At what BG will you start seeing symptoms?

[allie and newkitty]

Newkitty has been off the juice for 2.5 years. Lately her BG has crept back up to 150 and she has lost a little weight and we are seeing wrist walking. (She also has severe arthritis so it's hard to know the cause). How high does the BG need to be to cause weight loss and what # constitutes return to insulin?

She just had full bloodwork in May & July due to a kidney infection, FYI. Also cardiac ultrasound, xrays, etc.

 

[Chris & China (GA)]

I'm still fairy new to this, and haven't seen this question before, but my first thought would be that if you're seeing weight loss, as well as neurological issues, you're already seeing symptoms.

Might be a good idea to do a curve a few times and see how high Newkitty is going. She may need to go back on the juice.

Another thought...is there any chance the kidney infection is back?

 

[rhiannon and shadow (GA)]

I'd be interested in more testing too...
I had some numbers in the 140-150's a few months back ( still otj though) and we started using adequan for arthritis and the numbers
went down.

Is she peeing and drinking more?

 

[Marje and Gracie]

I agree with Chris. I'd get more than just a number here and there and see where she is. I'm not sure I'd do a curve but I'd get spot checks every day and try the method I've mentioned below.

If she is 150 on an Alpha Trak, that's a normal number. If you are using a human meter, anything above 120 consistently and you might want to think about a little insulin support for a bit. But you don't want to do it based on one number. You can also see if her pancreas is working by checking her BG before you feed her in the morning and at night, then feed her, then recheck three hours later and see if the number is coming down.

If she's losing weight and drinking alot, it could also be hyperthyroidism and/or kidney issues. Also, eating ravenously could be hyperT or diabetes.

Good luck...I hope you find out what's going on and she stays in remission.

 

[allie and newkitty]

Thank you for so many answers.

She is on massive pred and has early stage kidney issues so unfortunately her drinking doesn't tell us much. She finishes her antibiotic for the kidney infection on Sunday--she will have been on 2 abx for 8 weeks for that.

We use an old-school Accu Chek Advantage. I know there are newer, better, less blood-requiring meters but it's a superstitious thing. That Advantage got us through some tough times from 2004-2011!

I never expected her to go off the juice with the pred she HAS to take for her chronic panc, so I can't be too disappointed. Lantus really, really surprised me. And to think I hung on to Humulin U so long. I would rather it be diabetes than something else (not counting hypert, I am ok with that too). Of course you guys are right, I need to be doing more than a check here or there. I am rusty. I will be back in a day or two with #s.

Oh she had her thyroid checked in Jan and May and it was 1.1 both times.

 

[Marje and Gracie]

Cats can have hyperT and their numbers be normal. It took almost a year for my kitty's numbers to go up but she had all the symptoms. And thyroid numbers can change quickly.

 

[Sienne and Gabby (GA)]

There are a couple of additional points I'd add to what folks already mentioned. First, since you've seen your vet, what's your vet's impression of your kitty's numbers? I agree that some additional spot checks, especially a couple of hours after a meal, may help you get a better picture of where numbers are. I'm not a bit fan of fructosamine tests if you're home testing but, in this case, it will allow you to see numbers over a 2 - 3 week span and it is a reliable diagnostic tool. The other issue is the kidney infection. The infection may be slightly elevating numbers. It's not a reason to withhold insulin if it's needed but it may be contributing to the higher numbers.

 

[allie and newkitty]

We haven't talked about her numbers yet. On her last bloodwork (July) it was 150 and that looks like vet stress. But you guys were right, spot checks have turned up 238, 227. She is also off her food now, walking on her wrists. The only good thing about this is she really needed to lose the weight due to her arthritis. She is walking downstairs quite a bit now after months of summoning me to carry her. Ideally she would be eating better before I shoot, hopefully cypro will kick in.

I don't think this is her infection as she just finished the second abx today and that is 2 solid months of abx. If it is not gone I don't know what we'll do.

So what is the going BG now around here to start insulin again? Is it still 250? Newkitty was regulated so quickly on Lantus that I didn't chart for very long--I just adjusted her dose up slowly and then right back down over 2 years. She has been off 2.5 years now. I will text my vet tomorrow but am wondering in the meantime.

 

[julie & punkin (ga)]

i can't answer the question about exactly what number to start the insulin, but BGs in a cat that are less than 120 are normal. the only non-diabetic cats i've ever checked were in the 40's. so i'd think if you are consistently seeing numbers over that in your spotchecks, and you're seeing symptoms (which you are) it might be worth considering starting the insulin back up. high BGs are hard on the kidneys and if she's already having trouble i'd think it would be worth addressing.

are you also giving sub-q fluids for the kidney issue?

did you do the check marje & sienne suggested about checking her BG, feeding her and checking 3 or so hours later to see if the number has dropped? that might be helpful.

 

[allie and newkitty]

She has been getting sub-q's due to the infection and some diarrhea she was getting from either sneaking our civie's fancy feast or one of the abx. She does not normally as her numbers do not justify it yet (anti-jinx!)

I have not been able to do the check Marje suggested yet. Newkitty is a free-feeder and due to her chronic pancreatitis, can only eat dry low-fat food. This is the opposite of ideal in every way, I know, but we learned through years of trial and error that the pancreatitis gets what the pancreatitis wants first and foremost. It makes it harder to see if her pancreas is cooperating at all, but has not caused problems with regulation (she regulates much more quickly than our GA, who meal fed FF exclusively).

If I can get her to eat a big enough portion to count as a meal, I will try to get the +3 check even if I have to get up at 2 am to get it...

ETA: Since I am still getting numbers in the 150s and 160s without insulin, does that mean pancreas is at least sputtering?

My gut feeling is that insulin is needed soon but of course I will talk to my vet first. She has had many infections over the years and I never saw an increase in BG just from them. I know that's common, it's just not something I saw with her. I think this is the pred finally undoing the Lantus after a two+-year vacation.