Chester AMPS 517

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thursday

Member Since 2010
I posted in the old forum last year, but Chester went OTJ before the switch (back in December he had a hypo episode, and was on at least 4 units 2xs a day of Lantus).

I noticed in July that Chester's BG was getting into the 150's when he'd consistently been between 60-90.

Trying to figure out if the Lantus is bad, since I bought it in December (it's been unopened until two weeks ago). He gets down slightly after 2-3 hours, but his lowest BG in the last two weeks was 309 at +3. By +4 he's going up again. We were using just 1 unit 1x a day, but his low kept getting higher. Now he's hit 500. I'm irritated and unsure what to do, as I keep calling the specialist and emergency vet and neither calls me back.

He's lethargic (when isn't he, though?), drinking TONS, peeing a lot, voice is hoarse. Currently on 2 units of Lantus 2x's a day (he was suspected of acromegaly, but the specialist thinks the test gave a false positive. he thinks it unlikely a cat with acromegaly would go into remission. he tested positive for hyperthyroid)
 
Hi there

welcome to the Lantus forum!

Are you Dodie or Cyndi from the old board?

Would you be able to set up a spreadsheet when you have a moment?
Spreadsheet Set Up

You'll probably be asked to post more numbers or current readings, a spreadsheet helps others see more clearly what's going on with numbers.

Hang in there ok? Others will be by thru the day to assist.
 
I was Sarah & Chester on the old board. I have three other cats, but luckily no others are (yet) diabetic!
 
ok, I found you now, thanks for letting us know.

have you been able to check for ketones?
can you tell us what diet he is on?

and you're home testing regularly right?
 
He's on Purina DM, since the vets kept insisting that Fancy Feast was NO GOOD for him (he supposedly also had pancreatitis in the fall, suspected after the fact due to comparing ultrasounds).

My testing has been sporadic in the last few days - mainly since I knew he was over 400 no matter what dose of insulin I gave him (based on behavior). The vet is not happy that I've been testing at home. He thinks it freaks people out when they just need to wait it out.

He was never especially well-regulated last fall. Best we could get was between 150-250. Then, suddenly he was at 50.

I do still have some fancy feast from a few months ago, if it's still good. Chester is a very heavy cat - he'll eat ANYTHING. Oh, actually he's lost 1 lb in the last month. He's now 16.8, he was 18.0.

I absolutely HATE testing. I'm terrible at it. I always get nervous and sometimes need to poke his ear three to four times just to get one reading. But, I'm working on it. Will need to test here in another twenty minutes. Hope for some decrease (below 500?!!)
 
Welcome back (but sorry you're here!)

Well, first off, the vet is wrong. Acro kitties can go OTJ. Here's a link to Milo's spreadsheet if you need something to show to your vet. I saw from your Profile from the old Board that you're in Chicago. Who are you using as your vet(s)? (Feel free to send me a PM. I'm in Chicago, as well.) I'd love to know your vets' rationale re. DM vs. Fancy Feast. The ingredients in DM are really poor quality. FF is better quality and lower carb.

There should be an expiration date on your Lantus. The expiration date is for an unopened container so as long as you've opened the Lantus before that date and the insulin has been stored properly, it should be fine. The once a day dosing probably wasn't doing you any favors. A cat's metabolism is too fast, in general, for once a day dosing. How long have you been at BID (x2/day) dosing? It may be if it's been less than a week that Chester's shed hasn't filled.

Also, hyperthyroid can effect numbers. I'd really suggest getting Chester checked out medically to rule out problems like dental issues. That said, acro kitties may go in and out of remission because of the tumor and how it's producing growth hormone. Your experience of higher numbers and then numbers in the 50s is not atypical of an acro kitty. You need to keep in mind that diabetes is a symptom of the acromegly. BG numbers are dependent on whether the tumor is producing hormone. Once you get a spreadsheet up and running we'll be able to take a better look at what's going on and lend a hand.
 
