back at it again… bg 438, steroids…

hi folks. my 15yo boy frankie is currently being treated empirically for pancreatitis + IBD / potentially small cell lymphoma, prednisolone 5mg BID + metronidazole 250mg 1/4 tab BID. not currently willing to make the decision to have his gut biopsied. now i know diabetes and steroids don’t mix, but 438 at 1pm before lunch seems a biiiit much. for his vomiting/constipation i’ve been feeding him royal canin “digestive” thin slices in gravy (OTC) one 3oz can TID for a while and it’s done wonders for his poops. he loves eating it too so all has been marvelous. it’s not on the food chart that i can see but from a q&a question on chewy it’s allegedly “4.08% on an as fed basis and 23.34% on a dry matter basis.” not totally sure what that means but… any ideas on what’s going on here? could it be the gravy? steroids? 2 greenies pill pockets BID? should i stop giving him dry treats as i’ve always done? any diet advice for diabetic cats with gut issues? i’ve tried a few “exotic” meats but he’s so picky and hated all of them, lol.

anyways, my vet is closed today so i’m gonna call them first thing in the AM and hopefully pick up a vial of prozinc as mine is uhhhh profoundly expired. thanks

 

I don't know of any cat food with gravy that is low enough carb for a diabetic cat. Looking at the ingredients list, I see lots of things that could be loading carbs. I suspect that food is driving up the BGs.

 

hm... so the guaranteed analysis and "4.08% on an as fed basis" may not be accurate then? either way it's back to pate for now. thanks!

 

Guaranteed analysis is not accurate, but on an as fed basis should be. Although the ingredients list contains a lot of higher carb items.

Steroids can definitely throw a cat in remission out of remission. IBD and small cell lymphoma are different diseases with different treatments so getting a definitive answer can help. My latest kitty with SCL got an endoscopy, which is less invasive. IBD kitties do well with novel proteins and diet makes no difference to SCL cats. Novel protein can just be one they haven't eaten before, it doesn't have to be exotic.

Both IBD and SCL can have a steroid component, though SCL for short term, IBD possibly longer term. You might want to ask your vet about budesonide instead of prednisolone. It's a locally acting steroid (in the gut) and many cats don't see a BG impact. Mine did not.

 

thanks so much... the vet quoted me for the biopsy and explained how invasive it was and everything considered i just decided it may not be the best course for him/us, and she kind of agreed with me. i may change my mind, but she said if current treatments don't work we can just try chemo after to see if the inflammation remits. next time i see her i'll ask about the endoscopy though. i'll also ask about the budesonide. he was on once daily pred for a few weeks before she bumped him to twice daily, which is when we started noticing increased urine output and i decided to test. if not budesonide maybe we could go back to once daily.

i think my plan for now will be to call tomorrow and let her know the situation to see if she wants to decrease the steroids, and see if she wants him to have insulin. my main concern at the moment is ketones. i'm going to go back to FF pate in the meantime.

 

Once daily vs twice daily for steroids doesn't make a difference. You could just double the once a day dose for less pilling.

 

called the vet today and she does want to continue the pred for a bit longer because it seems to be helping his GI issues (he hasn't been vomiting) and she prescribed lantus solostar 1 unit BID for him for now, which i'll pick up tomorrow. i'm just glad i was able to get some insulin before it got any worse. he was 337 when i checked today with my relion meter around noon. he has f/u bloodwork on the 15th so we'll see if there's been any improvement in the pancreatitis. such a struggle balancing all these disease states at once with a picky eater!