Could this be remission?

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margotb

Member Since 2012
Hello all - new poster to this board, but you all were very helpful in the early days of Baxter's diagnoses of diabetes earlier this year. Hoping I can get some answers - the vet tech is perplexed and basically laughed at my goal to get him in remission. Here's the story:

Baxter is diagnosed with diabetes 9/21/12
His glucose level is 449, his cholesterol is 271
His triglycerides are 1835

Switched his diet on 9/21 from all dry kibble to Fancy Feast 9/21/12 (approx 2 cans per day, 3 oz per can)

Glucose measure at home on 9/30 (6:30pm before food), his number is 297.

Start insulin injections, 2 units twice a day (the vet had recommended 3 but I lowered the dose to 2 based on information I had read here about starting "low and slow".

Started him on raw food on 10/7/12
www.primalpetfoods.com/product/detail/c/7/id/10
He gets 4 oz, 2x per day (recently reduced to 3.5 oz each meal)

Went to vet on 10/5 for all day blood curve.
Weight is 11 lbs
8:40am- BG 468
8:45am- 1 full can Fancy Feast and ate 100%
Followed with 2U insulin (ProZinc SQ)
10:40am-BG 394
12:40pm-BG 241
2:40pm-BG 170
4:30pm-BG 153
vet confirms the 2U of insulin is a proper dosage.

10/12: BG 378 (7am)

We continue to monitor his BG through oct and nov.... always tests in the high 200s to mid 300s. Continue with 2 unit dose of insulin after each meal.

Went on vacation, we return on 11/18/12, and test him (before food) the following morning. He's 118. Twice daily testing since then, and he is anywhere from the 80s to about 130. Have had him off insulin since 11/19/12. His energy level is great, he's eating his food, has gained ALL of his weight back, he's not lethargic or strange in any way. In fact he's more loving than he's ever been. Can i consider him to be in remission? How often do i have to continue to test him? Can i go every other day for awhile? What are the odds he will stay healthy now that his BG is back in normal range?

Thanks so much for any guidance!! :-D
 
You are doing great. I would drop the testing to every other day unless you see symptoms of high BG like drinking a lot or being very hungry.
 
I'm also super curious to know... can I relax a little? Do cats that go back to normal BG levels (I am assuming from the diet change from dry kibble to raw food)... do they ever spike back into diabetes if their diet stays healthy?
 
Some do, some don't. Remission can come and go - going back up to a higher carb food can definitely bring them out of remission but so can things like an infection, injury, bad teeth, and so on. Some cats just go into remission and then right back out for no apparent reason, like my Scooter. He went into remission for all of a month, back on insulin, and now he's close to remission numbers again. I don't know why. Cats are weird :lol:
 
Thanks for asking. I too am interested in the answers as I'm in the same position. I haven't needed to give any insulin since sat am.

I'm going with a BG test on friday, then maybe only once a week from then using daily monitoring of his water intake and behaviour to guide me. (He's not a great fan of BG testing so I don't do it too often - one feral parent). After nearly killing him with insulin on saturday however I will ALWAYS BG him before every shot if he ends up needing them again)

I totally changed his diet, and my vet too said remission was uncommon when he first got diagnosed and I asked then. My vet said remission should be considered temporary, and anything permanent would be a bonus. I think if I keep his diet on this low carb high protein little and often throughout the day that this will help significantly tip the balance in the favour of remission.
 
violetxx218 said:
I totally changed his diet, and my vet too said remission was uncommon when he first got diagnosed and I asked then. My vet said remission should be considered temporary, and anything permanent would be a bonus. I think if I keep his diet on this low carb high protein little and often throughout the day that this will help significantly tip the balance in the favour of remission.
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Your vet is uninformed, and I wouldn't take any more diabetes advice from your vet anymore until he/she catches up on their feline diabetes research. You're doing a great job with Baxter.

84%+ of cats go into remission with the right treatment plan--daily home testing, a long acting insulin, and a low carb, canned or raw diet. Lantus and Levemir are the preferred insulins with the highest chances of remission because they have the best duration of action in cats (12hrs), but Prozinc has an ok duration of action (8-10 hrs), so remission is not uncommon. Unlike humans or dogs, a cat's pancreas has the amazing ability to heal when blood glucose is well regulated for a period of time and their carb intake is controlled (less than 8-10% carbs).

2u is a high dose of insulin for cats. Most cats on a low carb diet need around 1u of insulin or less. Cats become very sensitive to insulin after a severe hypoglycemic incident, and sometimes this can jump start the pancreas and cause remission (Note this is not recommended to do on purpose). This is likely what happened to Baxter.

