Angel staying high

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Lisa and Angel

Lisa and Angel

Member Since 2023
Hi all,

Angel's been having really poor numbers ever since the Metronidazole. I don't get it. Her BG was doing so well before (check end of 2023 on SS), now I can't even get her down into the low yellows.

Does anyone have any idea of why this is happening?

There's some matter of urgency involved. Once she's regulated and mostly seeing blues/greens again, she can have surgery for her chronic nerve pain. But because that's major soft tissue surgery, we can't do it until she's regulated. Until then she'll be in pain, on her mega (over)dose of pregabalin, which in turn is causing her digestive troubles and preventing her from going onto a canned lowcarb diet.

What to do? I'd like to start following TR protocol's quicker dose adjustments to get her to regulation quicker, but she can't be on a canned lowcarb diet (yet). Can I up by 0.5 if she hasn't gone below 200 the next time we increase? Advice is welcome.
 
What is she prescribed the metronidazole for? There is always a possibility that she needs a different antibiotic.

The other issue may be that the pain medications aren't really helping with her pain. Both an inflammation or infection can cause blood glucose numbers to be elevated. Did the vet explain why she needs to be better regulated for a surgery? Diabetic humans have surgery all the time.

Even with TR, a 0.5u increase isn't recommended unless nadirs are over 300. Given that Angel's nadirs are largely in the 200s, you would need to increase by 0.25u.
 
Sienne and Gabby (GA) said:
What is she prescribed the metronidazole for? There is always a possibility that she needs a different antibiotic.

The other issue may be that the pain medications aren't really helping with her pain. Both an inflammation or infection can cause blood glucose numbers to be elevated. Did the vet explain why she needs to be better regulated for a surgery? Diabetic humans have surgery all the time.

Even with TR, a 0.5u increase isn't recommended unless nadirs are over 300. Given that Angel's nadirs are largely in the 200s, you would need to increase by 0.25u.
Click to expand...

She was prescribed the Metronidazole for her persistant bowel infection with elevated white blood count. It was an 8 day prescription, final pill was given on january 9th. No more antibiotics since then.

The pain meds are definitely helping, though not enough (hence the need for the surgery). It's gonna be a major major soft tissue surgery with a huge surgical field/wounds. Her high BG will impact wound healing, and she absolutely needs to be in the best possible state of health for optimal healing. If the wound doesn't heal well, the chance is high her nerve pain will return.

Wendy&Neko said:
What format is the metronidazole? It's a foul tasting medication. If liquid, they might have added sugars to it.
Click to expand...

It was a pill called Metrovis. Ingredients are:

Metronidazole
Microcrystalline cellulose
Sodium starch glycolate, type A
Hydroxypropyl cellulose
Yeast (dried)
Beef flavor
Magnesium stearate

But it's been almost a week since the final pill so I don't think it could be affecting her anymore...
 
Lisa -

Sometimes it's a matter of having to increase the insulin to compensate. We often see this is a cat has to be prescribed a steroid. With any source of inflammation such as pain or an infection, blood glucose levels tend to increase. Just like you saw today, you increased Angel's dose, and her +3 is in a better range.
 
Welp, seems Angel got tired of my complaining. Maybe she had a bit of glucose toxicity going on? Either way, she broke through it last night.

I felt safe giving a small token dose just now, hopefully that was the right choice. Gonna nap for a bit then get a +2 test.
 
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