an antihistamine? I've seen a lot of people swear by Cetirizine Hydrochloride (Zyrtec) for allergies in cats. I was giving it to my civvie Tiger for stomach rash/baldness and think it helped.
 
Yes, bad as pred is, effectively treating other serious issues trumps diabetes. The reason I mentioned going back on Pred was in case the Atopica really is causing a lot of stomach issues.

Is Rufus on an antihistamine? I've seen a lot of people swear by Cetirizine Hydrochloride (Zyrtec) for allergies in cats. I was giving it to my civvie Tiger for stomach rash/baldness and think it helped.
At this point, I think he has been eating more dry food because of the Atopica. He is eating less and less wet though. I'm not sure if he's eating enough calories lately. With the wet food I could tell, but not with dry. I have been giving an onda 2x daily and gave a cerenia late last night. Now this am he did eat at 1, 3 and 5 dry food, but refuses wet and wont even look at it.

Rufus took zyrtec for 3 months last year and didn't notice a change in him at all.
 
So we are at 196 now. Hasn't eaten in 5 hours, only had the Atopica. hmm.. I think tomorrow we will skip the Atopica and see what numbers do.
 
Sean, just want to thank you for asking this question which has generated so much informative discussion. I, too, wondered at what BG would a kitty be considered "out of remission".

My cat Meeja was diagnosed in Aug '17 with a BG over 600, was hospitalized for several days and started on 1U Lantus twice daily. I was following my vet's advice on dosing (quickly raised to 2U, then back to 1.5U) and was not home testing but periodically taking her to vet for tests. Big mistake on my part. About a month after diagnosis, Meeja's BG went very low (40s) and I again followed my vet's advice to stop giving insulin "cold turkey". Meeja has been OTJ for 6 months now, but according to some of the responders, she would not necessarily be considered in remission. Like Rufus, Meeja's BG has periodic spikes but seems to come back down. In hindsight, I wish I had the information & knowledge contained in the responses to your question because I would have continued Meeja on insulin and tapered off the dose, as you are doing. I've thought about re-starting her on a small dose, but that idea really drives my anxiety level through the roof at this point in time. I feel sad to think I might have jeopardized her chances for long-term remission, and as Sandy noted, increased the potential for ketones/DKA. Sometimes it's just so difficult to know what to do.

Wishing you & Rufus continued success.
 
Ok, got off the phone with Atopica. They never did testing on animals with diabetes and Atopica, however they have cases of non-diabetic cats having raised BG levels and cases of cats becoming diabetic. Also need to watch creatine levels and BUN I think he said. Half life of the product is 6 to 40 hours. So I dont have middle of the night tests, and I should get some, but I do know that he is decent in the am and then rises after I give him the Atopica and then falls back down in the pm.

So, is this product better or worse then prednisone? I don't know. I'm kind of discouraged that the IM vet didn't know that this product COULD raise BG levels. Maybe it is just that this product doesn't raise it as many animals as pred does?
 
Sean, just want to thank you for asking this question which has generated so much informative discussion. I, too, wondered at what BG would a kitty be considered "out of remission".

My cat Meeja was diagnosed in Aug '17 with a BG over 600, was hospitalized for several days and started on 1U Lantus twice daily. I was following my vet's advice on dosing (quickly raised to 2U, then back to 1.5U) and was not home testing but periodically taking her to vet for tests. Big mistake on my part. About a month after diagnosis, Meeja's BG went very low (40s) and I again followed my vet's advice to stop giving insulin "cold turkey". Meeja has been OTJ for 6 months now, but according to some of the responders, she would not necessarily be considered in remission. Like Rufus, Meeja's BG has periodic spikes but seems to come back down. In hindsight, I wish I had the information & knowledge contained in the responses to your question because I would have continued Meeja on insulin and tapered off the dose, as you are doing. I've thought about re-starting her on a small dose, but that idea really drives my anxiety level through the roof at this point in time. I feel sad to think I might have jeopardized her chances for long-term remission, and as Sandy noted, increased the potential for ketones/DKA. Sometimes it's just so difficult to know what to do.

Wishing you & Rufus continued success.
It is very difficult to know what to do! I agree! Now that I know his BG could be elevated from this new medication, I'm not sure where to go from here.
 
