Help with unstable BG cat

Steve & Merlin

Steve & Merlin

Member Since 2019
We are new to the forum as we just found out about its existence. Merlin is a 14 year old orange tabby that was diagnosed with diabetes almost 11 years ago. Except for some very very bad beginnings with trying different insulins and severe hind quarter neuropathy from sky high BGs, he has been extremely stable on Lantus for 10 years @ 2.0 units twice a day. His historical BG's were in a stable average band between 100 and 250 during this time. He ranged in the high parts when he had dental issues and was on antibiotics and had some teeth removed. He was very comfortable and solid in this range and I did not want to upset his stability trying to go lower and fiddling with his dosage. He only eats low carb canned food. His neuropathy completely disappeared once his BG reached his normal range and giving him B12.

In January his BG numbers started going unstable and he was losing weight and his fur was shedding in clumpy patches. No bald spots and new fur was growing in before the old fur fell out, but he no longer looked sleek. He was also drinking tons of water and terribly hungry all the time. He was kind of looking like the BG unstable cat of 11 years ago. I took him to the vet to find out what caused his sudden BG instability. I had them do every test in the book to look at all possibilities. The blood tests, thyroid, endocrine, kidney, etc. looked great. With the exception of his BG (410), he is in remarkably good health with numbers for a much younger cat. His kidneys are fine.

I followed my vet's instructions as annotated on Merlin's spreadsheet. Nothing has worked and I am concerned that he will start showing clinical signs of his high BG and don't want more scary bounces high and low which are something he never did before. His recent drop to 36 was precipitous and scary and I intervened with Fancy Feast Gravy food as recommended in the Don't Panic Sticky. Our vet suggested a 0.5 unit reduction for his next dosing and following up at 2.0 units. It looks like this was not a good idea. I finally got all the data I had entered in the spreadsheet so there is data on his BG numbers to review. Any help would be appreciated. He needs his next dose in 3 hours and I don't know if I should stick with 2.0 or up it higher. I think the SLGS approach is best for him.
Thanks
 
The depot is a bit unstable right now. I will let others weigh in on dose, but I would be inclined to stick with 2 units. That's what it would have been if you did the .25 reduction instead of the .5 reduction.
 
Welcome to the group!

Do you know what tests the vet ran? For example, the usual blood tests may give you some kidney values but it may be helpful to have and SDMA. This is a newer test that is predictive of kidney disease.

When was the last time Merlin had his teeth cleaned? Dental issues is one of the biggest issues that will throw a well regulated cat or a cat that's in remission/regulation into the weeds. It can be difficult to get a really good look at teeth on a routine vet visit.

With today's number, please keep an eye out on Merlin. Your +2 is considerably lower than your AMPS. This kind of early drop in numbers is often a sign that a kitty is going to have an active cycle (i.e., numbers are going to keep dropping).
 
That's what I just did. I figured it was better to be conservative. I will be monitoring closely all day.
Sienne and Gabby (GA) said:
Welcome to the group!

Do you know what tests the vet ran? For example, the usual blood tests may give you some kidney values but it may be helpful to have and SDMA. This is a newer test that is predictive of kidney disease.

When was the last time Merlin had his teeth cleaned? Dental issues is one of the biggest issues that will throw a well regulated cat or a cat that's in remission/regulation into the weeds. It can be difficult to get a really good look at teeth on a routine vet visit.

With today's number, please keep an eye out on Merlin. Your +2 is considerably lower than your AMPS. This kind of early drop in numbers is often a sign that a kitty is going to have an active cycle (i.e., numbers are going to keep dropping).
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i don’t think the new test was run, but she said his values were not different than his historical numbers. We did look in his mouth and there did not appear to be any inflammation. When he had dental issues in the past, his blood work showed the inflammation and his breath was bad. I would expect the blood CBC to show signs of inflammation anywhere bad enough to cause this upset. The only change in his life in the last 6 months was we changed to the Putin’s Pro Plan Food. But nothing really happened BG wise after the change and he likes it better.

I was surprised at the fast drop too and am prepared for another deep dive in his numbers. I will test very frequently if his number drops below 100. Is his depot full or is this an issue independent of it? I thought is was empty when he went up to 500. He never has gone that high even in the beginning.
 
Kudos to you Steve for taking care of Merlin and his diabetes for so long. He is a lucky kitteh to have you as his Dad.

Our Leo has pretty bouncy BG numbers his whole diabetic time (since mid 2015). The way I deal with it - is to monitor BG a lot. For example, Leo was heading into a hypo last night, so he got gravy food and BG monitoring. In the recent past, we also gave a variable dose when Leo was getting more insulin (above 3.0 units), based on BG values.

Our primary goal with Leo is to get him one or two nadirs/day in the 100-200 range. That sounds like Merlin's goal too. There are other bouncy cats on the forum too.
 
Yeah Maybe that will be our new normal as he ages. But I sure got spoiled with his rock solid 2.0 dose for 10 years and a 100 - 200 curve.
 
Those years of great BG stability are making Leo very jealous. And for 10 years - wow.

There are other stable kittehs on the forum as well. Some of them hang at 100 for their whole cycles.

In 2015 my vet get me good advice for Leo's diabetes treatment. She said "Keep Leo safe." I have used that as a mantra for his years of treatment. The 2016 radiation therapy for his Acromegaly certainly helped bring his condition into better control.
 
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