Dx 2.13.17 w/ Glargine - Remission or ?

[Heather Pavey]

New to the forum postings.

Vader 13yr n/m Abyssinian
Feed majority of diet dry as free feeding. Wet food various brands in small amounts offered twice a day with boiled chicken breast from kitten-hood.

2.13.17 - dx with FD BG 477mg/dl in hospital - Renal wnl, Pancreatitis ??. Has annual dental care done throughout his adult life. Presented with weight loss, Pu/pd, lethargy and sleeping more in a sternal position with feet tucked under rather than on his side or curled up. Past weight hx was around 13 lbs and now just unber 11lbs. Glucose in urine, no UTI or ketones.

All other labs work WNL, no Spec fPL values performed, Radiology views insignificant finding per DVM.
Treat for FD, using home testing and Glargine. Testing kit is the AlphaTRAK 2

* Contiuned with Dry food and started canned Purina D/M. After a few weeks started wet food new brand offering of Low Carb, lower numbers in Fat due to ? Pancreatitits, wet food only, omitting dry diet. Have two other felines in the household making the food transition along with Vader non of them a fan of Purina D/M.], trying other brands. Started on a TR once food transition off dry was achieved.

Added in Cereina once a day for 5 days when he seems painful or off and Famotidine twice a day as needed to reduce upset and intestinal stress, both as needed and noted on spread sheets.

* More active and behavior patterned are returning to normal. Much less with respect to the pu/pd prior to dx.

I was hoping that maybe someone has the time to scan his spreed sheets as I feel he maybe going into remission and I am not sure if I should give Insulin or see what the next few days / weeks bring?
Trying to avoid Hypoglycemia.

Welcome suggestions and recommendations -
Thank you,
Heather and Vader

 

[Sienne and Gabby (GA)]

It would be extremely helpful if you could convert your test data to the format that we use. While what I'm presuming is your pre-shot test values are helpful, Lantus dosing is based on the nadir, not on the pre-shot numbers. In other words, you hold the dose for a specified period of time unless a dose reduction is warranted. Changing the dose every cycle is likely to result in "wonky" numbers and will not give you the desired response to Lantus.

The issue of fat and its relationship to pancreatitis is rather dated. If a Spec fPL wasn't done, it's going to be next to impossible to make a diagnosis of pancreatitis.

I also can't tell from your spreadsheet if you're following tight regulation. For TR, it is required that you test more than twice a day. I'd encourage you to read over this sticky on the Tight Regulation Protocol. It reviews what is necessary for following the protocol.

 

[Heather Pavey]

Ok - Thank you for your suggestions Sienne and Gabby.
Using the spreed-sheet my DVM made

Interesting on the Spec fPL - The DVM told me that the specialist rec that the abnormal pancreatic ultrasound was the best method for a possible dx as the Spec fPL is not a reliable source to date along with a less fatty content wet food and low carbs. Will ask again the treating DVM.

Will try to do a more precise TR, I work six days a week 12 hour days, I have tired to due more self testing curves at home on my days off. Maybe is is why the DVM made this spreed sheet rather than the + hours I see that is recommended. hum..

Thanks for the information.
Heather

 

[Sienne and Gabby (GA)]

Heather:

Take a look at the sticky the discusses using TR if you work full time. Many of us do work full time. TR can be more challenging, but it's possible if you have a challenging schedule. What isn't possible is using TR if your only test at pre-shot times. Many vets will dissuade caregivers from testing since they think it will cause their cat to "hate" them. I've yet to see this happen. The difficulty with not getting tests closer to nadir is that you can end up increasing the dose if you are basing your adjustments only on pre-shot values. My cat would be in the 400s at pre-shot, drop into the 40s, and then bounce back into the 400s by the next pre-shot test. If I didn't have that test somewhere in the middle, I would have increased, rather than decreased the dose.

You may want to look over this post that Marje/Gracie put together -- A Primer on Pancreatitis. The post will review the basics of diagnosis and treatment. An ultrasound is certainly one method but a Spec fPL is much less expensive. There are pros and cons to each method. The issue with fat in the diet, however, is very old school.