My regular vet won't take him anymore, since he's been so difficult. He's seeing Dr. Ghantous, an internal medicine specialist at Clybourn & Western (CVES) - he used to be at the Northbrook AERC. He tested positive for nearly everything you can think of. He does has mild dental disease.

He has none of the obvious symptoms of acromegaly or cushings (which he also tested positive for). He does have obvious hyperthyroid symptoms.

He's only been on the 2x's a day for four days - and his BG has gone up every day. The Lantus expires in July 2011, so I figured it should be ok to use. I doubt it could have frozen in my refrigerator, but I suppose it's possible it could've gotten too warm (you never know with a rental fridge!).
 
I have a great regular vet -- Holly Pohl, DVM at Cat Hospital of Chicago -- around California and Irving Park. (It's close to your IM specialist.) She uses CVES (and AERC) for emergency and 24 hour and specialty services. She's never referred Gabby for diabetes management. My vet practice is expensive but they are cutting edge and will listen. When I told her I wouldn't feed the prescription food because it was poor quality and I could get better quality and lower carb with Fancy Feast and Wellness, she was fine with it. She knows I use the Board extensively and pretty much leaves me alone with Gabby's management.

The insulin should be fine. You may just need to increase the dose because the tumor is active. Try to pull a spreadsheet together with whatever data you have. There are lots of people here and on the High Dose Board who can help. It just sounds like Chester's tumor is active again. Vets were trained that acro is rare. It's less rare than was once thought.
 
Also, where do you purchase your food? Petsmart? Or is there somewhere better to get a good selection?

Thanks for all of the attention!
 
Sienne and Gabby said:
Welcome back (but sorry you're here!)

Well, first off, the vet is wrong. Acro kitties can go OTJ. Here's a link to Milo's spreadsheet if you need something to show to your vet.
Click to expand...

Milo's spreadsheet is irrelevant if you are trying to prove that an untreated tumor can go into remission. Milo and Boo's remission was due to the SRS treatment. Fletcher's spreadsheet, with his untreated tumor, would be quite useful.
 
thursday said:
Also, where do you purchase your food? Petsmart? Or is there somewhere better to get a good selection?

Thanks for all of the attention!
Click to expand...


Hi Sarah

yes Petsmart and any pet store would be good choices for cat food.
Grocery stores too will carry the mainstream brands like Fancy Feast, Friskies, etc...

I second the thoughts on Purina DM. And you don't need a vet's permission to change foods, most would rather have you buy their overpriced prescription food.
When you are changing foods, it is a good idea to get a variety of flavours.

Check the food charts Janet & Binky's Food Charts
(Fancy Feast is located in the "old list") compare carb %'s...you'll want to stock up on anything HC (high carb) as well, usually with gravy in it.

this site will help you with food transitioning. It's mainly for dry food, but it's still very handy to read thru.
Dr Lisa's Feline Nutrition

If you're having issues with home testing, have a look thru this link for tips:
Home Testing Links

Testing does get easier, practice is good, and kitty will get use to it as well.
 
Welcome back, Sarah. I'm sorry you have to be here.

I wouldn't say that Milo's spreadsheet is irrelevant. It's true that Fletcher's is probably more relevant. Here it is: http://spreadsheets.google.com/pub?key= ... lRFE&gid=0

Do you remember what the result (number) of the acro test was? Just curious, I ask because if he is acro, then that could explain why he went from under 100 to over 500 with little warning. The tumor puts out growth hormone, and the amount can wax and wane. It makes dosing tricky sometimes. Of course non acro cats go on and off the juice all the time too, for lots of reasons, or sometimes for no reason.

If you are able to test at least every preshot, and at least one other test per day (and try to grab nadir tests whenever you can), you can increase the dose more frequently. You have to test, though, because you don't want to blow past the dose.
 
It looks like his IGF-1 was around 250 (tested in November 2009). Definitely curious about levemir and if it would be better than Lantus or not. BG is still above 500. Looks like this happened for weeks last fall - I'd go in for a check after a week, we'd get a number around 560. His lowest pre-insulin number was 250.
 
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