Sean, just want to thank you for asking this question which has generated so much informative discussion. I, too, wondered at what BG would a kitty be considered "out of remission".

My cat Meeja was diagnosed in Aug '17 with a BG over 600, was hospitalized for several days and started on 1U Lantus twice daily. I was following my vet's advice on dosing (quickly raised to 2U, then back to 1.5U) and was not home testing but periodically taking her to vet for tests. Big mistake on my part. About a month after diagnosis, Meeja's BG went very low (40s) and I again followed my vet's advice to stop giving insulin "cold turkey". Meeja has been OTJ for 6 months now, but according to some of the responders, she would not necessarily be considered in remission. Like Rufus, Meeja's BG has periodic spikes but seems to come back down. In hindsight, I wish I had the information & knowledge contained in the responses to your question because I would have continued Meeja on insulin and tapered off the dose, as you are doing. I've thought about re-starting her on a small dose, but that idea really drives my anxiety level through the roof at this point in time. I feel sad to think I might have jeopardized her chances for long-term remission, and as Sandy noted, increased the potential for ketones/DKA. Sometimes it's just so difficult to know what to do.

Wishing you & Rufus continued success.
Also, I think her numbers look great!! I don't think you should worry at all!
 
I really dont want to, but if the choice is insulin or not eating/death from lymphoma I'd have to choose the steroids.
Not all cats on steroids develop diabetes. My overweight older fixed male civvie was on pred for a year and a half and it just raised his BG's about 20 points. And there is an alternative to pred, which is budesonide. That's what Neko was on for her lymphoma, because she could not have pred due to her heart. It did not raise her BG's, though I have seen it do so in one cat. We've had a few cats here on budesonide.
So, is this product better or worse then prednisone?
Note, it's prednisolone which is the appropriate drug for cats, not prednisone.

I too would rather deal with diabetes than inappetance/lymphoma or IBD. You can test and dose appropriately with diabetes. The rest you have no visibility into and it's a guessing game what will work.
 
Note, it's prednisolone which is the appropriate drug for cats, not prednisone.
When I got the "pred" form 2 different vets, both labels indicated "Prednisone". When I asked the 2nd vet about switching to "PRednilsone" instead, she said "Oh, he is on Prednilsone, they just interchange the names sometimes". Ummmmmm OK? So, I'm not sure what he was on.

I too would rather deal with diabetes than inappetance/lymphoma or IBD. You can test and dose appropriately with diabetes. The rest you have no visibility into and it's a guessing game what will work.
The IM vet doesn't think it's lymphoma and thinks the inflammation will go away once we get the offending food out of the pic. I guess I should just get a biopsy.

We've had a few cats here on budesonide.
Vet put that on bottom of list too, as far as I know.
 
Oh, he is on Prednilsone, they just interchange the names sometimes".
Yikes!! My vet/vet tech was very careful about getting the right drug and labelling it properly. The lymphoma list I'm on, we've seen people get prescribed prednisone instead, so not an uncommon imistake by vets.
The IM vet doesn't think it's lymphoma
My vet didn't think Neko had high dose conditions, but she had two. We found out by testing. We couldn't test her for lymphoma vs. IBD, because she couldn't take the anesthesia for the biopsy or endoscopy. Sometimes you gotta go with the information you have but I'd rather have known for sure. The two conditions are treated differently. I hope you can get the allergies under control so you can know for sure.
 
Remission numbers, one data point: Quintus is between 6-8mmol/l on an animal meter (you can check his SS. I think what is important is stability. If I take his BG before food, after food, hours after food... it stays on that zone.

150 (animal meter) might come from that being a value at which a cat would be considered pre-diabetic. It’s still a “normal” reading, though it’s not ideal. The risk/benefit analysis of giving insulin vs not is different with a cat hanging out in the 150s or in the 300s.
 
My vet didn't think Neko had high dose conditions, but she had two. We found out by testing.
It is my biggest concern. I told her that if it comes back as IBD that it could be lymophoma. She has assured me multiple times that shes confident that its not cancer. She said she can tell by markings. Now, I could do endoscopy for $2000, but who know if that will tell us what we need to know.
 
Remission numbers, one data point: Quintus is between 6-8mmol/l on an animal meter (you can check his SS. I think what is important is stability. If I take his BG before food, after food, hours after food... it stays on that zone.

