Are rotten teeth making my cat Leo temporarily diabetic?

[Javier and Leo]

Lantus forum previous thread: https://www.felinediabetes.com/FDMB...m-400-to-50-60-with-1-4u.240697/#post-2708361

Hi all,

This is Javier, I recently introduced myself and my cat in the Lantus subforum. We took Leo to the hospital for a check-up after his DKA episode and initial stages of diabetic care at home. The doctor said Leo has two rotten teeth they'd like to remove once Leo is more stable. They said the rotten teeth could be contributing to his current diabetic state.

Leo's BG is dropping sharply with puny doses of insulin (sometimes 1/4). His response to insulin could be seen as him potentially moving into remission once his teeth are taken care of.

Does any of you have experience with this issue: dental problems and the connection to a state of diabetes?

Thank you!

 

[Noah & me (GA)]

I can't offer anything about your current situation but have dealt with long term dental pain in a diabetic cat whose teeth could not be pulled. When the time comes and if you have problems administering pain meds check my profile for transdermal BUPE. Or PM me.

 

[Bron and Sheba (GA)]

Rotten teeth can certainly raise the BGs and can sometimes take kitties who are in remission, back out of remission. But with DKA so recently I think it is too soon to have a dental.

I can’t see Leo’s SS. Have you pressed the share button. I’ll ask @Bandit's Mom to have a look at it. Thanks Bhooma!

Your signature says you are only giving insulin at night. Is that correct?
Lantus is a twice a day insulin and if Leo is only just recovering from DKA he needs to have insulin twice a day to ensure that ketones are kept at bay. If the dose is dropping him down to 60....you can halve the dose he is getting once a day and give half in the morning and half at night.

Are you giving lots of small frequent meals during the day and evening as well? After DKA it is really important that Leo gets lots of food to eat.

Are you testing the urine daily for ketones? That is also really important that you do that. You can buy a bottle of Ketostix from Walmart or a pharmacy and test the urine with a test strip. Read the result exactly 15 seconds later against the colours on the side of the bottle. Anything above a trace needs vet attention.

 

[Bandit's Mom]

Hi Javier, Welcome to FMDB!

You need to share your spreadsheet for anyone to view. Click on the "Share" button at the top right corner of the spreadsheet and change the settings to "Anyone on the internet with this link can view".
Let me know if you face any issues doing this.

 

[Javier and Leo]

Apologies, I just shared the spreadsheet.

At times we are skipping the morning insulin dose as per recommended by the vet. We are skipping the insulin dose when his morning BG is too low (around 60). Just 0.5U at night seems to be sending him to such low numbers but it's more than likely that Leo needs to eat more as many of you are suggesting,

We are not testing the ketones, but I'm taking note of this recommendation too.

I'll be adding more numbers to the spreadsheet today.

Thank you!

 

[Bron and Sheba (GA)]

Thanks I can see the SS now!
Javier, you would be better reducing the dose of insulin to 0.25 units (1/4 unit) and giving the insulin twice a day. That is a much better option, especially with a kitty who is just recovering from DKA. Insulin is really important in the prevention of ketones and if you only give it once a day you are leaving the other 12 hours with no insulin coverage.

If you are getting an AMPS of 60, that would indicate to me that Leo is dropping lower than that during the night and is just on the way back up again at AMPS. That is another reason to halve the dose and give 0.25 in the morning and 0.25 at night.

Are you feeding before the shots?
I would also make sure you test inbetween the shots to see how low the dose is taking Leo. That is really important as Lantus is dosed on how low the insulin takes Leo, not the preshot.
I would try and get a test in at say +2 and + 4 and +6 to see how low the dose is taking Leo. And don’t forget the pm cycle as most cats drop lower at night.

Yes, please get a bottle of Ketostix as soon as possible and test daily at least for the ketones. Catching any that form early is the way to keep Leo safe.

Keep asking questions and post daily to let us know how he is going please.

 

[Bandit's Mom]

I can see it now, thanks!