Confused with Vet

[Shauntae Ellis]

Our cat has an upper respiratory infection. Stayed at the vet for 2 nights released on Wednesday. Upon release they said it appears he is in remission but to test his numbers for 2 weeks and then bring him back in but to do once daily at home tests. I have the alphatrak glucose monitoring system the same as my vet. I calibrated it and it tests accurately. I did not test him Thursday night just because he looked so beat up from all the prodding and poking from the vet. Last night his number was 540 this morning 595. He is on antibiotics but he isn't acting like himself and doesnt have a real appetite. I just am not sure those numbers are remission. He was getting 6 units am and pm and I had his numbers down to on avg 180. I have a call into the vet but haven't gotten a response and i am just worried. Thank you for your time.

 

[Noah & me (GA)]

I don't know enough to comment about antibiotics and his appetite but numbers over 500 are definitely not remission.

 

[Lisa and Witn (GA)]

I agree, he is not in remission. The antibiotics may be making him nauseous. Ask the vet for something for that or you can give him 1/4 tablet of the original Pepcid AC.

6 units is a lot of insulin. What insulin are you using? His needs may be high due to the infection, but most cats normally do not need more than 2 units. How long has he been on insulin and what was his starting dose? You also may have another issue going on. Too much insulin can cause a condition called Somogyi effect or bouncing. This causes the glucose levels to be high because the body is trying to protect itself from hypoglycemia when too much insulin is given. Also when the infection clears, his dose also may need to be lowered.

 

[Kris & Teasel]

I agree that this doesn't look like remission. Normally you wouldn't see a cat drop from 6 u AM and PM to needing no insulin. Their need generally diminishes over time until they can hold their BG in the normal range all day every day with tiny doses and then no insulin.

If he's been ill with an infection, on antibiotics that affect his willingness to eat and is at high BG levels that increases the risk of developing diabetic ketoacidosis substantially. Have you ever tested his urine for ketones at home? It's easy. Buy some ketone testing strips at any human pharmacy and try these tricks to get a sample of his urine when he's in the litter box:

• put the end of the test strip right in his urine stream as he's peeing
• slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
• put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.

Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

If a test gives you anything other that "negative" call your vet right away. If it's higher than "trace" he needs to see the vet ASAP.

 

[Peter Moore]

What's the antibiotic exactly? Some of them also contain corticosteroids as an anti-inflammatory, which if so would almost certainly explain the BG spike.

I've also found that vets don't understand how to handle an apparent remission. They see one low nadir and get spooked and say to stop the insulin, which is a huge mistake. It has to be reduced extremely gradually. (We've gone from 1U, to 0.5U, to 0.25U, to 0.1U, and now down to 2 DROPS. But we had one premature declaration of remission early on (which I am convinced dragged this on for months longer than it needed to last), and almost had another one recently until I put my foot down and found this wonderful community.