Diabetes and steroids

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stefandmorgan

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My 13 year old Morgan has an auto immune disease that has needed a continued steroid treatment since February 2009. We attempted to wean her off the steroids and she crashed again. As a result I am unable to take her off or lessen her dose of steroids without fatal results.

This past week, Morgan went to the Vet her regular blood cell count check and she was unusually stressed -- they had to use gloves and restaint for the first time in her life. She was needless to say -- stressed. Her results showed good levels for her counts but a glucose level of 358 -- whic the vet indicated was too high to just be the stress of the visit. IS that true?

Also, she is researching the effectiveness of an insulin treatment on a cat that must remain on steroids. Apparently steroid induced diabetes is usually treated by taking the cat off the steroids. I don't have that choice.

I am looking for basic advice and experience. When Morgan crashed the second time, I nursed herback to health with warming blankets, eye droppers of chicken broth in her mouth, round the clock care as I took a week off of work -- I am not worried about taking care of her -- I just don't want to stress with a treatment that won't be effective and just looking for advice on what to expect. . .

I love my kitty and would like to keep her longer :(
 
Morgan is probably diabetic. A fructosamine blood test would be the test to really determine if the Morgan is diabetic together with a simple test of urine for glucose.
 
There are cats who have to be on steroids and some develop diabetes. You can totally treat the diabetes and work around the steroids, so don't despair! I'd get a fructosamine done to confirm and then work with your vet to immediately begin treatment using either lantus/glargine, levemir/determir or Prozinc PZI.

Jen
 
agree - if the cat needs steroids, then just treat the diabetes.

My Norton needed steroids - they greatly improved his quality of life. So we just gave him the insulin that he needed to control his blood sugar. Low carbohydrate canned food also helped reduce blood sugar, of course.

Start at a low dose of insulin (either 0.5 unit or 1.0 unit every 12 hours).
 
In 1994, my Gwyn was diagnosed with IBD and put on steroids. We tried many times to wean her off the steroids, but were never successful. In 2005, Gwyn was diagnosed with diabetes. We tried again to wean her off the steroids, but went back to them when her bowel movements went down to one every six days.

We've never managed to get Gwyn off the steroids, nor have we ever gotten her diabetes into remission. She gets insulin twice a day, every day. But it's been more than five years since became diabetic, and she's still here, just a month short of her 20th birthday.

If you need the steroids for something, then you need the steroids. You can work the diabetes around them.
 
cleo started steroids this year when she developed lymphoma.
it is harder to get a diabetic cat regulated when on steroids but you can eventually find an optimal dose. we've just started to get back to nice lower numbers on prednisolone and lantus. took a while, tho, and her dose went up to 2 units from her normal 0.75 units.

yes, i'd think the 358 is higher than you'd expect from vet stress. we hear here of cats going about 100 points above normal from stress, if you want to use that as a parameter.

from my own experience, my cat cleo's number does not go higher with vet stress, and my other cat goes about 40 points above normal when at the vet. morgan sounds like a diabetic from that number, tho the vet would confirm it via tests. for example, a urine test could show glucose in the urine. he/she might also run a fructosamine test to see whether your cat's glucose levels have been high over the past two weeks. my vet merely confirmed it via urine and blood tests rather than the fructosamine, tho.
 
So had a long talk with the Vet today. We are scheduling a fruc. test to confirm the diabetes. She has consulted with an emergency vet and they are concerned the steroids will not allow Morgan to regulate so they think we should consider switching her from the pred. to a chemotheraphy drug . . . .This is making my head spin.

I would rather keep her on the pred. as it has been working for her. The Vet told me her blood count numbers went down by 10 points since the lat visit so she is concerned Morgan is growing a resistence to the steroids. . .

Anyone have a cat on chemo drugs and insulin??????
 
yes, cleo has cancer and diabetes, and is on chemo and pred.
she has lymphoma, and her chemo is CCNU and her steroid is prednisolone. she was on leukeran first but didn't tolerate it well and is doing better on CCNU.

i would not think of taking her off the pred. it's part of a lymphoma protocol that has proven very successful for cats. sure, if it was causing major health issues i'd stop it but right now it is working for her even tho it drives her blood glucose up. you just counteract that by giving more insulin and/or adjusting the diet to make sure it's lower carb canned food.

the type of steroid depends on what they have, tho. pred is the steroid you give lymphoma kitties. my cat harry has IBD and he gets budesonide because it doesn't affect his BGs and it targets his gastrointestinal tract.

i know steroids can throw cats into diabetes but sometimes they are necessary so i am a staunch fan. if it wasn't for steroids i know my cats would still be very sick.
 
Hi, and welcome.

I had a cat with severe immune-mediated disease and he needed steroids (10mg/day pred) forever, and he went on and off insulin within months. A lot of vets are scared of diabetes (just as people are) but once I did my second disastrous attempted steroid-weaning, I just buckled down and decided that if my cat developed diabetes, I'd just deal with it. He did develop diabetes the next year, and I just dealt with it. For us, hometesting of BG was very important because he sometimes needed two shots/day, sometimes just one, and occasionally I could skip a day. We used Lantus which is a nice, steady-state sort of insulin.

I would get keto-diastix at your pharmacy (urine testing strips for ketones and glucose) and test her urine at home. If she has glucose in her urine all the time, she needs treatment with insulin.

I know it sounds scary but really it's not the end of the world :smile: My cat and I found diabetes to be the least of our problems!
 
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