Remember that a diabetic cat in remission is still and always will be diabetic--which means you need to make sure he eats a proper diet (less than 10% carbs and absolutely no dry food or high carb treats), and monitor his blood sugar regularly. I would continue to test every other day like Larry recommended for a few weeks, and then after that you can drop it down to once or twice a month. The reason you want to continue testing is because a cat can be knocked out of remission by certain things--some common causes of relapse are eating a high carb diet again, infection, dental issues, secondary illness, or stress. The sooner you catch the relapse and begin the recommended treatment, the sooner and more likely your cat will get back to remission. After a year on Lantus, my Bandit went into remission in 2010, and he went out of remission in 2011 after some stressful dental surgery. Because I started treatment immediately, he only needed insulin for 3 weeks before he went back into remission. He's been perfectly healthy and in remission ever since.

Here's a link to the article that discusses the high remission rates in cats, if you'd like to print it out and give it to your vet.
 

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Wow - thank you all for the thorough information! Julia, super helpful! I do NOT trust the vet at all, never have. She laughed when I said I was putting him on a raw food diet back in the beginning... and was shocked when I told her his BG was within normal for the past week+.

Will continue to monitor and watch him, probably go down to once a week testing and keep my eye on things! :-D
 
@ Ry & Scooter - oy. Baxter apparently has a mouthful of tooth issues... just off the phone with the vet to the tune of $1200 worth of work they want to do. Do not know how I will talk the hubby into that expense. Perhaps I should be looking for a second and third opinion... :cry:
 
I believe once you've gone two weeks without needing insulin you're considered OTJ or in remission. That's what I did with Hobbs. It's been since January so my memory is failing me on why I thought that though...
 
Thank you SabrinaFaire - Baxter has been insulin-less since the 19th. Will continue to keep our eye on him...
 
margotb said:
Baxter apparently has a mouthful of tooth issues... just off the phone with the vet to the tune of $1200 worth of work they want to do. Do not know how I will talk the hubby into that expense. Perhaps I should be looking for a second and third opinion... :cry:
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Unfortunately, it's really important that you get his mouth done for him to stay healthy and in remission. I would call around and ask for quotes on the dental from other vets in your town (the cleaning + however many number of extractions he needs). Just make sure that you ask the vet you choose what devices he's monitored with while he's under anesthesia--you don't want to go to vet that is not monitoring EKG, heart rate, body temperature, oxygen saturation of red blood cells, efficacy of ventilation, and doing both manual and monitor-generated blood pressure measurements. Bandit's old vet quoted us $1200 for his cleaning and many extractions, but my current vet was able to do everything for $750. Most vets take CareCredit--get an account, and you can get credit at 0% interest for 6-12 months (depending on your vet's office promotions), and pay it back in installments. That's what I did with Bandit.
 
I would look to see if there is a specialty hospital in your area - maybe the 24 hour emergency place and find out if they have a dental specialist - even a board certified one.

while yes, it may cost a little more than the general vet doing a dental, in my opinion, I think it is well worth the cost.

I take my cats to a dental specialist and feel very comfortable with the level of treatment, follow up and care they receive.

just my 2 cents
 
Thank you. I am putting the teeth next on my list. He's going in Friday to take care of a probable yeast infection in his ear. Poor boy! Teeth to come next month. I do realize the importance of getting his teeth taken care of. Thanks for all of the input - a big help!! :smile:
 
I forgot to mention, that I took out a personal loan from the bank for my other's cat dental and paid it back over 12 months at much lower interest than the CareCredit card, because I was having rough times and I knew I couldn't pay it all back in 6 months that the CareCredit required.
 
Sad sad, Bax's remission lasted all of 2.5 weeks. We took him to the vet (twice) to deal with an ear infection and have been wrestling him down twice a day to drop medicine in his ear. Talk about Mr. Sensitive. I think now we shall deal with both ear and dental issues... then begin the journey once again towards and stress-free existence. With any luck.
 
margotb said:
Sad sad, Bax's remission lasted all of 2.5 weeks. We took him to the vet (twice) to deal with an ear infection and have been wrestling him down twice a day to drop medicine in his ear. Talk about Mr. Sensitive. I think now we shall deal with both ear and dental issues... then begin the journey once again towards and stress-free existence. With any luck.
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Sorry to hear, but not surprising with nasty ear and teeth issues. Poor guy. I've been there with Bandit, certainly.

The good news is that once you get those issues cleared up, it shouldn't take very long at all to get him back into remission. As long as the problems are taken care of asap, he should be back off insulin in no time.
 
Thank you Julia, that is certainly my hope! You're in agreement it makes the most sense to deal with all health issues now, and put my remission goals on the back burner (as opposed to getting him into remission again and keeping him there for a certain length of time and THEN dealing with the dental issues?) I think I would be pretty hesitant to do the second option, just want to make sure I'm not missing anything.
 
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