ADIVCE PLEASE: 7/5 PMBG 156 +1~173 7/6 AMBG~74, +2~148

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Erica & Chigga (ChiggaButt)

Erica & Chigga (ChiggaButt)

Member Since 2010
Hello everyone!

Back again - thought we were in the clear after that last dental. I realize her spreadsheet is sparse but when she went otj after the dental things seemed to be going well until recently. I don't know what's going on with her numbers. She's jumping from greens to blues yet is purring and playful. She has had a bout with throwing up right after she eats and ten eventually I find a fur ball. At the last dental the doc said I might need to keep an eye on one of her back left teeth and it seems as of late she's been turning her head to the side to eat - so this morning (because of the number jumps) I set an appointment to have another dental for monday. Joy!

I really don't want her to have to go back on the insulin but with her numbers as they are showing now - what do you guys think? I see greens and I'm thankful and then she pops up into those blues and I get so frustrated and confused. Should I put her back on insulin? I'm not sure how it works when she's OTJ and has some great greens but then a blue. Even with the low numbers mixed in with some higher blues does that indicate she may need insulin again?

I do feed her only twice a day because I'm at work all day and I leave a whole can of Friskies Mixed grill which is 172 cal and I do this in the morning and at night so that's two cans a day. Sometimes she doesn't eat all of it and sometimes I come home and that plate is empty - like last night which is when I tested her (I have no idea when she ate it all) an her numbers were 156 then 173.

Sorry for rambling. Just not sure what to do about insulin - if I should do anything at this point. Advice would be MUCH appreciated.

Thanks!

Erica and Chiggabutt
 
Hi, Erica!!

One of the patterns I'm seeing is that Chigga often brings her numbers down after she's eaten. That's usually a signal that her pancreas is working. I'm wondering if it is a bad tooth or something medical that's going on. Did your vet ask that you get pre-dental labs drawn? If not, I'd call back and see if you can get bloodwork done before the dental to make sure there's no infection. (My vet won't do a dental if there's an active medical problem.)

What I would suggest is to get some frequent tests when you're home over the weekend. If Chigga's numbers are still outside of the normal range 2 - 3 hours after a meal, then when you're at the vet for the dental, ask for a prescription for Lantus. Waiting a bit to see if her numbers come back into the normal range, especially if there are dental issues, may be indicated. Frankly, I don't know that I'd start insulin with a dental scheduled this close. Anesthesia can lower BG levels and you'd probably be skipping a shot on Monday, anyway.
 
Thank you so much for the response - it helps to know there are people that are going through this stuff too and can help.

I think it might be a bad tooth since she does seem to be eating to one side and the vet even said at her last dental in March I should keep an eye on her back left tooth. My vet is going to do pre-dental labs for sure and I even asked for the fPL1 even though like you said it seems her pancreas is working but I'm just a worry wart.

I just took her BG and this is now about three hours after eating and her number is up to 163. Soooo frustrating. But I guess I should wait til after the dental to see what happens before I start giving her insulin. I'm going to take some more numbers over the weekend. Her dental is Monday so I'll then see how it goes after that.

Does this seem like a good plan? I'm going to ask for the prescription anyway just in case after the dental there aren't any improvements. And then I guess I'll go from there.

Thanks again,

Erica
 
The biggest caveat would be if Chigga is prone to developing ketones. If that's the case, I'd suggest you pick up some Ketostix and monitor. If her numbers skyrocket, I'd also be concerned. Another possibility is if you really think it's a tooth, you may want to ask for vet for antibiotics and start them before Monday.
 
I actually don't know if she is prone to it or not. I'll pick up a testing kit today. Would she have key tones even though her numbers aren't super high? What would key tones mean in this case? I feel so clueless and freaked out.

When you say skyrocket, what numbers would you consider skyrocketing?

Sorry for all the questions - I'm just kind of freaking out here.

I'll call the vet today.

Blech - this is not fun. My poor baby.
 
Just an update on her numbers. So I just tested again and her numbers are going down.

8:00 am ~ 74
Ate some where around 8:30 or 9:00 (this is the problem with grazing but I know she didn't eat after 9:00 cause I've been staring at her on my desk since then)
9:30am ~148
11:00am~163
12:00pm~135
 
The presence of ketones can indicate a developing case of diabetic ketoacidosis (DKA). DKA is caused by (1) infection (2) not enough insulin and (3) not enough food/water intake. While typically we see DKA developing in cats with high BGs, it is not exclusive to those cats. So if there is any possibility that there is infection present, it is a good idea to be cautious and just use a strip to test the urine. It's an inexpensive and simple way to have some piece of mind.

Skyrocketing would be a sharp increase over a short amount of time. If she went from 90 to 150 in an hour, that would be skyrocketing.

Sending healing vines for your baby!
 
Since she went from 74 to 148 in two hours (feeding after her 74 test number) would that be considered skyrocketing even though it was over the course of two hours and after food?
 
No, that's not skyrocketing. I was thinking more along the lines that Chigga was in pink numbers, or even high yellows, and stayed there. At this point, it looks more like Chigga is taking a stroll -- she walks up the hill; she comes down the hill.

I didn't mean to freak you out by mentioning ketones. You would have known if Chigga had a history of developing ketones. She'd have been a very sick kitty. I encourage people to test, particularly if the cat's situation has changed, more as a preventative measure than anything else. A cat that develops DKA is going to require hospitalization and it gets very expensive. If you catch the situation before it turns critical, it's easier to manage and far less dangerous. I'm being cautious, and urging you to be cautious because you seem pretty certain there's likely an infection in her mouth.
 
I totally appreciate your help - I need to be checking these things. I should check her key tones anyway just to know what's going on so thank you for that advice.

The reason I think it's a tooth thing is because the last visit she had the vet mentioned there was one tooth that would probably need to be extracted at some point and it seems like she's chewing on one side of her mouth. I can't see anything really but I guess it's better to get the dental and blood work to know if that's causing the numbers or not. If not then I need to figure her insulin needs out from there.

Is it possible for her to go OTJ again? Even if I have to give her insulin for a bit? I just want to know that it's possible. :sad:

She's definitely crusin' in the blues this afternoon. Settling right around 120.

I just evaluated her food and I'm gonna go even lower carb with higher protein vs fat and maybe that will also help?
 
Yes -- it's absolutely possible for a cat to return to OTJ status. Jill's Alex has come back from the Falls and gone OTJ on three separate occasions. Illness was always the reason for her dropping out of remission. There are several people whose cats came out of remission due to dental issues. They were all on insulin for a bit and went back into remission.

Lower carb right now is good. Whatever Chigga will be happy eating (unless it's ice cream) is fine!!
 
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