150 (animal meter) might come from that being a value at which a cat would be considered pre-diabetic. It’s still a “normal” reading, though it’s not ideal. The risk/benefit analysis of giving insulin vs not is different with a cat hanging out in the 150s or in the 300s.
And Rufus' numbers are generally inline with Quintus'. He is going higher now because of the Atopica. We'll have to see on Monday what the IM thinks. I am going to skip his Atopica tomorrow and see what happens.
 
And Rufus' numbers are generally inline with Quintus'. He is going higher now because of the Atopica. We'll have to see on Monday what the IM thinks. I am going to skip his Atopica tomorrow and see what happens.

Though if I’m not mistaken you’re using a human meter, so reading a bit lower than what you’d be reading with an AT?

You might find interesting some of the discussions around the time I stopped giving insulin to Quintus (there is disagreement in them): http://www.felinediabetes.com/FDMB/threads/1-2-quintus-no-juice-today-musings-on-treating-fd.188968/ not just about remission, so you have to hunt around a bit, but it’s in there
 
Though if I’m not mistaken you’re using a human meter, so reading a bit lower than what you’d be reading with an AT?

You might find interesting some of the discussions around the time I stopped giving insulin to Quintus (there is disagreement in them): http://www.felinediabetes.com/FDMB/threads/1-2-quintus-no-juice-today-musings-on-treating-fd.188968/ not just about remission, so you have to hunt around a bit, but it’s in there
No, I am using an AT2. I'll take a look at that post :)
 
When I got the "pred" form 2 different vets, both labels indicated "Prednisone". When I asked the 2nd vet about switching to "PRednilsone" instead, she said "Oh, he is on Prednilsone, they just interchange the names sometimes". Ummmmmm OK? So, I'm not sure what he was on.

What happened to me once was that I went to a drugstore with a prescription for prednisolone and they gave me prednisone without asking me about the switch. Luckily I noticed the label and protested. The pharmacist said they were the same thing and it took a phone call to my vet to convince her that for cats it DOES make a difference. I had to special-order it because prednisolone isn't widely used in the US. Maybe that's why vets usually dispense it themselves. I think your 2nd vet is wrong and you need to assume the label is correct, and make sure you get actual prednisolone if Rufus ever goes back on pred.
 
Last edited:
What happened to me once was that I went to a drugstore with a prescription for prednisolone and they gave me prednisone without asking me about the switch. Luckily I noticed the label and protested. The pharmacist said they were the same thing and it took a phone call to my vet to convince her that for cats it DOES make a difference. I had to special-order it because prednisolone isn't widely used in the US. Maybe that's why vets usually dispense it themselves. I think your 2nd vet is wrong and you need to assume the label is correct, and make sure you get actual prednisolone if Rufus ever goes back on pred.
That's for sure! Makes zero sense to me the nonchalance of it. It's drugs! I think it matters how its labeled! :)
 
Side note sort of: Interesting you mention a predicable rise in bg after Atopica. When I was on very high dose prednisone I saw the same rise and fall in my bg and found with keeping my carb intake as low as possible during the peak action of the pred I could keep my bg to halfway reasonable levels. I wonder if a very small dose of insulin timed to have peak effect at the same time as the Atopica peak effect might be possible, or maybe splitting the dose am and pm which I also found very helpful. Just a thought to maybe take to your vet.
 
Side note sort of: Interesting you mention a predicable rise in bg after Atopica. When I was on very high dose prednisone I saw the same rise and fall in my bg and found with keeping my carb intake as low as possible during the peak action of the pred I could keep my bg to halfway reasonable levels. I wonder if a very small dose of insulin timed to have peak effect at the same time as the Atopica peak effect might be possible, or maybe splitting the dose am and pm which I also found very helpful. Just a thought to maybe take to your vet.
Can you just give a small dose 1x per day? As long as he's under 200 if not TOO worried i think.
 
Side note sort of: Interesting you mention a predicable rise in bg after Atopica. When I was on very high dose prednisone I saw the same rise and fall in my bg and found with keeping my carb intake as low as possible during the peak action of the pred I could keep my bg to halfway reasonable levels. I wonder if a very small dose of insulin timed to have peak effect at the same time as the Atopica peak effect might be possible, or maybe splitting the dose am and pm which I also found very helpful. Just a thought to maybe take to your vet.
I just had a thought. I could be wrong, but I'm pretty sure he isn't eating as much during the middle of the night. Maybe just give the Atopica to him at 8 or 9 pm instead??
 
