Trying to plan ahead for shot time in 1 hour. We've only been back on insulin for 5 days. Praying that elevated glucose was due to RX Atopica/cyclosporin (immunosuppressant for extreme atopic dermatitis). Stopped the Atopica 3/6/24 so the vet thinks it should have already been fully out of his system a few days ago and he will need to be on insulin long term. I learned long ago that vets don't know everything. At +11 he is at 90. At what number do I still give insulin in his case? Or is it better to lower the dose instead of skip the shot?
Forgot to add, he already had ketones in urine at vet appt 3/11/24 if that matters in terms of insulin dosing
waiting for the ketone strips to arrive. I actually went back to his labs that the vet sent over and it said he was negative for Ketones. I guess I heard the doctor wrong when we were discussing our options... He was 96 at shot time.
Okay. You’ve had experience with this before. How do you feel about shooting the 1 unit dose or shooting a reduced dose? Will you be able to monitor some of the cycle to make sure he will not drop too low. I know we only have a few days data so far, but it looks like he’s fairly steady and doesn’t drop a lot. He also doesn’t seem to rise much after his shot as the previous shot wears off. Having said all that, if you truly want to follow SLGS, he’s already close to the reduction point at preshot.
I think I'd feel comfortable doing a very small dose since like you said it doesn't seem to lower him a ton, but we don't have any high carb options for him now that he is on raw food. He can't digest any treats and they make him vomit within 20min. We do have Karo but that would have to be an absolute last resort. I'm using U40 syringe so I'll have to do best guess but do you think around .5 or less? We didn't start a spreadsheet until after diet changes that led to remission the first time so there is no valuable data on there unfortunately.
And yes. Karo would be for if he hits 50 or less. Although sometimes you can add a small drop of karo to some low carb food and create a kind of medium carb food.
We will give that a try and keep an eye on him! And thank you, he was our first baby. He chose my husband nearly 18 years ago and recently has been the most amazing kitty for our 1 year old. The past 2 weeks have been extremely hard on him and we really debated what was best for him on Monday. I'm thrilled to see such progress in just 5 days.
Oh yes. Please know that we can help you. He already is having an amazing response to the ProZinc. I look at a lot of spreadsheets and I feel very optimistic for your baby. I’m assuming that since you’ve done this before that you already know about feeding multiple smaller meals in the early part of the cycle (before about +6) and nothing for two hours before the preshot tests. I see you have a good raw diet. Does he have inflammatory bowel disease or something?
Oh, and it would be really good to buy the U-40 syringes with the half unit markings. They are available on Amazon and other places like ADW Diabetes Supply. It really helps when you need to make dose changes in .25 unit increments.
When he was first dx in 2019 I found this group and started low carb diet and cut out all kibble. He started to develop itching/licking allergies. Vet wanted a novel protein diet but he starved himself when we tried it so I opted to try raw so that I could control ingredients. Made a huge difference and we didn't see the allergies/ licking for nearly a year. In that time he was dx with hyperT and we had him treated with radioactive iodine. During that testing we discovered he was CKD stage 3 ~2021. We've held him stable but the allergies/ dermatitis came on with vengeance this past summer. Couldn't sit still for 5min without scratching. Constant fur balls from all the fur he was licking off. We had to try something as a last ditch effort to give him quality of life. The vet says that when the Atopica is truly out of his system the licking will come back and it will be our sign to let him go since we've tried so many other things to no avail and we won't let him suffer any more with the constant itchies.
I don’t understand why the vet would advise discontinuing the Atopica if it will result in you having to euthanize your beloved cat. I have never read in any of the information about its side effects that Atopica raises blood glucose. I have looked into it for several of my cats due to severe allergic dermatitis. I understand how bad that can be. We’ve had some completely bald cats around here and those who lick into their skin. My poor baby Marcus had to go off of his Dexamethasone (a steroid) this past summer when he had an overgrowth of Demodex mites and bacteria on his skin. It was almost unbearable for him. He had to wear a surgical recovery suit to prevent him licking himself as much (it even had legs on the suit.). We gave him Gabapentin to sedate him a little and that helped keep the licking down. After a couple of months though, we restarted the Dexamethasone. It does raise his BG a little bit on the days he gets the pill (every other day.). Marcus isn’t diabetic but he is FIV+ so it’s not optimal that he has to take an immunosuppressive steroid every other day, but he usually stays pretty healthy and he has to have it or his quality of life would be awful. Honestly, I think that it’s our house that is causing the allergies. I hope that I can soon get a Reme Halo whole house air cleaning system to remove allergens. There are cats here who must take a steroid (usually prednisolone) for various medical conditions like asthma or IBD, and it does raise their blood glucose on the day that they take it, but it can be managed with insulin. For some cats it doesn’t raise the BG enough to warrant any changes in insulin.
I guess I hadn't thought about trying the Atopica again while on insulin. He became so lifeless and recluse on it, but I'm not sure if that was the Atopica or the diabetes. She also made it sound like steroids were not an option at all due to his diabetes. He's been through the ringer, that's for sure! Maybe it was because I explained that our approach is high quality over quantity of days. I know it can be a touchy subject for some because we all have different views on what quality life means. I will need to investigate further now that you've got me really thinking about it! And yes, the insert for the Atopica even says that it can cause elevated glucose especially in cats that are already diabetic. I should have read that whole insert sooner and maybe he wouldn't have started to crash so hard had I been watching and testing his BG from the start of the meds. He did well through the night and even jumped up on the bed to snuggle which he hasn't been able to do in 3 weeks now. I tried 4 times to get a reading from him through the night but I'm struggling to find the sweet spot in his ear again. This morning he was 175. I'm really hoping he's green again tonight so that I can skip the evening insulin all together and just get up earlier for his AM dose. I've been off work all week so I've been able to stall and push back his shot time but now we're about 3 hours off from where it needs to be so that I can give it before leaving for work Monday morning.
I’m glad to know that the package insert mentions the possibility of elevated glucose. I had never found that before. Thanks for sharing that. I guess it’s not something that would be a problem for every cat but definitely something to track. I also understand your desire to make sure that Pete has good days and isn’t feeling sick. I’m really happy to hear that he already seems to be feeling better with lower glucose numbers. If we could get him into reasonable numbers between even 90 and 150 then I bet he would feel better and have more energy, would be able to actually put his food to good use and would not be drinking tons of water and peeing it all out again. Did the vet do a Fructosamine test which would give you an average of his BG over a period of 2-3 weeks? Or just a one time glucose reading at the vet office? You have a copy of his labs? Are they on the labs tab of his spreadsheet? I haven’t looked there yet. Can you share them? You can adjust his shot time by 30 minutes per day normally— you can probably do a little more safely if he’s high.
Are you warming his ears? Using larger lancets? His ears probably aren’t used to being pricked anymore and giving blood.
