Glucose numbers going down but she is not more active?

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Pixie's Mom

Pixie's Mom

Member Since 2023
So thanks to the FreeStyle Libre and ongoing real time numbers my vet was comfortable over the last 10 days making a few tweeks to her insulin dose. The result - after 7 days of the slightly higher doses - Pixie's levels are going down. Certainly not down to target yet but where they were over 500 sometimes thru the day and not dropping below 360's, she has been getting down to 150-180 and staying there for several hours and not climbing over 340.
But, she is still very lethargic, not really wanting to eat much...just not the bright engaged kitty she was a mere 3 months ago when she was diagnosed.
How long with levels coming down would she start to "look" better?
Or if I am not seeing improvement is that an immediate concern?

Thanks for any insights. Just really worried about my girl with what seems like a downward spiral over the last 6 weeks.
 
Here is your last ad for continuity https://felinediabetes.com/FDMB/threads/where-to-find-sliding-scale.276223/#post-3062449
I will tag @Suzanne & Darcy re the dosage as I am not a Prozinc user.
And @FrostD
And @Shelley & Jess
I would ask the vet about getting a fPL test for pancreatitis. Pixie may have nausea and will need an antinausea medication such as cerenia or ondansetron. Cats that are nauseated do not want to eat and it is really important that diabetic cats eat plenty of food.
If Pixie is not eating well and is lethargic I would also test for ketones in the urine. To do this you need to buy a bottle of Ketostix from Walmart or a pharmacy. You collect a urine sample and dip the test strip into the urine and read it exactly 15 seconds later against the colours on the bottle. There should be no ketones.
 
I asked the vet late this afternoon about cerenia in a transdermal. The pill didn't go well.
Interesting was that last Wed when her first libre was applied she was given a small dose buprenhol for sedative at vet and sn injection of cerenia at my request. When she got home although a little loopy she was demanding food. Since she hadn't been eating much I gave it to her off feeding time. It was great to see. But didn't last. So not sure if it was the pain med or cerenia.
Test for pancreatitis is next on the list. Was hoping to give her a break from vets.
 
Pixie's Mom said:
I asked the vet late this afternoon about cerenia in a transdermal. The pill didn't go well.
Interesting was that last Wed when her first libre was applied she was given a small dose buprenhol for sedative at vet and sn injection of cerenia at my request. When she got home although a little loopy she was demanding food. Since she hadn't been eating much I gave it to her off feeding time. It was great to see. But didn't last. So not sure if it was the pain med or cerenia.
Test for pancreatitis is next on the list. Was hoping to give her a break from vets.
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If it is pancreatitis she she will need pain meds and antinausea meds. Ask for some to give at home.
I’d get her into the vet asap as she needs to be eating well.
 
It does take time for cats to adjust to being in lower numbers and some feel really crummy for a while as they approach more normal numbers. I'm happy to see some blue on her spreadsheet. I definitely would test for ketones as Bron recommended. That's really important. If she is producing ketones then take her to your vet (if it's more than a trace amount.) Also, the Spec fPL pancreatitis test that the vet needs to send out to a lab would be a very good one to get. It's interesting how she had a better appetite on Cerenia. Those injections only last about 24 hours. You would need tablets to give at home. They are very bitter so it is best to insert the half (probably half) tablet into a size 4 gelatin capsule (can be ordered from Amazon) and then give her the pill. Some people put them in pill pockets, but unless she's a gobbler who will swallow it up and never taste the pill that is probably a very bad idea. If you don't have a "pill shooter" you should get one.
 
Vet is seeing us tomorrow. Will do the blood test for fPL. Will also have him test to make sure the UTI she had in Dec is gone (no symptoms) and have him check her Ketones too. He said we could do both the pain shot and cerenia shot if I want tomorrow. But if I do them both again I won't know if she was wanting to eat after because the pain shot was making her more comfortable; or if it was the Cerenia. Cerenia is avail now as a transdermal and he said he would approve that prescription if I wanted to try it.

He is open to transitioning from ProZinc to Lantus just warned about that there can be some fluctuations during transition. I have more than 1/2 vial left of ProZinc so in theory could wait until complete - but if it would be better to transition her sooner I have no problem doing that!