Well, Rufus hasn't had Atopica for 28 hours, but his BG is up to 223. I know that the half life of Atopica is 6 to 40 hours, but he was going down and now back up so not sure if I can blame the Bg numbers fully on Atopica. He will not any wet food right now, so he's eating 30% carb kibble.
 
Ah, well I think you might like Quintus's SS! I felt bad about the blue initially but then I remembered that if I were testing him with a human meter he would probably be all green, and I got over it.
That was exactly my thinking, if he's in the blues it's ok with me. Hopefully in mid to lower blues. But now we are getting up in the low yellows. Kibble and meds are to blame :(
 
I'm still testing Mark occasionally and do keep his spreadsheet up to date. We stayed with the AT2 the entire time because he seemed to be heading towards remission and I didn't think we needed to switch monitors if he were going OTJ. Unless he goes back on insulin, we will stick with the AT2. He seems to be handling remission well. He's been on a daily antihistamine since mid-February, which does not seem to be negatively affecting his BG.

He wasn't real strong in the greens when we went OTJ but he had been hitting some low numbers in the evening then bouncing up in the morning. Since we were unable to test at all during the day, I was afraid of him having a hypo while we were at work. When we did the OTJ trial, I was home for a week so I could closely monitor his behavior/BG and was prepared to get him back on insulin very quickly if needed. I'll be home again for a few days at the end of this week and will try to do a curve to fill in his spreadsheet a bit.

I had no idea his spreadsheet could still be helpful to anyone. That's good to know. :cat:
 
Very interesting post.

I'm curious why more people don't try "Natural" meds before using drugs? My cat a few years ago had melanoma on this lip I had surgery done but it came back .He stopped eating.

Someone suggested Slippery Elm , I tried it & it worked amazingly well. It helped with nausea , vomiting & Diarrhea.My kitty continued to eat good till the day he died from the cancer. I still use the Slippery Elm on my cats now.

This article explains how it works : https://draxe.com/slippery-elm-for-pets/

I've also used CBD oil for my cats ,for pain & to increase their appetite. It also works Very well. Contrary to what some people believe it's legal to order in all states & it Does NOT get anyone High.
 
Very interesting post.

I'm curious why more people don't try "Natural" meds before using drugs? My cat a few years ago had melanoma on this lip I had surgery done but it came back .He stopped eating.

Someone suggested Slippery Elm , I tried it & it worked amazingly well. It helped with nausea , vomiting & Diarrhea.My kitty continued to eat good till the day he died from the cancer. I still use the Slippery Elm on my cats now.

This article explains how it works : https://draxe.com/slippery-elm-for-pets/

I've also used CBD oil for my cats ,for pain & to increase their appetite. It also works Very well. Contrary to what some people believe it's legal to order in all states & it Does NOT get anyone High.

JoyBee, there are many, many people here who use SEB, CBD oil, both or many combinations of natural supplements (myself included, look at Asia’s SS in the Med/Supplements tab). Some use them exclusively, many use in conjunction with allopathic medicines. FD is a complicated disease and several cats here have comorbidities that require “big guns”. I don’t think anyone sets out to give their cat a bunch of drugs and many start out trying a more natural approach until it is not enough.
 
:bighug: I know, it really stinks! We are all rooting for you and Rufus though!! Hopefully soon.

They need heart emojis on this site LOL. <3 <3 <3
I totally agree about the heart emojis! I've been jonesing for one of those several times lately. I'm about to fish one out of the old Windows Char Map... :joyful:
 
Oh my word! I'm laughing... I think Sean might want to change the title of this thread to "Acceptable remission BG numbers plus a little bit of this & a little bit of that" since we've managed to touch on such a wide range of topics besides the original topic of discussion... Atopica, symptomatic vs non-symptomatic hypos, AT OTJ SSs, YA dry food, steroids, antihistamines, high dose conditions, lymphoma, "natural" meds, and last, but not least... emojis!!! LOL!
:D:p:D:p:D
 
Status
Not open for further replies.
Back
Top