Today she was a little more alert. Still didn't eat a lot; nothing major at any one time. I was able to get her to eat most of 3 (spread out over the day not at once) of the little treat/stew packs. Definitely not enough but at least something. Interesting was that she really acting like she wanted to eat but then a few bites and stepped away. I was the loon following her around shoving the bowl under her face to get her to eat a few more bites. LOL
No excessive water consumption or excess clumps in the litter box.

Very open to any suggestions if I should ask for a different test? Or a different med?
 
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Bron and Sheba (GA) said:
I would get the pain and antinausea injections done and ask for both in pill form or the transdermal to take home, and see what the fPL says.
I think I would finish the insulin you have before swapping. See what @Suzanne & Darcy thinks about that.
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So you think I would be best served (meaning Pixie) to do both the pain and Cerenia injections together like before vs trying one or the other. I do believe I am fortunate in that my vet is open and willing vs being one of those who already knows everything and doesn't want to hear about learnings from others. He also is not one that goes crazy recommending tests he typically will err on the side of caution/respect for the pocket book. Which is refreshing to be sure.
 
If Pixie has pain and nausea she will need both. It will not hurt her to have both and you will have the result of the fPL test in a day or two and then can decide what to continue with. That's what I would do if the vet is happy with that.
 
So the vet did give her a pain/sedative shot and ran blood work but not the fPL. Reason was that I mentioned that while she wasn't coughing anymore (2 weeks ago visit) that she seemed to be breathing hard. He initially suspected pneumonia because he could hear fluid in her chest and she was running a fever. Blood work did not indicate infection. The only elevated item (other than glucose at 269) was RGB. He did chest xrays and saw a lot of fluid. He believes it is end stage heart failure. Strongly recommended that I take her immediately to ER. But while the ER near me is fantastic (had my prior cat cared for a few times with kidney/heart failure) they do not have cardiologist over the weekend. So likely they would just be monitoring her - which is important but I know will also cause her significant stress. Right now I brought her home (in tears of course) and will decide later if I will take her right away, tomorrow (so only 1 night if they keep her before the cardiologist is there) or hold off until Mon morning and call for an immediate appointment. Would like to believe as a former patient they would work with me. Just really struggling with this. 2 weeks ago her chest sounded fine to him and no heart sounds. Now it is end stage? Seems hard to fathom.
He did remove the libre as it would interefere with the xray so she doesn't have that on.
Will look at getting a new one if we can get through this more urgent issue. She just turned 11. Way too soon to lose my girl.
 
I am sorry to hear she has fluid in her lungs. Did the vet give her lasix or something to reduce the fluid?
And with a fever, did I her give you antibiotics?
Is she eating any better?
I would monitor her breathing rate and if it increases and she seems distressed I would take her to the ER.
 
At the ER now. They started lasix and will tap her chest to pull out fluid. They can yest the fluid for infection and then hopefully with less fluid get a better x-ray of her heart.
They are not optimistic.
 
Bron and Sheba (GA) said:
I am sorry to hear she has fluid in her lungs. Did the vet give her lasix or something to reduce the fluid?
And with a fever, did I her give you antibiotics?
Is she eating any better?
I would monitor her breathing rate and if it increases and she seems distressed I would take her to the ER.
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Vet wasn't comfortable doing any meds for infection or lasix based on what he was seeing. I was hoping she could hold her own until mon when I could get cardiologist direct. But just walking to the litter box was open mouth breathing.
Scary how bad things went from yesterday
 
Pixie's Mom said:
At the ER now. They started lasix and will tap her chest to pull out fluid. They can yest the fluid for infection and then hopefully with less fluid get a better x-ray of her heart.
They are not optimistic.
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I am really glad you took her to the ER and they have given her lasix and tapped the chest to get rid of some fluid.
Praying she will get better.:bighug:
Please keep us posted.
 
Appreciate the concern. Unfortunately I had to let my Pixie go. I am thankful for the guidance here on her diabetes - unfortunately found out she had more critical issues. Mass in her chest that had already spread. I am heart broken but blessed to have had my girl for 11 years - not long enough but blessed forever.
 
Oh Nicole, I am so sorry. You must be heartbroken.:bighug:
Kitties are so good at hiding their illnesses from us.
You did everything you could to help her and then gave her the final gift of helping her over to the rainbow bridge.
Fly free sweet Pixie:rb_icon:cat_wings>o
 
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